Military Officer - September 2006 - (Page 42) askthedoctor Celiac Disease A daily staple for many, grain-based foods such as bread and pasta can cause health problems for people with a gluten sensitivity. By Rear Adm. Joyce Johnson, D.O. G Think You Have Celiac Disease? ■ More information about celiac disease is available from the Celiac Sprue Association, (877) CSA-4-CSA (272-4272) or www.csaceliacs.org. luten is a general term for certain proteins found in many grains, including wheat, rye, and barley. In people with celiac disease — also known as celiac sprue, nontropical sprue, or gluten-sensitive enteropathy — these proteins cause an autoimmune response (that is, they cause people to produce antibodies against their own cells). The cells in the small intestine are most affected. The small intestine is important in absorbing food nutrients and various body fluids. Healthy small intestines are lined with very small projections (villi) that increase the surface area and absorption. With celiac disease, the autoimmune response damages the villi so they are unable to absorb nutrients, causing malnutrition, diarrhea, and dehydration. Symptoms of malnutrition include weight loss, fatigue, and general lethargy. Sometimes malnutrition is accompanied by a ravenous appetite; in other cases, abdominal cramping, bloating, and gas may predominate because of the continued decomposition of food and partially digested bowel contents. Other symptoms of malnutrition, resulting from deficiencies of specific nutrients (indicated in parentheses), include: weak bones (calcium and vitamin D), night blindness (vitamin A), anemia (iron), poor blood clotting (vitamin K), and swelling and edema (protein). Celiac disease is fairly common — nearly 1 percent of the American population has it — but it’s estimated that about 2 million people with it have not been di- agnosed. Though it is genetically transmitted, it can become apparent at any age. In children, consider a diagnosis of celiac disease if there is growth failure coupled with diarrhea and vomiting. In adults, the combination of weight loss, chronic diarrhea and other abdominal complaints, and apparently unrelated symptoms (due to malabsorption and malnutrition) might suggest celiac disease. If you suspect celiac disease, try a gluten-free diet; if you have the disease, you will see an improvement. Specific blood test results and a biopsy of the intestine will confirm a celiac diagnosis. Although there is no cure for celiac disease, totally eliminating gluten proteins from the diet will protect the villi, and symptoms will cease. Staying healthy will require a lifelong adherence to a glutenfree diet. However, this diet can be complex to follow. While some foods (often found in health-food stores) are labeled “100-percent gluten free,” generally labels won’t list gluten or specific grain proteins; instead they will list the grain or grain by-product. Wheat and other grains are used in many products, and even minute amounts of gluten proteins can cause symptoms, so completely eliminating them requires diligent attention; it is always critical to read food labels. MO — Rear Adm. Joyce Johnson, USPHS-Ret., D.O., M.A., is vice president, Health Sciences, Battelle Memorial Institute, Arlington, Va. Find more health and wellness resources at www .moaa.org/wellness. For submission information, see page 16. PHOTO: STEVE BARRETT 42 MILITARY OFFICER SEPTEMBER 2006 http://www.csaceliacs.org http://www.moaa.org/wellness http://www.moaa.org/wellness
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