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May is Celiac Disease Awareness Month. Spread the Word!

celiac disease awarenessCeliac disease awareness is desperately needed – now more than ever. 

While the gluten-free diet has exploded in popularity, celiac disease remains massively under-diagnosed.

Why? Two Reasons: 

1. The public has shifted its focus to the gluten-free diet and away from celiac disease due to the media. The media likes diets. Diets sell. Oddly named diseases that are difficult to describe in catchy sound bites don’t sell.

2. Doctors do not have the information they need to recognize, diagnose and treat this common disorder. The information exists but there is no authority that actively ensures

Constipation, Chronic

Constipation in a young child as seen on X-ray. Lowest circle shows hard feces in the pelvis. Source, James Heilman, MD.

What Is Chronic Constipation?

Chronic constipation is an intestinal motility disorder characterized by abnormal stool formation, consistency, and evacuation.

Motility disorder means the normal rhythmic movement of intestinal muscles, called peristalsis, that moves food matter through the gut is hampered or dysfunctional.

Studies show that methane gas present in the colon induces constipation by delaying transit time, which is the time it takes for stool to pass through the colon.

Researchers investigating the relationship between methane and constipation found that methane positivity was detected in 75% of patients with slow transit, 44% of patients with normal transit and and 28% of the patients who were controls. However, methane positivity was not related with stool consistency.1

Other researchers investigating the total amount of methane produced found that there was significantly more methane production in patients with constipation (21.1 ppm vs. 6.1 ppm, respectively) than in controls without constipation.2

Q. How does methane get into the colon?

A. Methane is produced in the colon by intestinal methanogens (microbes) that metabolize hydrogen, one of the end products of normal anaerobic (meaning without oxygen) bacterial fermentation.  Fermentation of the undigested starchy part of carbohydrates produces hydrogen in the intestine which is the substrate (food) for methane production by intestinal methanogens.

Hydrogen and methane are excreted in the flatus and in breath giving the opportunity to indirectly measure their production using breath testing. Methane is detected in 30%-50% of the healthy adult population worldwide.3

Other common causes of constipation include not getting enough exercise, not drinking enough fluids, not eating enough fiber in the diet, not eating foods that supply microbes needed by the colon (probiotics), not eating foods that nourish the good microbe population (prebiotics) and supply minerals needed for healthy movement of stool, and food sensitivities. Too much cows milk is a common cause of stool that forms into balls.

Who is Affected in the General Population? Chronic constipation is a remarkably common and costly condition that can negatively impact the quality of life and result in a major social and economic burden. Based on the definition, either self-reported or using Rome criteria, chronic constipation can affect up to 27% of the population. There is strong evidence that constipation occurs more frequently in women.4

What Is Chronic Constipation In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Triantafyllou K, Chang C, Pimentel M. Methanogens, Methane and Gastrointestinal Motility. J Neurogastroenterol Motil. 2014 Jan;20(1):31-40. Epub 2013 Dec 30. [↩]
  2. Triantafyllou K, Chang C, Pimentel M. Methanogens, Methane and Gastrointestinal Motility. J Neurogastroenterol Motil. 2014 Jan;20(1):31-40. Epub 2013 Dec 30. [↩]
  3. Triantafyllou K, Chang C, Pimentel M. Methanogens, Methane and Gastrointestinal Motility. J Neurogastroenterol Motil. 2014 Jan;20(1):31-40. Epub 2013 Dec 30. [↩]
  4. Sanchez MI, Bercik P. Epidemiology and burden of chronic constipation. Can J Gastroenterol. 2011 Oct;25 Suppl B:11B-15B. [↩]

Headache (Emicrania)

Infant with Acute Diarrhea and Swollen Belly - Hallmarks of Celiac Disease.
Malnourished Infant With Acute Diarrhea and Swollen Belly.

What Is Acute Diarrhea?

A cute diarrhea is a small intestinal motility disorder characterized by excessively rapid movement of intestinal contents through the small intestine with excessive loss of fluid and electrolytes that leads rapidly to a life threatening hypokalemia (low potassium blood level) and acidosis.

Q: What is hypokalemia?

A: Hypokalemia is characterized by dehydration that may result in vascular collapse, muscular malfunction that may result in paralytic ileus (bowels do not move), paralysis (cannot stand), and respiratory hypoventilation (shallow breathing) or failure, metabolic acidosis resulting from diarrhea, and impaired nerve conduction.1

While diarrhea may be a common symptom of small bowel mucosal disease, the consequent malabsorption can lead to substantial malnutrition and nutrient deficiencies. The small intestine, unlike the colon, has been relatively inaccessible, and systematic evaluation is often necessary to identify and treat small intestinal mucosal diseases that lead to diarrhea. All patients with severe diarrhea or diarrhea associated with features suggestive of malabsorption may have a disease of the small intestinal mucosa that requires careful evaluation and targeted management.2

What Is Acute Diarrhea In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Kathleen Mahan and Sylvia Escott-Stump, ed. Krause’s Food, Nutrition & Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000. [↩]
  2. Murray JA1, Rubio-Tapia A. Diarrhoea due to small bowel diseases. Best Pract Res Clin Gastroenterol. 2012 Oct;26(5):581-600. doi: 10.1016/j.bpg.2012.11.013. [↩]

Weight Gain, Unexplained

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What Is Unexplained Weight Gain?

Unexplained weight gain is characterized by increased body mass due to excess fat accumulation that is not desired by the individual.

A body mass index (BMI) of 25 to 30 signifies being overweight.

What Is Unexplained Weight Gain In Celiac Disease and/or Gluten Sensitivity?

Depression

What Is Postbulbar Duodenal Ulceration/Stenosis?

P ostbulbar duodenal ulceration is a chronic inflammatory disorder characterized by thickening of the intestinal lining with excoriation penetrating the muscularis mucosae (muscle layer of the intestine) associated with villous atrophy.

The ulcer is well-defined. Stenosis due to thickening of the area narrows the hollow inside of the duodenum which impairs passage of foodstuffs and may lead to obstruction.

Q: Is postbulbar duodenal ulceration painful?

A: Postbulbar duodenal ulceration may not cause symptoms but usually causes gnawing pain that is relieved by eating food. After eating there develops nausea and bloating.

Complications include obstruction, bleeding, and perforation of the duodenal lining. Ulcers do not usually become malignant.

What Is Postbulbar Duodenal Ulceration/Stenosis In Celiac Disease and/or Gluten Sensitivity?

How Gluten Causes Alopecia Areata

Alopecia-Areata-wikimedia-227x300[3]Do you recognize this circular hair loss pattern? It is called alopecia areata. According to the National Alopecia Areata Foundation, “no FDA approved treatment or cure exists yet.”

No cure, eh? It is amazing how many times I hear this “no cure” declaration when I KNOW people who have been cured of the condition in question, in this case, alopecia areata. Maybe they mean no DRUG exists that cures it.

I was recently shopping at a department store to pick up some new exercise shorts when the security guard walked past me.

He was a young man, about twenty-five, medium height with a thick build, pale skin and short cropped black hair. I noticed several round spots where hair was missing from the side and back of his head. It looked like he had taken an electric razor and buzzed those places bare.

I said hi. He replied with a smile and a hello. I told him I didn’t mean to pry, but I noticed the bald spots and asked whether he got them in an accident. He said no, they just started appearing a few years ago and he’s tried everything to get the hair to grow back.

I asked if he was taking zinc supplements. He said no and asked why…

I looked up hair disorders in our Gluten Free Works Health Guide.

According to the Health Guide, alopecia areata is caused by an immune reaction and targets the area and zinc deficiency. The immune reaction can be caused by gluten and the zind deficiency by either not eating enough, or more likely, by malabsorption of zinc – a common problem in people with celiac disease who are not on a gluten-free diet. Taking zinc and following a gluten-free diet can turn around alopecia areata so that the hair grows back.

The guard thanked me about ten times. He was ecstatic to discover that he might have hope of getting his hair back after all.

Now, I don’t know how smart it is to walk up to a stranger and start advising them on their hair loss, but in this case I already knew a number of people whose alopecia areata resolved after they went gluten free.

This is why we gathered medical information from around the world to create the Gluten Free Works Health Guide. So, everyone, no matter where they live, can access it and find out what is causing their symptoms and the steps they need to take to fix them. So, they could discover which of their medications might be depleting the nutrients they need and which foods or supplements they need to ingest to replete their levels. So, they could connect the dots and take charge of their health. So, they could get healthy and stay that way.

Most People Do Not Realize How Sick They Really Are 

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We are told the gluten-free diet is the only treatment for celiac disease and gluten sensitivity. We follow the diet, but do not recover fully. Many times, because we feel better than before, we do not grasp that we can be so much healthier than we are.
 
There are a host of health issues that can and should be treated through diet, supplements and medications, reducing inflammation and correcting deficiencies. Hundreds in fact.
 
Many times, we are told our symptoms are just who we are. And we accept that, because we don’t know any better.
 
Even our doctors have no idea that their patients who suffer from fatigue, thinning hair, flaking fingernails, poor vision, constant irritability, forgetfulness, mottled skin and hundreds of problems that they believe are “normal” day-to-day conditions actually result from

Apathy

Cows Milk enteropathyWhat Is Milk Intolerance (Bovine Beta Casein Enteropathy)?

B ovine beta casein enteropathy is characterized by raised serum IgA antibodies to bovine beta casein found by blood testing and damage to mucosa of the jejunum found by biopsy.

The jejunum is the second section of the small intestine, between the duodenum and the ileum.

Mucosa damage is similar to damage caused by gluten.

Q: What is bovine beta casein?

A: Bovine beta casein is a protein found in cow’s milk.

An immune reaction to protein in milk is totally different from lactose intolerance. Lactose intolerance develops from deficiency of an intestinal enzyme called lactase which is required to digest lactose, the sugar in milk.

What Is Milk Intolerance In Celiac Disease and/or Gluten Sensitivity?