What Is The Puerperium Complicated by Celiac Disease?

C eliac disease complicating puerperium is an adult manifestation of celiac disease that appears during the 6 weeks after delivery of a baby(ies). It is characterized by severe diarrhea in the newly delivered mother and results in malabsorption.

Ordinarily, celiac disease very rarely manifests during pregnancy or after childbirth possibly due to hormonal and immunological changes.

How Prevalent Is The Puerperium Complicated By Celiac Disease?

What Are Obstetrical Complications?

O bstetrical complications are reproductive disorders during pregnancy, labor and delivery that endanger the mother and unborn infant.

Complications may result from prolonged constipation, malnutriton, hormonal imbalance, infection, systemic disease such as diabetes, obesity, tumors of the uterus, medication adverse effects, drug abuse, smoking, and alcohol abuse.

What Are Obstetrical Complications In Celiac Disease and/or Gluten Sensitivity?

What Is Miscarriage?

M iscarriage, or spontaneous abortion, is a reproductive failure characterized by loss of an unborn baby before the 20th week of pregnancy.

What Is Miscarriage In Celiac Disease and/or Gluten Sensitivity?

What Is Severe Iron Deficiency Anemia In Pregnancy?

S evere iron deficiency anemia in pregnancy is characterized by abnormal formation of small, pale red blood cells that impair the ability of the fetus to obtain adequate oxygen for proper growth and development and imperil its life and cause the mother extreme fatigue with increased risk of infection.

Q: Why does this anemia imperil the fetus and cause the mother extreme fatigue with increased risk of infection?

A: Severe iron deficiency anemia significantly impedes the ability of the mother’s blood to carry sufficient oxygen for both her needs and the unborn baby’s needs. In this anemia the blood cells do not have adequate hemoglobin which functions to carry oxygen from the mother’s lungs to her body. Of course, the fetus gets its oxygen only from the mother’s blood.

Red blood cell production and function are dependent on a sufficient level of iron in the body and also the ability to use iron to make hemoglobin in red blood cells.

Hemoglobin is a protein that binds oxygen in red blood cells to be carried by the bloodstream to cells throughout the body. In iron deficiency anemia,  hemoglobin in females is below 12.5g/dl (normal range is 12.5g/dl  to 16g/dl ).

What Is Severe Iron Deficiency Anemia In Pregnancy In Celiac Disease and/or Gluten Sensitivity?

What Is Short Duration Of Breast Feeding?

S hort duration of breast feeding, or lactation, is characterized by inadequate milk production by a mother who has just given birth.

Normally, lactation begins with the production and release of colostrum from the mammary glands during the first few days after birth until the milk comes in. Colostrum is a yellow colored, nutrient rich fluid, high in calories and containing immunoglobulins to protect the baby from infection.

Lactation depends on adequate secretion of prolactin hormone by the pituitary gland which begins after the rapid decrease of estrogen and progesterone from the ovaries that occurs with childbirth. Prolactin secretion is afterward stimulated by sucking of the infant and continues as long as the infant nurses.

Milk production to meet the needs of the infant depends on adequate nutrition on the part of the mother.

What Is Short Duration Of Breast Feeding In Celiac Disease and/or Gluten Sensitivity?

What Are Sperm Abnormalities?

S perm abnormalities are the result of gonadal dysfunction (testicles) characterized by inability to either produce sperm or to produce viable sperm or mobile sperm which results in prohibiting fertilization of the female ovum.

Q: How are sperm normally produced?

A: There are two testicles, or testes, that are oblong, egg shapes about 2 inches long and an inch wide and enclosed in a protective sac called the scrotum which hangs outside the body. The testes have these functions:

• Produce and store millions of sperm cells called spermatozoa.
• Produce hormones, including testosterone which stimulate the production of sperm.

What Are Sperm Abnormalities In Celiac Disease and/or Gluten Sensitivity?

What Is Infertility in Males?

I nfertility in males is characterized by inability to either produce sperm or to produce viable sperm or mobile sperm resulting in prohibiting fertilization of the female ovum (egg).

To the left is a false-colour scanning electron micrograph of seminiferous tubules in the human testis (cross section), the site of production and maturation of sperm.

Round undifferentiated cells lining the tubule wall (brown, pink) become sperm by halving their chromosome number, and transforming in a process which takes about two months. During this time the cells move toward the centre of the tubule and develop tails (orange). Mature sperm migrate up the cavity of the tubule and are stored in the epididymis. 200-300 million sperm are released in an average ejaculation. Courtesy of Professor P. Motta, Dept.of Anatomy, University of Rome Science Photo Library.

Male androgen hormones control the development and maintenance of male sex organs and masculine secondary sex characteristics and are required for health, especially bone health.

Testosterone is the major andogen hormone. While most of this steroid is produced by the testes, some is also produced by the adrenal glands.

What Is Infertility In Males In Celiac Disease and/or Gluten Sensitivity?

What Is Impotence?

I mpotence is an erectile dysfunction disorder in males characterized by the distressing inability to achieve or maintain an erection satisfactory for coitus.

What Is Impotence In Celiac Disease and/or Gluten Sensitivity?

What Is Inflammatory Vaginitis?

I nflammatory vaginitis, also called desquamative inflammatory vaginitis, is a female genital disorder characterized by non-infectious tissue inflammation of the vagina (birth canal).

Inflammatory vaginitis presents in females of any age including girls with a history of discomfort, irritation, and in those who are sexually active, painful sexual intercourse. Patients may also report an increased vaginal discharge.

Q: How do the tissues appear?

A: Examination of the vulva is normal, but erythematous regions on the vaginal walls are evident with increased vaginal secretion. This secretion is high in polymorphonuclear leukocytes, with an increased number of immature squamous epithelial cells. Repeated cultures are negative for bacteria, viruses and yeast.¹

What Is Inflammatory Vaginitis In Celiac Disease and/or Gluten Sensitivity?

1. Murphy R. Desquamative inflammatory vaginitis. Dermatol Ther. 2004;17(1):47-9. [↩]

What Is Primary Dyspareunia (Painful Intercourse)?

D yspareunia is a distressing female genital disorder characterized by pain during or after coitus involving the labia, vagina or pelvis.

There are two types of dyspareunia: primary which affect the vagina itself in the abscence of pelvic pathology and secondary which involves problems in the pelvis other than the vagina.¹

• Causes of primary dyspareunia include hormone changes in menopause, Sjogrens syndrome, diabetes, psychological conditions, and nutritional deficiencies.
• Causes of secondary dyspareunia include problems with uterus, bowel disease, urinary tract infection, uterine prolapse, and pelvic disease such as endometriosis and cancer.

Q: How common is dypareunia?

A: Dyspareunia is the most common cause of pelvic pain in women.²

What Is Dyspareunia In Celiac Disease and/or Gluten Sensitivity?

1. Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014 Mar 1;89(5):341-6. [↩]
2. Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014 Mar 1;89(5):341-6. [↩]