HOUSTON BUSINESS REVIEW

Health Tip: Celiac Disease, a Great Masquerader
By Mike Alexander Sr.

Mike is involved with several organizations including the National Association of Health Underwriters, Independent Insurance Agents Association, East End Chamber of Commerce, Better Business Bureau and the National Association of Small Business Owners, to name a few. Mike is a licensed Risk Manager and highly regarded in the insurance industry.

For more information on ABM and Mike Alexander, visit their site here.

Celiac disease is an inherited digestive disorder of unknown cause that affects the small intestine. Other names for this condition are celiac sprue, nontropical sprue, and gluten-sensitive enteropathy. If someone in your immediate family has it, chances are about 10 percent that you may have it too. Once thought rare, celiac disease has recently been estimated to affect 1 of every 133 Americans. Those who have celiac disease cannot tolerate a protein called gluten, which is present in wheat, rye, and barley. When a person with celiac disease eats foods containing gluten, an immune reaction occurs in the small intestine, resulting in damage to the surface of the small intestine and an inability to absorb certain nutrients from food.

Eventually, decreased absorption of nutrients can cause vitamin deficiencies which can lead to other illnesses affecting a number of organs.

Celiac disease symptoms may start in childhood or adulthood, with onset and severity influenced by the amount of gluten that is eaten. Some of the ways that celiac disease can present include:

* An infant may have abdominal pain and diarrhea (even bloody diarrhea), and may fail to grow and gain weight.
* A young child may have abdominal pain with nausea and lack of appetite, anemia (not enough iron in the blood), mouth sores and allergic dermatitis (skin rash).
* Teenagers may hit puberty late and be short.
* Adults typically have abdominal pain, chronic diarrhea, weight loss and pale foul-smelling stools.

Celiac disease may also present itself in less obvious ways, including irritability or depression, stomach upset, anemia, joint pain, muscle cramps, skin rash (dermatitis herpetiformis), mouth sores, osteoporosis, and tingling in the legs and feet (neuropathy).

Celiac disease appears to be an under-diagnosed condition since it can be confused with other gastrointestinal problems such as irritable bowel syndrome, gastric ulcers, lactose intolerance, and parasite infections.

If suspected, celiac disease can be confirmed with blood tests used to detect high levels of the antibodies (antiendomysial antibody, antitransglutaminase, antigliadin IgA and IgG) responsible for the immune reaction and by examining a small piece of the intestine from a biopsy.

There is no specific medicine or surgery to treat celiac disease. Instead it is "managed" through complete avoidance of gluten. Gluten-containing foods that must be avoided include:

* Breads or baked goods prepared from wheat, barley, or rye
* Cereals made from wheat, rye, or barley
* Pasta prepared from wheat, rye, barley, or semolina
* Salad dressings, gravies, sauces, and soups prepared with gluten-containing ingredients

Following a gluten-free diet is a lifetime requirement for individuals with celiac disease. A gluten-free diet will stop symptoms and allow for healing of the intestinal damage. Gluten-free flour, bread, pasta, and other products are available, which makes this diet more tolerable.

Improvements after starting a gluten-free diet may be especially dramatic in children. Not only will their physical symptoms improve, but their behavior may improve also.

It is very important to recognize and treat celiac disease since if left untreated it can result in a number of serious conditions including malnutrition, osteoporosis, and nerve damage. Celiac disease has even been associated with a higher risk of developing colon cancer and intestinal lymphoma.

For more information on this condition including the foods that constitute a gluten-free diet go to http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/ If you think that you could have this condition, it is important that you not begin the gluten-free diet until you have been tested. If you have other questions about celiac disease, please direct them to one of our eDocs and well be glad to help.