Make The Most Out Of Your Celiac Test
Why test for Celiac Disease?
Celiac disease is often difficult to diagnose because the symptoms are similar to those of many other gastrointestinal conditions, such as irritable bowel syndrome, gastric ulcers and anemia.
For many people, celiac disease is asymptomatic. This is thought to be due to the disease being milder in these cases and therefore, not provoking typical symptoms.
The long term consequences of asymptomatic or silent celiac disease remain unclear although people with asymptomatic or ‘silent’ celiac disease are thought to be at risk of developing anemia, osteoporosis or other secondary disorders relating to deficiency states due to the malabsorption of single nutrients.
You might consider testing for Celiac Disease if your patient is not responding to treatment for gastrointestinal disturbances in a typical manner.
Because celiac disease is a hereditary disease, if one family member is diagnosed with it, other family member should also be tested.
In New Zealand, it is advised that a diagnosis based on a blood test is followed up with a biopsy of intestinal tissue.
This hereditary disorder is caused by sensitivity to the gliadin fraction of gluten, a cereal protein found in wheat and rye and less so in barley and oats. An abnormal response by the immune system causes gliadin to be recongnised as an antigen, forming an immune complex in the intestinal mucosa thus promoting aggregation of killer lymphocytes. These lymphocytes cause mucosal damage with loss of villi and proliferation of crypt cells.
When the loss of villi and resulting lesions are extensive, they may impair absorption of virtually all nutrients.
In approximately one third of the cases, symptoms begin in childhood however a second peak occurrence rate occurs during the third decade of life.
Symptoms and Signs
There is no typical presentation of celiac disease.
If overt gastrointestinal symptoms (e.g. diarrhoea, abdominal discomfort and distention) occur, celiac disease may be easier to detect. Without these clues, the disease may not be suspected.
There are many people with ‘silent’ celiac disease who may not have diarrhoea as sugars and fats can still get absorbed further down the intestine, although most patients will have steatorrhea that varies in severity. Many symptoms e.g. anemia, weight loss, bone pain, parasthesia, edema, skin disorders are secondary to deficiency states.
What to look for:
• Chronic diarrhoea or constipation
• Abdominal pain and distention
• Delayed growth in children (‘Failure to Thrive”)
• Bone and joint pain
• Weight loss despite normal caloric intake
• Dermatitis herpetiformis (skin rash)
• Discoloured tooth enamel
• Easy bruising and bleeding (i.e. vitamin K deficiency)
• Deficiencies in copper, iron, selenium, zinc, carnitine, vitamins A, D, E, K, B12, B6 and folic acid
Celiac Disease – What to do
• Most importantly, a gluten free diet must be followed. The effects of celiac disease usually are reversed after removal of all wheat, rye, barley and oat gluten from the diet. Corn and rice products can be used as substitutes.
• Pancreatic enzyme supplementation enhances the benefit of a gluten-free diet during the first thirty days after the initial diagnosis.
• Check and correct any vitamin and mineral deficiencies i.e. folic acid, vitamin B12, iron, fat soluble vitamins. Consider taking a high-potency multi vitamin and mineral complex.
• Check for other allergies – dairy products may aggravate the condition and reduce intestinal healing. Consider removing dairy from the diet.
• Repair of the intestinal villi is also important. Essential fatty acids, glutamine, Ulmus rubra (slippery elm) and Althaea officinalis (marshmallow root) can support the villi and reduce gastro-intestinal inflammation.
• Consider using a dairy free probiotic to replace friendly bacteria. Studies have shown Lactobacillus casei to be useful in the treatment of the disease.
• Consider balancing immune function with Echinacea, vitamins ACE and Zinc if necessary.
Gluten can be found in many nutritional supplements. Read the labels carefully and use supplements which are hypoallergenic, wheat free and yeast free.