gluten free

2006-11-05T05:33:00.000-08:00

Celiac Disease

By Andy Casasanta

Tip! There is no treatment or cure for Celiac Disease.Except for a lifelong adherence to a strict gluten-free diet.

Celiac Disease is a digestive disorder found in patients who are susceptible, with the resulting damage to the small intestine by an interference with the absorption of nutrients. The main culprit with Celiac Disease is a protein called Gluten.

These proteins are found in all forms of main stream and non-mainstream wheat products.

Such as durum semolina, spelt,einkorn,kamut and related grains such as rye, barley, and oats. Damage to the mucus on the surface of the small intestine is caused by a toxic reaction to the ingestion of gluten.

Tip! It is now well established in medicine that 1 in approximately 100 have celiac disease. Many have the disease without having any symptoms.

Effects Of

With Celiac Disease the villi,which are the tiny hair-like projections in the small intestine, shrink and eventually disappear. This is the destructive reaction to Celiac Disease. Damaged villi interferes with the body's ability to absorb nutrients such as carbohydrates, proteins, fats, vitamins, and even possibly water and bile salts. If left untreated, damage to the small bowel can be life threatening, posing an increased risk of many disorders.

If Left Untreated

Iron deficiency, Anemia, Vitamin K deficiency, Vitamin deficiencies such as folate, B12, B6, or an iron deficiency, and other mineral deficiencies, Other food sensitivities.

Symptoms May Include

Abdominal cramping,gas,and bloating.Diarrhea or constipation.
Fluctuation of weight(loss or gain), fatigue, weakness, lack of energy,and all thats associated with with lack of energy.

Possible Treatment

There is no treatment or cure for Celiac Disease.Except for a lifelong adherence to
a strict gluten-free diet. When gluten is removed from the diet, the small intestine will begin to heal and general health will be improved.You may want to consider supplementation for any
deficiencies.Consult your doctor about this.

Lifestyle changes are in order for the Celiac sufferer.Become a label reader. If you are unsure about a certian food or ingredient, stay away and learn to identify ingredients that may contain that hidden gluten. Be very diligent

Be aware that hidden gluten can be hiding in some unlikely foods such as low or non-fat products, deli meats, soups, hard candies, soy sauce, even salad dressings. If there is no
label to read such as candy in a dish, stay away, again be very diligent.

Tip! What these studies suggest is that a �normal small intestine biopsy� may exclude Celiac disease as defined by strict criteria but it is not a gold standard for detecting gluten sensitivity. This fact is appreciated by many individuals who have respond to a gluten-free diet they start based on their symptoms, family history, suggestive blood test or stool antibody test(s).

Gluten may also be used as a binder in prescription medicines.Again ask youre doctor about Gluten in medications.

Alcohol that's properly distilled shouldn't contain any harmful gluten. Research indicates that the peptide is too large to carry over in the distillation process. Beer is a definite no-no.
You might want to consider staying away from alcohol altogether (like the author of this site). This might seem drastic to some but our health is at stake. Wine from the Liquor store
might bother youre stomach, like it does mine possibly because of Sulfites as preserative to give it a longer shelf life. Home made Wine wthout any added ingredients in moderation seems to be O.K.

Sometimes Gluten products are added to alcohols and Vinegars after the distilling process
and should be avoided intirely. Malt vinegars are not distilled and therefore are not gluten-free. This in a nutshell is what Celiac Disease is. I might have left out some details, I'm not a
doctor. But, I am a Celiac sufferer and I know what Celiac's go through.

Tip! Peter Berlin is the founder of A Personal Touch Publishing which publishes books written from people's first-hand experiences in dealing with life's challenges. Their book A Personal Touch On�� Celiac Disease is available on-line at http://www.

Submitted by Mr Andy Casasanta. Author of this article and the creator of a tremendous health and pharmacy website. In this site you will find up to 40 health articles, a 7000 reciprocal link exchange page and Generic medications. Savings of up to 80% on all popular drugs. Viagra, Lipitor, meridia, and hundreds more all for pennies on the dollar. Please visit http://www.medheadquarters.net

2006-11-02T05:57:00.000-08:00

Why Doctors Frequently Miss Celiac Disease and Gluten Sensitivity

By Dr. Scot Lewey

Tip! The symptoms of celiac disease are very similar to a host of other intestinal disorders. They are: diarrhea, abdominal pain, gas, bloating, and weight loss.

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Doctors frequently fail to diagnose a very common condition known as Celiac disease or gluten sensitivity. The average delay in diagnosis is 11 years in adults. There are several reasons for this delay. Celiac disease was once considered to be rare and affect only young children. This is what most doctors practicing today were taught in medical school and they are unaware of how the spectrum of Celiac disease has changed.

Screening blood donors only recently confirmed Celiac disease occurs in 1 in 133 people in the U.S. However, that information most physicians are unaware of this for several reasons.

Celiac disease is treated by a gluten-free diet not a drug. Drug companies subsidize much of the continuing medical education received by doctors and most of the medical research in the United States. Without drug company money and marketing, Celiac disease does not appear in medical journal ads or get mentioned by drug reps detailing doctors. It is rarely a topic of major conferences or research grant proposals. It is a disease that is largely "out of site, out of mind" for most doctors.

Tip! With Celiac Disease the villi,which are the tiny hair-like projections in the small intestine, shrink and eventually disappear. This is the destructive reaction to Celiac Disease.

Doctors who actually remember Celiac disease envision in their mind a very young, pale, emaciated child with skinny limbs and a big "potbelly" like the picture they were shown years ago in medical school. The medical history linked with this image is a malnourished child that is not growing and has numerous, bulky, and foul smelling diarrheal stools. Surveys of primary care providers have confirmed that most are unaware that Celiac occurs in adults. If they do think it could occur in adults they don't believe it can occur in someone who is overweight and constipated or has no intestinal symptoms.

Tip! Various ultrasound findings have been reported in Celiac disease, primarily in the European literature. Colli et.

They lack awareness that symptoms such as fatigue, bone and joint pain, headaches, and skin rashes are common in Celiac. Most are also it is associated with other autoimmune conditions like thyroid disease, diabetes, rheumatoid arthritis and lupus. Malabsorption complications such as anemia and osteoporosis are often not recognized as common presentations of untreated Celiac disease. Over 250 symptoms involving nearly every part of the body have been reported in Celiac disease. Unless you provide your doctor distinct clues such as a family history of Celiac or mention the possibility that you think you might be gluten senstitive they don't even consider the possibility of it to be the cause of your being ill.

Tip! People with type 1 diabetes are at greater risk of developing celiac disease. It follows that they will need to manage a diet which controls both conditions.

Many doctors are unfamiliar with the specific blood tests or genetic tests for Celiac disease. Others are not thinking about the possibility of Celiac while listening to your symptoms so they never consider ordering the blood tests. Either way you never have chance of being diagnosed unless you ask them to test you. Even then your request may be ignored unless you insiste because of your family history, advice of family member or friend, or you present to them your own research. Their preconceived biases or misconceptions about Celiac may difficult to break. If you have little to no symptoms you may still may need to be tested because of risk factors but your doctor may be unfamiliar with the indications for screening of high risk individuals.

Tip! One natural remedy for Celiac is Cardamon, which is found in India. It has been used successful in treating Celiac disease in children.

It should be noted that many doctors don't like changing a diagnosis they have made and therefore may fail to consider an alternate diagnosis when new symptoms present. Instead they may attempt to fit the new symptoms into an existing condition or diagnosis. Because people with untreated Celiac disease frequently have neuropsychiatric symptoms your doctor may label you depressed, anxious, stressed, neurotic or just plain crazy. As a result they may stops listening or taking your concerns seriously and you may be tempted to stop mentioning your symptoms or concerns.

Lastly, doctors are under tremendous pressure to keep medical costs down. Diagnostic tests are one the biggest expenses in medical care and are ordered by doctors. Many insurance companies track individual doctors according to the number of tests they order. Therefore, your doctors may feel pressured to avoid ordering any perceived "unnecessary tests". For some doctors who still believe Celiac disease is rare, blood tests or endoscopies required for diagnosis may not be ordered for these reasons. If ordered, however, blood tests may be misinterpreted or falsely negative. Endoscopy may be done but no biopsy performed or poorly interpreted. You and doctor may be under the false assurance that Celiac disease and gluten sensitivity have been excluded.

Tip! Fraquelli M; Colli A; Colucci A; Bardella MT; Trovato C; Pometta R; Pagliarulo M; Conte D. Accuracy of ultrasonography in predicting celiac disease.

I recommend you help your doctor if you believe you may have Celiac disease or gluten sensitivity by 1) Writing down all your symptoms and your understanding of how they may be due to gluten sensitivity 2) Sharing your family history, including your ancestry and any genetic tests done 3) Being familiar with the diagnostic tests for Celiac disease and gluten sensitivity and their limitations 4) Politely ask your doctor to test you for Celiac disease pointing out why you believe it may be a cause of your symptoms 5) Being willing to undergo adequate and appropriate evaluation and 6) Being prepared to obtain a second opinion if necessary. Being educated and prepared will help your doctor help you.

Dr. Scot Lewey is a physician who is specialty trained and board certified in the field of gastroenterology (diseases of the digestive system) who practices his specialty in Colorado. He is the physician advisor to the local Celiac Sprue support group and is a published author and researcher. He is developing a web based educational program for people suffering from food intolerance and Celiac disease http://www.thefooddoc.com

2006-10-31T07:16:00.000-08:00

Celiac Disease and the Grains That Cause this llness

By Rudy Silva

Tip! Many doctors are unfamiliar with the specific blood tests or genetic tests for Celiac disease. Others are not thinking about the possibility of Celiac while listening to your symptoms so they never consider ordering the blood tests.

Eating grain products - breads, cakes, cereals - have long been consider a healthy choice. If you look at the RDA recommendations, grains, at the bottom of the pyramid, are what you should be eating the most of to maintain a healthy body.

The RDA's recommendations do not consider any food to be harmful for you. You must remember that the RDA's recommendations come from a government agency and indicating a particular food could be harmful to your health could financially affect that industry. The government does not want to destroy any industry even if it is harmful to your health. Just look at the smoking industry. It's still alive.

Tip! With Celiac Disease the villi,which are the tiny hair-like projections in the small intestine, shrink and eventually disappear. This is the destructive reaction to Celiac Disease.

In medical and alternative medicine circles, celiac disease is well known for being the cause of numerous detrimental body conditions. In its basic form, celiac disease is the damage of the intestinal lining by gluten proteins, which come from grains - the bottom of the pyramid.
Let's get technical for a moment and say that the specific proteins in gluten that damage the intestine are called "gliadin."

What you need to know about gliadin is that when you eat it, it acts like an invading substance, which activates your body's immune system to destroy and eliminate the invader - your favorite food bread and cereals.
Eating an excess of gluten causes celiac disease. Where is gluten found? It is found in products made from wheat, rye, barley, kamut, triticale, oats, and spelt.

It is now well established in medicine that 1 in approximately 100 have celiac disease. Many have the disease without having any symptoms. The continual use of and eating of detrimental grains will eventually bring on symptoms. People with celiac disease can expect to have illnesses associated or connected with:

* cancer

* epilepsy

* attention deficit disorders

* auto immune diseases

* osteoporosis

Tip! Why some people develop Celiac Disease or become sensitive gluten is not well understood. Risk factors include onset of puberty, pregnancy, stress, trauma or injury, surgery, viral or bacterial infections including those of the gut, medication induced gut injury or toxicity (e.

* brain disorders

* neurological diseases

* premature death

* premature births

* chronic liver diseases

* gastrointestinal problems

* food allergies

* chronic fatigue

* malnutrition

* and the list goes on and on

When the intestinal lining is damage by gluten, your overall health is damaged. Your immune system is activated to prevent further intestinal damage causing your overall response to other body crisis to diminish. Your ability to fight off other diseases is diminished. Your ability to absorb nutrients from your food is reduced leading to nutritional deficiencies.

How does gluten create so many problems in the body? As gluten moves into the intestine, it is digested and broken down into small protein molecules - peptides (which consist of 2-3 amino acids bound together) and free amino acids. Amino acids are the basic building blocks the make up protein. Once digestion is complete, peptides and free amino acids easily move into the intestinal wall cell structure and then into your blood stream. This is what happens in a healthy person.

Over many years of eating gluten, the intestinal cell structure deteriorates. Digested protein no longer passes through the cells walls but passes between cells and into the blood. These holes in the intestinal walls is what is know as "leaky gut syndrome"

Because of the existence of these tiny holes in the intestinal wall, harmful substances can pass into the blood and settle into your organs and cells causing irritations and damage. Your intestinal wall is no longer a barrier keeping out unwanted substances from your blood and body.

Tip! Antibodies for gliadin (AGA), the toxic fraction of gluten are considered very sensitive but not specific for Celiac disease. Newer assays for AGA antibodies for gluten that has undergone a chemical change called deamidation appear to be more specific for Celiac disease (Gliadin II, Inova) than the older gliadin tests.

Undigested foods can now enter your body creating food allergies. Toxins from various foods - dyes, preservatives, food additives, artificial flavors - can now enter you blood stream. Pathogens such as bacteria, worms, fungus and viruses can also enter your body and invade your organs. When this happens, you will slowly come down with a variety of symptoms and illnesses that you cannot attribute to anything specific.
Absorption of undigested proteins is a major threat to the health of your organs and to your immune system.

Tip! WGO-OMGE Practice Guideline Celiac Disease. World Gastroenterology News.

It is estimated that up to 40% of all people have some intestinal damage from eating gluten and are passing undigested proteins into their blood stream.

There are some of you that do not have the enzymes to digest gluten. Those of you have what is called "gluten sensitivity." Those of you that have the enzymes to digest gluten are not as prone to celiac disease and have less damage to your intestinal wall.

So what are the foods that you should be eliminating from your eating habits?

* wheat starch, wheat grass, wheat germ oil, wheat triticum

* bread flour, brewer's yeast, bran, brown flour

* oats, oat straw,

* baking powder, edible starch, germ, gum base, dextrin

* malt, rice malt,

* rye, spelt, kamut, wheat, bleached flour, couscous, pearl barley, bulgar

*soy sauce, teriyaki sauce, shoyu, miso

* durum wheat triticum, semolina, emolina triticum

* beer

* blue cheese

One natural remedy for Celiac is Cardamon, which is found in India. It has been used successful in treating Celiac disease in children.

For women, celiac has been found to be associated with osteoporosis, since the intestinal walls are compromised and absorb Calcium poorly. To over come this make sure you take magnesium and Vitamim B12 to increase your absorbtion of Calcium. Or better yet find some form of ionic calcium and magnesium and use them as a supplement.

Not all is known about the effects of gluten on your body and how it creates illness. What is known is that gluten is responsible for celiac disease and many other diseases that result from having celiac.

Don't always believe what the government says about food. Their interest is in economics and not in your health.

Rudy Silva is a natural nutritionist. He writes a newsletter called "Natural Remedies That work." You can subscribe to his newsletter and read some of the back issues which give you information of how to have better health. Read his latest newsletter at: http://www.natural-remedies-thatwork.com/nl-111.html

2006-10-24T05:13:00.000-07:00

Celiac Disease Versus Gluten Sensitivity: New Role for Genetic Testing and Fecal Antibody Testing?

By Dr. Scot Lewey

Tip! One natural remedy for Celiac is Cardamon, which is found in India. It has been used successful in treating Celiac disease in children.

Celiac disease (CD) has a prevalence of 1/100. Between 90-99% of Celiacs are HLA
DQ2 and/or DQ8 positive. Every individual has two DQ serotypes. Because the
molecular HLA nomenclature can be confusing DQ serotyping is a method for
simplifying the results. There are four major types and 5 subtypes: HLA DQ1, DQ2,
DQ3 and DQ4; DQ1 has two subtypes; DQ5 and DQ6 whereas DQ3 has three
subtypes; DQ7, DQ8 and DQ9. Each individual has two copies of HLA DQ. One DQ
type is inherited from each parent.

Though 35-45% of individuals of Northern European ancestry are DQ2 &/or DQ8
positive only 1% have classic CD as defined by abnormal blood tests and small
intestine biopsies. Several autoimmune conditions also occur more frequently in
DQ2 and DQ8 positive individuals.

There is accumulating scientific evidence that many individuals are gluten sensitive
and respond to a gluten free diet though they have normal blood tests and/or
normal intestinal biopsies (fail to meet strict criteria for CD). This is more commonly
being referred to as non-Celiac gluten sensitivity (NCGS). Many individuals who
have NCGS are relatives of confirmed Celiacs and were previously referred to as
latent Celiacs. Electron microscopy and immunohistochemistry studies of
individuals with normal biopsies but suspected of or at risk (1st degree relatives of
Celiacs) have revealed ultrastructural abnormalities of the intestine and those who
chose gluten free diet usually responded and many who did not ultimately
developed abnormal biopsies on long term follow-up. Seronegative Celiac has also
been recognized, that is blood tests are negative, but the biopsy reveals classic
abnormalities of Celiac and the individual responds to gluten free diet.

Fecal antibody testing for gliadin (AG) and tissue transglutaminase (tTG) by
Enterolab in Dallas has revealed elevations in 100% of Celiacs tested and up to 60%
of symptomatic individuals without Celiac disease (NCGS) even if not DQ2 or DQ8
positive. (Fine, K unpublished data, www.enterolab.com). The only DQ pattern he
found not associated with gluten sensitivity is DQ4/DQ4, a pattern typically found in
non-Caucasians who are known to have a low prevalence of Celiac disease.

Testing for DQ2/DQ8 has been suggested as a way to exclude CD. That is, if you are
negative for DQ2 and DQ8, then you are very unlikely to have CD. However, well
documented cases of CD and Dermatitis Herpetiformis (DH) have been confirmed in
DQ2 and DQ8 negative individuals. Moreover, we now have the clinical experience
that other DQ patterns predispose to gluten sensitivity because these individuals
frequently have elevated fecal antibodies to AG or tTG and respond to gluten free
diet.

Why some people develop Celiac Disease or become sensitive gluten is not well
understood. Risk factors include onset of puberty, pregnancy, stress, trauma or
injury, surgery, viral or bacterial infections including those of the gut, medication
induced gut injury or toxicity (e.g. NSAIDs), immune suppression or autoimmune
diseases, and antibiotic use resulting in altered gut flora (dysbiosis). The severity of
the sensitivity is related to the DQ type, pre-existing intestinal injury, degree of
exposure to gluten (how frequent and large a gluten load an individual is exposed
to), and immune status. Once initiated, gluten sensitivity tends to lifelong. True CD
requires lifelong complete gluten avoidance to prevent serious complications,
cancers, and early death.

Tip! I recommend you help your doctor if you believe you may have Celiac disease or gluten sensitivity by 1) Writing down all your symptoms and your understanding of how they may be due to gluten sensitivity 2) Sharing your family history, including your ancestry and any genetic tests done 3) Being familiar with the diagnostic tests for Celiac disease and gluten sensitivity and their limitations 4) Politely ask your doctor to test you for Celiac disease pointing out why you believe it may be a cause of your symptoms 5) Being willing to undergo adequate and appropriate evaluation and 6) Being prepared to obtain a second opinion if necessary. Being educated and prepared will help your doctor help you.

Serotypes can be determined from blood or buccal mucosal cells obtained by oral
swab from several commercial labsl including Prometheus, Labcorp, Quest, The
Laboratories at Bonfils, and Enterolabs. Fecal IgA anti-gliadin and IgA tissue
transglutaminase antibody testing is only available in the U.S. commerically through
Enterolabs. The fecal AG and tTG testing may be helpful in those with normal blood
tests for Celiac and/or a normal small bowel biopsy but suspected of being gluten
sensitive. Though the fecal antibody results are not widely accepted by many "Celiac
experts" numerous testimonials of individuals testing positive only on fecal tests
who have responded to gluten free diet can be found in support groups, web
postings, personal communication from Dr. Fine and this physician's clinical
experience.

Bibliography

Abrams et.al. Seronegative celiac disease:increased prevalence with lesser degrees
of villous atrophy. Dig Dis Sci 2004;49:546-550.

Alaedini A. and Green P.H.R. Narrative Review: Celiac Disease: Understanding a
Complex Autoimmune Disorder. Ann Intern Med. 2005;142:289-298.

Arranz et. al. Jejunal fluid antibodies and mucosal gamma/delta IEL in latent and
potential coeliac disease. Adv Exp Med Biol. 1995; 371B:1345-1348.

Dewar D. and Ciclitira P. Clinical Features and Diagnosis of Celiac Disease.
Gastroenterology 2005;128:S19

Kappler et.al. Detection of secretory IgA antibodies against gliadin and human
tissue transglutaminase in stool to screen for coeliac disease in children:validation
study. BMJ 2006; 332:213-214

Tip! Gallbladder disease should be considered in Celiac disease patients despite normal ultrasound and HIDA tests, especially if a 'supranormal' ejection fraction is noted and pain reproduced with CCK. Patients with abnormal high gallbladder ejection fractions should be considered as possible undiagnosed Celiacs and should undergo blood tests for Celiac disease and consideration of upper endoscopy with small bowel biopsy.

Kaukinen et.al. HLA-DQ Typing in the Diagnosis of Celiac Disease. Am J
Gastroenterol. 2002;97(3):695-699.

Fine KD and Rostami K. Don't throw the baby out with the bath water. BMJ February
13, 2006 rapid response editorial

Fine K. Early diagnosis of gluten sensitivity before the villi are gone. Transcript of
presentation to Greater Louisville Celiac Support Group, June 2003.
www.enterolab.com/essay/

Picarelli et.al. Antiendomysial antibody detection in fecal supernatants:in vivo proof
that small bowel mucosa is the site of antiendomysial antibody production. Am J
Gastroenterol. 2002 Jan;97(1):95-98

Sbartati A. et.al. Gluten sensitivity and "normal" histology: is the intestinal mucosa
really normal? Dig Liver Dis 2003;35:768-773.

Sollid L. and Lie B. Celiac Disease Genetics:Current Concepts and Practical
Applications. Clinical Gastroenterology and Hepatology 2005;3:843-851.

WGO-OMGE Practice Guideline Celiac Disease. World Gastroenterology News.
2005;10(2):supplement 1-8.

Dr. Scot Lewey is a physician who is trained and board certified in the specialty of
gastroenterology (diseases of the digestive tract) and has a growing practice focused in
the area of food intolerances, especially gluten and cow's milk protein. He is a
published researcher and author and founder of an educational website
http://www.thefooddoc.com dedicated to helping people with food intolerances.

2006-10-23T05:12:00.000-07:00

Irritable Bowel Syndrome May Be Due To Missed Celiac Disease Or Food Intolerance

By Dr. Scot Lewey

Tip! If you have been suffering from intestinal problems and have not gotten relief, find out all you can about celiac disease. Educate your doctor about it.

Irritable bowel syndrome is the most common gastrointestinal diagnosis yet it is not really a disease nor does it have confirmatory diagnostic tests. Rather, it is diagnosed based on a constellation of symptoms and the absence of other diagnoses. Common symptoms attributed to IBS are abdominal pain, cramping, diarrhea, bloating and excess gas. Celiac disease or gluten sensitivity is a common but frequently missed gastrointestinal diagnosis. Ingestion of gluten containing foods in affected individuals commonly causes symptoms attributed to IBS that are relieved with gluten-free diet in at least 10-20% of people misdiagnosed with IBS. Other food intolerances are also a likely a cause of IBS symptoms that may improve with avoidance of certain foods.

IBS is a diagnosis of exclusion. Other causes of symptoms of abdominal pain, diarrhea, constipation, or alternating constipation and diarrhea should be excluded by doctor's review of medical history, a physical exam and some screening laboratory tests and arguably a colonoscopy. The other conditions that traditionally doctors are most concerned about excluding include inflammatory bowel diseases (ulcerative colitis, Crohn's disease) and cancer. Less worrisome but treatable conditions that need to be excluded include lactose intolerance, intestinal infections especially parasites like giardia, and food intolerance. Celiac disease though now known to be very common, affecting approximately one percent of the U.S. population, has been largely ignored as a possible cause of IBS symptoms. Most primary care physicians are aware that diarrhea is a common symptom of Celiac disease but not that it may present in adults and be associated with constipation. Most doctors are unaware that the prevalence of Celiac disease in IBS patients may be as high as 20%.

Tip! The principles of planning ahead and the need to be well informed and to take control are exactly the same for celiac disease and diabetes. Confidence grows out of knowing what you can and cannot eat.

Typical lab tests ordered by doctors screening for more serious intestinal diseases that may mimick IBS include a complete blood count (CBC) looking for signs of blood loss or anemia (low hemoglobin or hematocrit), signs of inflammation or infection (high white blood cell count and/or platelet count) and stool tests for blood (fecal occult blood test or FOBT) or white blood cells (WBCs or fecal leukocytes). The stool tests are looking for signs of bleeding, infection or inflammation of the intestine. IBS does not cause bleeding or intestinal inflammation whereas inflammatory bowel disease, infection or cancer may. Normal tests are reassurring though do not exclude more serious disease. Most gastroenterologists believe a colonoscopy should be performed.

However, most doctors, even many gastroenterologists, fail to test for Celiac disease though it is common and screening blood tests exist. The reasons for this are many and are more fully explained elsewhere. However, the common incidence, presence of screening tests and available treatment should make screening for Celiac disease part of the standard evaluation of all patients presenting with symptoms suggestive of IBS before that diagnosis is established.

More recently, food intolerance other than gluten or wheat have been suggested as a treatable cause of IBS. Blood tests for a type of antibody known as IgG have been advocated by several researchers as being helpful for advising people about eliminating or avoiding certain foods as a treatment of IBS. Recent evidence suggests that a significant reduction of IBS symptoms can be achieved in people who avoid foods based on elevated IgG antibodies to foods. Atkinson et. al 2004 reported 10-26% improvement in symptoms in patients compared with controls. Deterioration was noted in those who relaxed their dietary restriction of foods they had avoided because of elevated antibody levels. These findings require further validation and are facing significant resistance to acceptance by many in the medical community, especially in the U.S. However, elimination diets have long been reported effective by many people. The possibility of food intolerance as a reversible cause of symptoms attributed to a syndrome with little other effective treatments except mostly ineffective treatments in the past and very new medications with limited efficacy and unproven long term safety should prompt further studies and an openness to dietary trials.

Tip! Doctors who actually remember Celiac disease envision in their mind a very young, pale, emaciated child with skinny limbs and a big 'potbelly' like the picture they were shown years ago in medical school. The medical history linked with this image is a malnourished child that is not growing and has numerous, bulky, and foul smelling diarrheal stools.

If you have been diagnosed with irritable bowel syndrome I recommend you confirm that Celiac disease has been excluded. Food intolerance should also be considered though testing may not be covered by your insurance and/or accepted by your doctor as valid. Elimination of common foods and their proteins causing intolerance, wheat, barley and rye (gluten); cow's milk protein (casein); soy; and peanuts is worth a try. Be sure to keep a food-symptom diary and re-introduce one food or food protein back into your diet at a time. One diet that effectively eliminates all the major food proteins causing intolerances but may be difficult to follow is the paleo diet (www.thepaleodiet.com).

Tip! Various ultrasound findings have been reported in Celiac disease, primarily in the European literature. Colli et.

1. Hoey. "Irritable Bowel Syndrome: Could it be Celiac Disease?" Can Med J. 2002; 166:479-80

2. Sander et al, "Association of Adult Coeliac Disease with Irritable Bowel Syndrome: A Case-Control Study in Patients Fulfilling Rome II Criteria Referred to Secondary Care." Lancet. 2001; 358:1504-8

2. Atkinson W; Sheldon TA; Shaath N; Wharwell PJ. "Food elimination bsed on IgG antibodies in irritable bowel syndrome; a randomised controlled trial." Gut 2004; 53:1459-1464.

3. Isolauri E; Rautava S; Kalliamaki M. "Food allergy in irritable bowel syndrome: new facts and old fallacies." Gut 2004; 53:1391-3.

Dr. Scot Lewey is a physician who is subspecialty trained and board certified in gastroenterology (diseases of the digestive tract) that has over 20 years of experience as an expert clinician, researcher, lecturer and author of more than twenty articles, book chapters, and scientific abstracts. His special interests include Celiac disease, food intolerance and allergies, colitis, Crohn's disease, irritable bowel syndrome & reflux.

2006-10-22T05:13:00.000-07:00

Gallbladder Problems Common In Celiac Disease May Be Missed By Doctors Because Of Normal Tests

By Dr. Scot Lewey

Gallbladder disease is a common condition typically affecting young and otherwise healthy individuals. Risk factors include obesity, diabetes, female gender, pregnancy, family history, rapid weight loss, liquid protein diets, and race or ethnic background. When typical symptoms of right sided upper abdominal pain, nausea, vomiting, and bloating occur within 15-90 minutes of eating, especially a fatty meal, gallstones are usually suspected. Ultrasound of the gallbladder is the first test ordered and will confirm the presence or absence of gallstones. If gallstones are confirmed then surgical removal of the gallbladder is recommended.

However, if the ultrasound is negative or normal and gallbladder disease is still suspected a nuclear test called biliary scintography or more commonly called HIDA scan is ordered. The basis of this test is the fact that a radiolabeled chemical is administered intravenously that is concentrated in the liver where bile is made before being stored in the gallbladder between meals. If the gallbladder is diseased it may fail to be seen on the scan due to blockage or fail to empty as expected when a hormone called cholecystokinin (CCK) is given intravenously. CCK is present in the body and released with meals to stimulate gallbladder emptying of bile into the intestine for digestion. Typically, the gallbladder will empty a third or more of its volume when CCK is given during a HIDA scan but usually not more than 70-80%. The fraction of volume the gallbladder empties is referred to as the ejection fraction. A low ejection fraction is typical of a diseased gallbladder. Reproduction of the typical pain of gallbladder disease and a low ejection fraction are considered diagnostic of gallbladder disease in the absence of gallstones and results in a recommendation that the gallbladder be removed surgically.

Tip! With Celiac Disease the villi,which are the tiny hair-like projections in the small intestine, shrink and eventually disappear. This is the destructive reaction to Celiac Disease.

An unusual phenomenon has been observed in some Celiac patients. Gallbladder type abdominal pain without gallstones and a "supranormal" gallbladder ejection fraction. Surgery relieves the gallbladder type pain and a diseased gallbladder is found. Radiology studies have been reported in the literature that shed light on this phenomenon though it's significance has been largely missed by the medical community.

Various ultrasound findings have been reported in Celiac disease, primarily in the European literature. Colli et. al in Italy noted increased fasting volumes of the gallbladder by ultrasound in untreated Celiac patients and Mariciani et. al. in the U.K. found increased gallbladder volumes and elevated gallbladder ejection fractions using MRI. Low CCK levels have been reported in Celiac patients (Deprez et.al. 2002, Rehfeld 2004). This physician has had several Celiac disease patients who have had high gallbladder ejection fractions (typically >90%) associated with classic gallbladder symptoms that resolved after gallbladder surgery. Chronic gallbladder disease was confirmed pathologically.

Tip! If you have been suffering from intestinal problems and have not gotten relief, find out all you can about celiac disease. Educate your doctor about it.

Gallbladder disease should be considered in Celiac disease patients despite normal ultrasound and HIDA tests, especially if a "supranormal" ejection fraction is noted and pain reproduced with CCK. Patients with abnormal high gallbladder ejection fractions should be considered as possible undiagnosed Celiacs and should undergo blood tests for Celiac disease and consideration of upper endoscopy with small bowel biopsy.

Tip! Several blood tests exist for Celiac disease. They have varying degrees of accuracy.

1. Fraquelli M; Colli A; Colucci A; Bardella MT; Trovato C; Pometta R; Pagliarulo M; Conte D. Accuracy of ultrasonography in predicting celiac disease. Arch Intern Med. 2004; 164(2):169-74.

2. Marciani L; Coleman NS; Dunlop SP; Singh G; Marsden CA; Holmes GK; Spiller RC; Gowland PA. Gallbladder contraction, gastric emptying and antral motility:single visit assessment of upper GI function in untreated celiac disease using echo-planar MRI. J Magn Reson Imaging. 2005; 22(5):634-8.

3. Deprez P; Sempoux C; Van Beers BE; Jouret A; Robert A; Rahier J; Geubel A; Pauwels S; Mainguet P. Persistent decreased plasma cholecystokinin levels in celiac patients under gluten free diet:respective roles of histological changes and nutrient hydrolysis. Regul Pept. 2002;110(1):55-63

Tip! One natural remedy for Celiac is Cardamon, which is found in India. It has been used successful in treating Celiac disease in children.

4. Rehfeld JF. Clinical endocrinology and metabolism. Cholecystokinin. Best Pract Res Clin Endocrinol Metab. 2004; 18(4):569-86.

Dr. Scot Lewey is a physician who is specialty trained and board certified in the field of gastroenterology (diseases of the digestive system) who practices his specialty in Colorado. He is the physician advisor to the local Celiac Sprue support group and is a published author and researcher who is developing a web based educational program for people suffering from food intolerances, http://www.thefooddoc.com

2006-10-19T05:08:00.000-07:00

Diagnosing Celiac Disease and Gluten Sensitivity

By Dr. Scot Lewey

Celiac disease, also known as gluten sensitive enteropathy is very common but frequently missed. It is a autoimmune disease of intestinal damage due to gluten in people who are genetically predisposed. Classic Celiac disease is diagnosed by abnormal blood tests and an abnormal
appearing intestine on biopsy and symptoms that resolve with gluten free diet.

Tip! Several blood tests exist for Celiac disease. They have varying degrees of accuracy.

Several blood tests exist for Celiac disease. They have varying degrees of accuracy. Some are more sensitive, meaning they will be positive in milder forms of the disease but are not specific, meaning a positive test may not indicate Celiac disease. Others are felt to be very specific, meaning that when they are positive, it is almost certain you have the disease.

The most specific tests are tests for Celiac disease endomysial antibodies (EMA) and
tissue transglutaminase sntibody (tTG) antibody tests. These two tests are IgA based tests and can be negative if you are deficient in the immunoglobin IgA, which occurs in 10-20% of people with Celiac. When either EMA or tTG are positive Celiac disease is very likely and usually the intestine biopsy is positive. Recent studies indicate that the tTG may only be positive in 40% of true Celiacs when mild degrees of intestine damage are present on biopsy. Seronegative Celiac, meaning the blood tests are negative but the biopsy is positive may occur in up to 20% of Celiacs.

Tip! Various ultrasound findings have been reported in Celiac disease, primarily in the European literature. Colli et.

Antibodies for gliadin (AGA), the toxic fraction of gluten are considered very sensitive but not specific for Celiac disease. Newer assays for AGA antibodies for gluten that has undergone a chemical change
called deamidation appear to be more specific for Celiac disease (Gliadin II,
Inova) than the older gliadin tests. They also may be as or more accurate than EMA and tTG
antibody tests but are not yet widely available.

The most distressing problem for people with lesser forms of gluten intolerance who have blood tests and/or biopsies that are normal or borderline yet respond to a gluten free diet is either not be taking seriously or knowing for sure if they are sensitive to gluten. For these individuals stool
antibody testing for antigliadin and tTG have been helpful. Such stool testing has been performed in research labs and published in a few studies but only recently available through the commercial lab, Enterolab. Founded by a former Baylor research gastroenterologist, Dr Ken Fine, the tests are available to order by people online without a doctors order but are not generally covered by insurance. Dr. Fine, who patented the test, has yet to publish the results of his findings in a peer reviewed journal so his tests are not widely accepted. However, his unpublished data and clinical experience of some of us who have used his test have
indicated the tests are very sensitive for signs of gluten sensitivity. He reports that they are 100% sensitive for Celiac disease and highly sensitive
for gluten sensitivity of lesser degrees. In the presence of symptoms that reverse on a gluten-free diet
abnormal stool antibody levels can be found in most people before blood tests or biopsies become
abnormal.

Small intestine biopsies during upper gastrointestinal endoscopy
are considered the "gold standard" for the diagnosis of Celiac disease.
However, recent studies have demonstrated that some people with gluten sensitivity, especially relatives of Celiacs
with little or no symptoms, have changes from gluten injury to the intestine that can't be seen with normal microscope examination. They can only be seen with special stains not routinely done or with a research electron microscope. The special stains are known as immunohistochemistry stains. They stain specialized white
blood cells called lymphocytes in the intestinal lining tips or villi. When these lymphocytes are increased it is known as intraepithelial lymphocytosis or increased IELs and it is the earliest sign
of gluten induced injury or irritation. Electron microscopy also reveals very early ultrastructural changes in some individuals when blood tests and standard biopsy exmination are normal. When people who have these changes are
offered the option of gluten-free diet they usually responded favorably. In contrast, those who continued to eat gluten often later developed classic Celiac disease.

Tip! The few doctors who appreciate the spectrum of gluten intolerance or sensitivity are outnumbered by the medical majority that continue to insist on strict criteria for diagnosis for Celiac disease before recommending a gluten-free diet. Doctors either unfamiliar with the limitations of the tests as documented by Celiac research or who insist on the strict criteria for Celiac being the only indication for recommending a gluten free diet unfortunately may confuse or frustrate gluten sensitive individuals.

What these studies suggest is that a "normal small intestine biopsy" may exclude
Celiac disease as defined by strict criteria but it is not a gold standard for detecting gluten sensitivity. This fact is appreciated by many individuals who have respond to a gluten-free diet they start
based on their symptoms, family history, suggestive blood test or stool antibody
test(s).

Another source of confusion is in the genetics of Celiac and gluten sensitivity.
Testing for specific blood type patterns on white blood cells known as HLA
DQ2 and DQ8 is increasingly be employed to determine if a person carries either of the two gene
pattern present in 95-98% of Celiacs and predisposing to development of Celiac disease. Some use the absence of these two patterns
as a way of excluding the possibility of Celiac disease and the need for testing or
gluten-free diet. However, there are rare reports of documented Celiac disease in people who are DQ2 and
DQ8 negative. Moreover, recent studies indicate other DQ
patterns may be associated with gluten sensitivity though unlikely to
predispose to classic Celiac disease.

Tip! Doctors frequently fail to diagnose a very common condition known as Celiac disease or gluten sensitivity. The average delay in diagnosis is 11 years in adults.

Testing for all the DQ patterns is advocated by Dr. Fine, based on his
experience with stool antibody test results. He reports the other DQ types are
associated with elevated levels of gliadin and tTG in the stool and symptoms that respond to a gluten-free diet.
According to his unpublished data, all the DQ types except DQ4 are associated with
a risk of intolerance to gluten. Therefore, testing for all the DQ types allows a person to
determine if they carrry one of the two high risk gene types for Celiac disease or the
any of the other "minor DQ" genes Fine has found associated with gluten sensitivity.

Enterolab's stool testing for gliadin antibodies and tissue
transglutaminase antibodies though not widely accepted, have gained favor in the lay
public's opinion as an option for determining sensitivity to gluten either despite of negative blood tests and/or biopsies or in place of the more invasive tests. Most doctors still recommend the accepted blood tests and small
bowel biopsy for confirmation of Celiac. Though the reports in the lay community
are overwhelmingly positive they have not been subjected to peer review in
the medical community pending Dr. Fine publishing his data or other researchers reproducing his results.

Tip! The only acceptable treatment for celiac disease is strict adherence to a 100% gluten-free diet for life. That measure can prevent almost all complications caused by the disease � without medication � as the small intestine will steadily heal and start absorbing needed nutrients and, therefore, eliminate painful symptoms.

However, doctors open to
the broader problem of gluten
sensitivity are reporting these tests helpful in many patients suspected of gluten
intolerance. Especially when someone has symptoms consistent with gluten sensitivity but has negative or inconclusive blood tests and/or biopsies these tests may be very helpful though some are not certain
how to interpret the tests. The national Celiac organizations are uncertain about how to
comment on their application without published research though a recent article
in the British Medical Journal did show stool tests highly specific for Celiac. Dr.
Fine's has publicly commented that his unpublished data demonstrates those with
abnormal stool tests indicating gluten sensitivity
overwhelmingly respond favorably to a gluten free diet with improvement of
symptoms and general quality of life.

Tip! Weight is part of a simple equation. The model I share in �Eat Well - Live Well with celiac disease describes it as a see saw in the park.

Another problem is that there is not universally agreed upon definitions for gluten sensitivity or intolerance. This becomes specially difficult for those who do not meet strict criteria for Celiac disease yet may have abnormal tests and/or symptoms that respond to gluten-free diet. Those individuals become confused when they try to find information but don't have a formal diagnosis of Celiac disease. Consensus in the medical community on definitions and more research in this area is greatly needed.

The few doctors who appreciate the spectrum of gluten
intolerance or sensitivity are outnumbered by the medical majority that continue to
insist on strict criteria for diagnosis for Celiac disease before recommending a
gluten-free diet. Doctors either unfamiliar with the limitations of the tests as documented by Celiac research or who insist on the
strict criteria for Celiac being the only indication for recommending a gluten free
diet unfortunately may confuse or frustrate gluten sensitive individuals. Some of these people then seek answers on the internet or from alternative practitioners. Many have their diagnosis missed, challenged, dismissed, or are misinformed. As a result they fail to benefit from the health
benefits of a gluten-free diet because they are advised that it is not required based on normal blood tests and/or normal biopsies. In the meantime, Celiac disease and gluten sensitivity continue to be undiagnosed or misdiagnosed. For more information visit http://www.thefooddoc.com.

Tip! Fraquelli M; Colli A; Colucci A; Bardella MT; Trovato C; Pometta R; Pagliarulo M; Conte D. Accuracy of ultrasonography in predicting celiac disease.

Dr. Scot Lewey is a physician who is specialty trained and board certified in the field of gastroenterology (diseases of the digestive system) who practices his specialty in Colorado. He is the physician advisor to the local Celiac Sprue support group and is a published author and researcher who is developing a web based educational program for people suffering from food intolerances, http://www.thefooddoc.com

2006-10-18T05:14:00.000-07:00

Living with Diabetes and Celiac Disease

By Gina Gardiner

Living with multiple health problems can complicate things. As a diabetic balancing the levels of carbohydrates, (starches and sugars) with the level of insulin requires thought and discipline. You should always consult your doctor and dietician for specific advice.

People with type 1 diabetes are at greater risk of developing celiac disease. It follows that they will need to manage a diet which controls both conditions. The diets do sit perfectly well together, but it needs careful planning.

In principle the same rules apply to your diet, whatever the problem. As a diabetic you need to eat a well-balanced diet. The one area of difficulty is managing your carbohydrate intake with gluten-free versions. You can find gluten-free carbohydrates in potatoes, rice, wild rice, buckwheat, maize, millet, sago, tapioca, corn flour, soya, polenta, flax, sorghum, linseed, gram flour, cargeenan, urd, channa (chickpea flour), quinoa, arrowroot, codex wheat starch, corn pasta, pure rice noodles, gluten-free pastas are available, as are gluten-free versions of bread.

The principles of planning ahead and the need to be well informed and to take control are exactly the same for celiac disease and diabetes. Confidence grows out of knowing what you can and cannot eat. Instead of tackling the conditions as two sets of restrictions, combine the needs of both. Having both diabetes and celiac disease is unfortunate but it is important to be positive and take control.

Always take a supply of suitable gluten-free carbohydrates and insulin with you. Plan ahead and involve school, friends and other organizations of your needs.

Tip! Another source of confusion is in the genetics of Celiac and gluten sensitivity. Testing for specific blood type patterns on white blood cells known as HLA DQ2 and DQ8 is increasingly be employed to determine if a person carries either of the two gene pattern present in 95-98% of Celiacs and predisposing to development of Celiac disease.

Gina Gardiner author of "Live Well Eat Well With Celiac Disease" writes from first hand experience of being a celiac. For more information go to http://www.celiacliving.com

Works as a professional life coach working with people developing their leadership skills, preparing people for promotion and supporting their ongoing development once in post. For more information contact gina.gardiner@ntlworld.com

2006-10-17T05:09:00.000-07:00

Depression And Celiac Disease

By Gina Gardiner

http://www.glutenfreehere.com

Tip! There is no treatment or cure for Celiac Disease.Except for a lifelong adherence to a strict gluten-free diet.

Depression is a condition which affects about 15% of the population. Women are more likely to be affected than men.

It is quite common for people who have been diagnosed as having Coeliac Disease to find themselves feeling depressed and anxious. For many there is a link between food and a sense of control over their lives. Celiacs are faced with something over which they feel no control.

A diagnosis of celiac disease, the restriction the new diet places upon you, and a sense of isolation created because you feel you are not able to join in with everyone else can bring on symptoms of depression.

Poor absorption of vitamins and minerals can make the celiac sufferer feel unwell, feeling depressed can be a side effect of not having the correct balance of foods which affect your mood and have a significant impact on how you are feeling emotionally. For some of you simply sticking to a strict gluten-free diet will be enough. For others, counseling and psychological support can be very helpful.

Taking control of your life, finding alternatives to foods you previously enjoyed and living with celiac disease rather than letting the condition rule your life are the key. See it as an opportunity to take control of your life, to eat better, fewer processed food, less junk food. A shopping trip is an adventure - what new gluten-free food can I find?

On a personal note I have become much more adventurous since becoming a celiac - I'll try anything once! I have extended my range of food; I can eat better and more healthily.

Gina Gardiner author of "Live Well Eat Well With Celiac Disease" writes from first hand experience of being a celiac. For more information go to http://www.celiacliving.com

The Benefits of a Gluten - and Casein - Free Diet

2006-10-16T17:55:00.000-07:00

The Benefits of a Gluten - and Casein - Free Diet

http://www.glutenfreehere.com

A Gluten Free Life. Think different, Act different, Eat different. New eBook reveals how to successfuly live with a wheat and gluten intolerance.

Research has proven the importance of a GFCF diet (gluten-free and casein-free) for many of the following conditions: Autism Spectrum Disorders, Celiac, Depression, Weight-Loss, Psoriasis, Migraines, Multiple Sclerosis, Chron's Disease, Schizophrenia, Ulcerative Colitis, Chronic Diarrhea Cystic Fibrosis.

Many individuals have problems breaking down the proteins that are in diary called caseins and the protein in wheat, oats, barley, rye and spelt flours are called gluten. Illness occurs when the incomplete breakdown of the gluten and/or casein pass the intestines as peptide chains and enter into the bloodstream passing the blood brain barrier. The incomplete breakdown actually turns into casomorphines from the casein and glutomorphines from the gluten and transforms into an opiate. Opiates can cause any or all of the following side effects: clouded mental functioning, insomnia, diarrhea, impaired social connection, blocking of pain messages, dilated pupils, inflammation on the stomach lining and depression.

It is a vicious cycle that never ends. You eat the foods that one cannot breakdown properly and the result is inflammation, leaky gut syndrome, skin disorders, depression, weight issues, behavioral and mental issues.

Take heart, there is hope. One can implement a specialized GFCF diet and assist their body in healing while removing any toxic residue from the incomplete digestion of the offending foods. In addition, the daily use of adding digestive enzymes will lighten the burden of the body in the digestion process. Don't be overwhelmed since there are so many delicious and nutritious alternatives to explore to eat. There are numerous cookbooks and local health food stores will offer gluten-free and casein-free products from snack bars, flours, deli meats, dinner dishes, breads, cakes and more. Read all the labels before consuming anything. Educate and empower yourself.
Let Food Be Thy Medicine and not Thy Poison.

GFCF diet support groups available at www.coachforhealthyliving.com.

By Nancy A. Guberti, Certified Nutritionist and Healthy Lifestyle Coach from http://www.coachforhealthyliving.com
Audio Cds available titled, “12 Steps to Promote a Healthy Lifestyle”, "Raising Children in This Toxic World" and "12 Steps for Expectant Moms".
Nancy has dedicated her life to helping others find the motivation and discipline to transform their lives into a healthy lifestyle of living. As a motivational speaker and healthy lifestyle coach she is available for seminars, coaching, and nutritional counseling. With over 15 years of corporate experience, she understands and addresses the needs of employees and the role of stress and health in their lives. The seminars are passionate, positive and powerful, producing amazing results in the employees' lives. She is affiliated with 85Broads, Holistic Moms Organization, Essential Moms and Clayton College of Natural Science. Nancy's approach is a nurturing, holistic, and natural one to heal and restore balance to achieve optimal health.

gluten free

2006-10-10T16:34:00.000-07:00

At Last! A Simple, Step-by-Step Guide Shows You How To Successfully Manage The Frustrations Of A Gluten Free Diet"

Are you are struggling with Celiac Disease and worried about consuming gluten?
Then let me tell you right now.. you can live and eat well, despite your gluten intolerance.
www.glutenfreehere.com