Hi G-Free Foodies, I'd like to introduce you to the newest member of the Gluten Free Advocates & Experts crew, Andrew Steingrube! Andrew has a Master's Degree in Nutritional Science and a passion for healthy eating & helping people live well. He's full of information & looking forward to helping us all live deliciously Gluten Free - so read on & feel free to ask questions, I'm excited he's joined our team! - KC
So you think you have Celiac Disease? You may be right and you may be wrong. Either way, it is often a difficult question to answer for many reasons. First, symptoms of Celiac Disease such as abdominal discomfort, bloating, diarrhea, fatigue, and poor weight gain often mirror those of other digestive disorders such as I.B.S. (Irritable Bowel Syndrome) and lactose intolerance. Furthermore, presenting symptoms often vary with age, with early onset cases presenting the more traditional digestive symptoms and later onset cases often concurrent with other autoimmune/ inflammatory diseases as well as consequences of malabsorption and malnutrition such as anemia and osteoporosis. Additionally, up to 50% of those with Celiac Disease may have either none or few obvious symptoms.
Celiac Disease can also be diagnosed at any point in the lifespan. The majority of cases are diagnosed between the ages of 40 and 60. Onset in children may be seen when gluten-containing foods such as breakfast cereals are added to the diet, and adult onset may be brought on by a variety of causes such as stress, pregnancy, or infection. And again, because of the variety of symptoms and presentations, Celiac may go undiagnosed for a long time. It is thought that the prevalence of Celiac Disease has been underestimated, with one recent estimate putting the prevalence at about 1 in 133 people in the U.S. There is also a genetic component to the disease.
Medical diagnosis of the disease is varied and sometimes inconclusive. The first reason for this is that as mentioned before, Celiac symptoms are often similar to many other digestive disorders. Additionally, Celiac patients that do remove gluten from the diet may continue to have symptoms after weeks, months, or even years following a gluten-free diet. Blood tests can be used to help diagnose the disease, but the diagnostic gold standard is intestinal mucosal biopsy. This basically involves taking a small portion of the small intestine and examining it under a microscope to look for the classic signs of Celiac Disease such as the degradation of villi (the structures in the small intestine responsible for absorbing nutrients). This process is done by an upper GI endoscopy. However, because this process can be expensive, it is not usually used when patients initially present with symptoms of the disease. There are also swallowable capsules that can send back images of the intestinal mucosa that can aid in diagnosis. Think of it as a swallowing a small camera. It is also important to note that people who periodically go off and on a gluten-free diet may over time fail to biologically/medically respond to the diet.
So as we have seen and as many Celiac patients can attest to, proper diagnosis and disease management can be a very tricky proposition. As with many things food and diet-related, what works for one person may not work for another. We are all individuals, and it is important to know yourself and know your body. Medical consultation combined with self-knowledge and a willingness to experiment to find what works best is extremely crucial to effective management of Celiac Disease and gluten sensitivity.
Article Courtesy: Andrew Steingrube