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Low Stomach Acid Production

low-stomach-acid1What Is Low Stomach Acid Production?

[dropcap]L[/dropcap]ow stomach acid production is a common disorder in celiac disease and dermatitis herpetiformis that is characterized by lack of sufficient hydrochloric acid needed 1) to properly digest food, which results in malnutrition and subsequent nutritional deficiencies, and 2) to destroy swallowed bacteria and other microbes, which may allow infections to develop.

It is also common in the general population, as well, affecting 50% of people age 60 years and about 80% by age 85 years.  Nevertheless, low stomach acid is not generally looked for as a cause of acute and chronic disorders that rob health with far-reaching effects.

[box type=”shadow” ]Understanding Stomach Acid Production and Function

The stomach digests incoming food into a liquid state, thereby releasing nutrients so they can be absorbed by the small intestine. Powerful stomach muscles churn food and mix it with gastric juice, dissolving and breaking it down.

Gastric juice is produced by gastric glands located in the stomach lining. These numerous, microscopic glands produce about 3 liters of juice a day. Gastric juice is composed of a high concentration of

Muscle Spasm And Muscle Cramps 

Muscle spasm and cramping in celiac disease and gluten sensitivity symptomWhat Are Muscle Spasm, Muscle Cramps?

[dropcap]M[/dropcap]uscle spasm and muscle cramps are  disorders of muscle function caused by painful involuntary contractions of affected skeletal muscles characterized by limited movement.

Q: What is the difference between muscle spasm and cramps?

A: Cramps are stronger and more painful than spasms, occurring while the muscle is in its most shortened state.

Skeletal muscles are those that move the body skeleton to do work as we choose. Examples are muscles that move the mouth, arms,  hands, legs, and feet.

What Are Muscle Spasm, Muscle Cramps In Celiac Disease and/or Gluten Sensitivity?

Headache (Emicrania)

headache gluten celiac disease symptomWhat Is Headache Or Emicrania?

[dropcap]E[/dropcap]micrania is a headache resulting from stimulation of, or traction of, or pressure on any of the pain sensitive structures of the head characterized by pain felt anywhere in the head.

In addition to gluten sensitivity and nutritional deficiencies, there are many causes of headache including cardiac, cerebral, vascular, psychiatric, metabolic, and neurologic diseases. Recent studies have highlighted that obesity is significantly associated with headache and disability in adults. This rule also applies to children.1

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

Sources:
  1. Laino D, Vitaliti G, Parisi P,   et. al. Headache, migraine and obesity: an overview on plausible links. J Biol Regul Homeost Agents. 2016 Apr-Jun;30(2):333-8. [↩]

Dermatitis Herpetiformis or Duhring’s Disease

Dermatitis Herpetiformis. Blisters Opened Giving Relief From Pain and Itching.
Dermatitis Herpetiformis On Forearm. Skin Is Darkened Where Old Blisters Healed.

What Is Dermatitis Herpetiformis?

[dropcap]D[/dropcap]ermatitis herpetiformis (DH) is an autoimmune extremely itchy, painful bullous skin rash (blistering eruptions) arising from the underlying dermis layer of skin as a consequence of gluten sensitivity.

Dermatitis herpetiformis is characterized by multiple intensely itchy, red blisters appearing on the elbows which can extend down the forearm to the wrist and the knees. Less usual areas involve the back, buttocks, scalp, and abdomen.

Q: Do the blisters leave a mark when healed?

A: Crops of skin eruptions begin with itching or a burning sensation in reddened papules. There are grouped vesicles and tense blisters. The blister contents may be serous or bloody, with symmetrical distribution (eg, both knees or both elbows). Fluid filled elements rupture leaving denuded areas of sore skin and crust. Subsequently, there is residual hypopigmentation (a white area) or hyperpigmentation (dark area).1

Rupture of blisters begins relief from intense burning and itching.

Dermatitis Herpetiformis Eruptions On Knees.
Dermatitis Herpetiformis Eruptions On Knees. Notice White Areas Showing Loss of Pigmentation From Healed Blisters.

What Is Dermatitis Herpetiformis In Celiac Disease and/or Gluten Sensitivity?

Primary care providers should be aware of this skin condition, as they are more likely than a gastroenterologist to be confronted with this type of presentation of celiac disease.2

Sources:
  1. Mendes FB, Hissa-Elian A, de Abreu MA, Gonçalves VS. Review: dermatitis herpetiformis. An Bras Dermatol. 2013 Jul-Aug;88(4):594-9. [↩]
  2. Robinson BL, Davis SC, Vess J, Lebel, J. Primary care management of celiac disease. Autoimmune Disorders. Nurse Practitioner. February 2015: Vol 40 – Issue 2; 28–34. [↩]

Small Bowel Intussusception

Invagination_Schema[1]What Is Small Bowel Intussusception?

[dropcap]S[/dropcap]mall bowel intussusception is a bowel derangement that is characterized by the slipping of one section of intestine into another, leading to bowel obstruction.

Acute bowel intussusception is a rare manifestation in adults, which mainly involves the small intestine.1

What Is Small Bowel Intussusception In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Grados A, Bernard F, Coquet-Reinier B, Rossi P, Bagneres D, Demoux AL, Marciano S, Frances Y, Granel B. Acute bowel intussusception revealing celiac disease a new case and literature review. Rev Med Interne. 2011 Oct;32(10):628-32. doi: 10.1016/j.revmed.2011.03.334 [↩]

Food Allergy – IgE and Non IgE

Baby with Allergic Reaction to Peanuts. GFW
Baby with Allergic Reaction to Peanuts. GFW photo.

What Is Food Allergy?

[dropcap]F[/dropcap]ood allergy is an abnormal immune response to food proteins that may damage the small intestinal  lining and produce malabsorption of food. The reaction is usually delayed which makes it difficult to identify the offending food that is causing symptoms.

Q: How does food allergy develop?

A: The gastrointestinal tract serves not only to digest and absorb foodstuffs but also to protect the body from unwanted substances. When allergic food substances are eaten, the immune response that is triggered in the gut produces inflammation with symptoms such as pain, vomiting and loose bowels.

Inflammation causes swelling of the gut lining that can interfere with the passage of nutrients through it to the body which results in malabsorption. Malabsorption deprives the body of nutrients needed for normal function.

Symptoms other than digestive may involve skin rashes, hives, and respiratory difficulties that can be distressing and life-threatening.

What Is Food Allergy In Celiac Disease and/or Gluten Sensitivity?

Cystic Fibrosis 

Bronchiectasis in Cystic Fibrosis. Courtesy Dr Jerry Nick National Jewish Medical and Research Center, Denver
Lung Tissue in Bronchiectasis.  Courtesy Dr Jerry Nick National Jewish Medical and Research Center, Denver

What Is Cystic Fibrosis?

[dropcap]C[/dropcap]ystic fibrosis is a genetic disease of the exocrine glands which causes the body to produce abnormally thick and sticky mucus and results in progressive damage to the respiratory system and digestive problems.

Severity of disease depends on the particular genetic mutation of affected individuals.

Q: How does the abnormal mucus damage the lungs and digestive tract?

A: In all cases of cystic fibrosis, sticky mucus build-up in the bronchioles (small breathing passages) of the lungs causes COPD (chronic obstructive pulmonary disease) that results in life-threatening lung infections. 

In the pancreas, the abnormal mucus damages its ability to produce required enzymes to digest food, causing failure to adequately digest fats, carbohydrates and protein which are vital for life.

Other tissues that may be involved are sweat glands, sinuses, and the male reproductive system, causing infertility.

Millions of Americans carry the defective cystic fibrosis gene, but do not have any symptoms. That is because cystic fibrosis requires the inheritance of two defective cystic fibrosis genes — one from each parent who carries it. An estimated 1 in 29 Caucasian Americans have the cystic fibrosis gene.

The disease is the most common, deadly, inherited disorder affecting Caucasians in the United States. It is more common among those of Northern or Central European descent. About 30,000 children and adults in the United States have cystic fibrosis while more than 10 million people carry the gene.1

There is no cure yet for cystic fibrosis, however, treatments have greatly improved in recent years. The goals of treatment include:

  • Preventing and controlling lung infections.
  • Loosening and removing thick, sticky mucus from the lungs.
  • Preventing or treating blockages in the intestines.
  • Providing enough nutrition.
  • Preventing dehydration (a lack of fluid in the body).2

What Is Cystic Fibrosis In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001167/ [↩]
  2. National Heart, Blood, and Lung Institute [↩]