Sorting through Celiac Disease and Food Allergies

I had an opportunity to attend a lecture at the 92nd Street Y here in New York City entitled: "Sorting through Celiac Disease and Food Allergies". The lecture was given by the pre-eminent celiac disease specialist Dr. Peter Green and a whip-smart (and funny) team of experts: Dr. Amy R. DeFelice, a pediatric gastroenterology doc; Anna Nowak-Wegrzyn, a pediatric allergist; and Anne Roland Lee, a nutritionist.

 

What is celiac disease?

Celiac disease is an auto-immune disease: "...an inflammatory condition of the small intestine, induced by gluten. It has diverse clinical manifestations that resemble a multi-systemic disorder rather than a primary intestinal disease."

 

Gluten is a sticky protein found in wheat, rye, and barley. Though it's primarily found in food, it may also be present in everyday products such as stamp and envelope adhesive, medicines and vitamins.

 

Celiac disease, which is sometimes referred to as "non-tropical sprue," has become the new media darling of diseases. In the last two years alone, the number of gluten-free products available in the mainstream market has dramatically increased. Add to that the number of people who are getting diagnosed as gluten-intolerant, wheat allergic and/or celiac and it seems like there is a real gluten-free movement afoot.

 

Who has Celiac Disease?

The latest numbers indicate that one percent of the American population has it. Worldwide, the United States has the lowest numbers of diagnosed celiacs. Comparatively, 70 percent of Finland's population is diagnosed with celiac disease, which is why you can go into any restaurant there and order a gluten-free meal.

 

In his lecture, Dr. Green postulated that one of the main reasons the U.S. has so few diagnoses is that there are few doctors that know about the intricacies of the disease. Additionally, there is little pharmaceutical company interest in a disease that diet, not medication, can cure.

 

What are the symptoms of celiac?

From Dr. Green's website: "The vast majority of individuals with celiac disease have little in the way of gastrointestinal symptoms or have symptoms that may receive a diagnosis of irritable bowel syndrome. While the classical symptoms include diarrhea, weight loss and edema, other patients may present with constipation, anemia, bone pain or bone loss, chronic fatigue, skin problems, abnormal liver chemistries, dental enamel defects and neurological symptoms such as peripheral neuropathy, ataxia or seizures. Some patients with celiac disease are truly asymptomatic or have symptoms related to an associated autoimmune problem."

 

How do you find out if you have celiac disease? According to Dr. Green, the "gold standard" diagnosis is through an endoscopic exam, which includes a small intestine biopsy.

 

Dr. Green acknowledged that no test is 100 percent perfect and even negative blood tests and biopsies can miss celiac disease. So if you suspect you have celiac, and your tests have come back negative but you still have symptoms like the ones listed above, go on a gluten-free diet. If that clears up your symptoms, it's a good indication of your diagnosis. However, as the gluten-free diet is restrictive and a LIFELONG commitment he recommends first getting as much medical testing done to get a proper diagnosis versus going on a gluten-free diet to start.