Indy Gastro | Colonoscopy, rectal bleeding, diarrhea, constipation, endoscopy

Celiac Disease: An Under-Diagnosed GI disorder?

By Dr. Lisa Bauman

It may not be easy for patients to talk about recurring problems in their bodies like chronic diarrhea or constipation, weight loss, pale stools, tingling numbness in the legs and skin rash. But it may be a sign of a condition which doctors are learning more about called celiac disease  which may explain the aforementioned issues.

celiac-disease-under-diagnosed

Celiac disease is a hereditary immune digestive disorder that interferes with the absorption of nutrients from food. It is a genetic disease that runs in families, affecting as many as one in every 133 Americans. The disease is more common in Caucasians and people of European ancestry. More than two million Americans have been diagnosed with Celiac disease, and recent studies suggest that the disease may be under-diagnosed because in some cases, Celiac disease can be silent.

Celiac disease damages the small intestine due to sensitivity to gluten - a protein found in wheat, rye, barley and oats. When a person with celiac disease eats foods containing gluten, their immune system responds by damaging the small intestine. Tiny finger-like projections known as villi, line the small intestine, enabling the absorption of nutrients from food into the bloodstream. In celiac disease these villi may be lost, resulting in malnutrition regardless of how much food a person consumes.

 

Celiac disease affects people in a host of different ways. Common symptoms include chronic diarrhea or constipation, weight loss, recurring abdominal pain/bloating, gas, pale stools, unexplained anemia, joint pain, tingling numbness in the legs, fatigue and skin rash. A person can have the disease lying dormant in their system until it is triggered by severe stress, pregnancy, surgery, physical injury or infection. Sometimes the disease is silent because the small intestine is still able to absorb enough nutrients. However, these persons are still at risk for complications of the disease.

In addition to a complete medical history and physical examination, diagnostic procedures for celiac disease may include blood work or biopsy.

  • Blood Work. Persons with celiac disease have higher than normal levels of certain antibodies in their blood. These antibodies include endomysial antibody and tissue transglutaminase antibody.
  • Biopsy. Your physician may perform upper endoscopy using a long thin tube called an endoscope through the mouth and stomach and into the small intestine. A tiny piece of tissue is removed from the small intestine to assess damage to the villi. Examination of the small intestine sample performed by a pathologist is considered the “gold standard” for diagnosis of celiac disease.

A gluten-free diet is the only treatment for persons with celiac disease.  Maintaining a gluten-free diet is a lifetime requirement, as consuming any gluten will further damage the intestine. Patients typically see improvement in their symptoms within days of starting the new A gluten-free diet is the only treatment for persons with celiac disease. Maintaining a gluten-free diet is a lifetime requirement, as consuming any gluten will further damage the intestine. Maintenance of a gluten-free diet is becoming very manageable. Many food brands are beginning to cater specifically to those intolerant of gluten and produce gluten-free pasta and breads.

Patients typically see improvement in their symptoms within days of starting the gluten-free diet. The small intestine usually heals completely within 3 to 6 months.

To learn more about our work with celiac disease patients or to schedule an appointment with one of our doctors please click the Contact Us button below

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