Ask Dr. H
by Mitchell Hecht
Question: My neighbor said she was diagnosed with celiac disease. Can you explain what it is?
A: Celiac sprue disease is a condition in which the immune system reacts abnormally to gluten protein. In another mysterious autoimmune reaction, gluten protein triggers the destruction of the tiny villi projections in the small intestine that help absorb important nutrients, such as iron, Vitamins B6 and B12, and folic acid.
Roughly 1 percent of the world’s population has celiac disease.
While most commonly seen in childhood, the condition can first appear in adulthood. Depending on the extent of small bowel destruction, there may be weight loss and diarrhea. If someone eats enough calories, they may overcome the decreased absorption of nutrients.
Sometimes, folks with celiac sprue are misdiagnosed as having irritable bowel syndrome (spastic colon).
To diagnose celiac sprue, any of several blood tests can be used to look for antibodies produced against the “foreign” gluten protein. If one or more test suggests celiac sprue, an upper endoscopy should be done to biopsy tissue in the duodenum (first part of small intestine just beyond the stomach).
If celiac disease is confirmed, strict adherence to a very difficult gluten-free diet will heal a damaged bowel lining. Web sites offering gluten-free foods include: www.glutenfreemall.com, www.glutensolutions.com and www.glutenfree-supermarket.com.
You can also look up the Celiac Disease Foundation at www.celiac.org.
Mitchell Hecht specializes in internal medicine. Send questions to: “Ask Dr. H,” Box 767787, Atlanta, Ga. 30076. Due to the large volume, personal replies are not possible.
Knight Ridder News Service