Issue link: http://www.wacmagazine.com/i/721677
SEPTEMBER / OCTOBER 2016 | Washington Athletic Club Magazine | 33 CELIAC DISEASE Celiac disease is an autoimmune disorder affecting primarily the small intestine that occurs in people with a genetic predisposition. It is an inflammatory reaction that results in a shortening of the intestinal villi, the finger-like projections that line our intestinal walls and are responsible for nutrient absorption. Typical symptoms include gastrointestinal problems, such as chronic diarrhea, abdominal bloating and pain, malabsorption, constipation, loss of appetite, and in children a failure to thrive. Estimates show that three million people in the U.S. live with celiac disease and that 97 percent of those cases are still undiagnosed. e traditional diagnosis process for celiac disease is a blood test for specific antibodies. If found, the final step is to biopsy the small intestine to see if the intestinal villi are destroyed. If they are totally atrophied and unable to perform their nutrient-absorption function any longer, then you have celiac disease. ere are a couple of problems with this diagnostic approach, however. First and foremost, the standard antibody blood test only has the capacity to reliably identify celiac disease at its final stage of intestinal deterioration. So someone with celiac disease whose villi are in the process of atrophy—but are still functioning to some degree—will not necessarily test positive. Because of this, celiac disease can often take six or more years to diagnose. In response, a better test of a broader antibody panel has recently been developed. is test can identify celiac earlier and in turn prevent further intestinal deterioration, reduce medical costs, and even extend lives. GLUTEN SENSITIVITY e most recognized manifestation of gluten sensitivity is celiac disease. Many people, however, experience adverse reactions to gluten but never develop the disease. In fact, some estimates show that seven out of 10 people in the U.S. and Europe have some form of gluten sensitivity. Symptoms can include migraines, iron deficiency, seizures, infertility, canker sores, skin rashes, fatigue, bone or joint pain, arthritis, depression, anxiety, ADHD, dental enamel defects, asthma, and muscle pain. Because gluten sensitivity can affect so many systems of the body, it can be hard to identify. People may have severe symptoms and be investigated for years before a diagnosis is achieved. Often, patients and doctors aren't looking for gluten sensitivity and tend to address any number of other causes for the symptoms experienced. TIME TO ACT If you're concerned you might have gluten sensitivity, talk to your doctor about testing options. It's critical that our healthcare system begin to make a concerted effort to educate doctors and the public about gluten sensitivity. Patients play an important role in asking for the care they want. Autoimmune diseases are 10 times more common in people with intestinal gluten sensitivity than in the general population. Moreover, studies show that people with asthma, Crohn's disease, or colitis are more likely to die early if they also have gluten sensitivity. Although the exact mechanism is not yet known, it looks as if gluten may cause affected people's immune systems to attack their own tissues. Traditionally, doctors haven't recognized this connection and wait for enough accumulated damage—to the thyroid, brain, skin or other organs—and associated symptoms before diagnosing an autoimmune disease such as celiac, Hashimoto's thyroiditis, Type 1 diabetes, systemic lupus, inflammatory bowel disease, or any number of other issues. Earlier identification of gluten sensitivity can result in earlier and better treatment, improved quality of life, and a superior prognosis. " Estimates show that three million people in the U.S. live with celiac disease and that 97 percent of those cases are still undiagnosed." Dr. Tom O'Bryan is an internationally recognized speaker and workshop leader specializing in the complications of non-celiac gluten sensitivity, celiac disease, and autoimmune diseases as they occur inside and outside of the intestines. Learn more at thedr.com and theglutensummit.com.