Gluten Intolerance (Celiac Disease) on the Rise after Weight-Loss Surgery
During my recent colonoscopy, the gastroenterologist found celiac sprue in my bowel. There was not enough presented to definitively diagnose me with celiac, and my gastroenterologist said it looked as if I were "either coming out of or entering into celiac." As I do not eat grains my ingestion of gluten is very low; therefore this skews the results and makes it difficult for even a specialist to pinpoint what is going on.
Whether I have celiac disease or gluten intolerance remains to be proven by further tests. In the meantime, I will take the safe approach and act as if I do. The treatment protocol is the same, either way: don't eat gluten-containing products.
Aside from the need to eat gluten-free, I had little knowledge of the disease. So I set about to educate myself. My most pressing question: Why did I develop celiac disease now?
Now, when I am eating fresh from-the-farm, locally grown and raised organic food...
Now, when I am in my forties.
It would have made more sense to me had I developed celiac disease before I had bariatric surgery and turned my health around. My former self lived on processed foods. I was, in fact, a proccessed food junkie.
Understanding Celiac Disease
Celiac disease is an autoimmune illness affecting about one in 133 Americans. Gluten is commonly found in wheat, rye, barley, most oats and all products made from or with them - it is found in virtually every processed food unless labeled as gluten-free. Gluten also is hidden many foods such as soy sauce, malt vinegar, beer, some liquor and other obscure food items. Some people may be born with celiac disease (genetic cause), while others acquire the condition later in life (acquired).
Read: Food that Contain GlutenMayo Clinic describes celiac disease as follows: Normally, your small intestine is lined with tiny, hair-like projections called villi. Resembling the deep pile of a plush carpet on a microscopic scale, villi work to absorb vitamins, minerals and other nutrients from the food you eat. Celiac disease results in damage to the villi. Without prominent villi, the inner surface of the small intestine becomes less like a plush carpet and more like a tile floor, and** your body is unable to absorb nutrients necessary for health and growth**. Instead, nutrients such as fat, protein, vitamins and minerals are eliminated with your stool.
**Causes of Acquired Celiac Diseasluten Intolerance after Bariatric Weight-Loss Surger **
Celiac disease may as a consequence of surgery, including weight-loss surgery. According to Mayo Clinic, while the exact cause is unknown, it is suspected that the trauma caused by surgery may lead to the body having an abnormal immune response to eating gluten.
Terry Simpson, MD, a bariatric surgeon, claims surgeons have discovered a high incidence of celiac disease in patients who had undergone gastric bypass surgery. It is assumed that since bariatric surgeons had bypassed the traditional area for gluten breakdown in the small bowel, that the protein being seen further down began a process of an acquired celiac disease.
Environmental Factors Examined in Celiac Disease
A study published in the Annals of Internal Medicine and led by the University of Maryland School of Medicine Center for Celiac Research, found that the incidence of celiac disease has doubled every 15 years since 1974 and that the incidence increased as subjects aged.
Peter H.R. Green, MD, director of the Celiac Center at Columbia University, New York City, believes that the enhanced amounts of gluten in our diets and, especially, the excess exposure to heavily processed forms of gluten may contribute to the increasing rates of celiac disease.
So... Why Did I Develop Celiac Disease Now?
Based on my research, which is distilled above, my non-professional conclusion is that the combinations of these factors caused me to acquire celiac disease in my forties:
- **First, my decades of living life as a processed food junkie resulted in excess exposure to heavily processed forms of gluten.
*** ** Later, the gastric bypass weight-loss surgery that I had in 2003 led to my body having an abnormal immune response to eating gluten.**
Whether this abnormal immune response was caused by the trauma from the surgery as suggested by Mayo Clinic or, as Dr. Simpson claims, as a consequence of bypassing the part of the intestine in which gluten is broken down, remains to be proven by the numerous studies underway. I look forward to the results of these studies and will keep you posted as I learn more.
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USA Today http://usatoday30.usatoday.com/yourlife/health/medical/conditions/2010-09-27-celiac27_ST_N.htm
Mayo Clinic http://www.mayoclinic.com/health/celiac-disease/DS00319/DSECTION=causes
Annals of Internal Medicine http://annals.org/article.aspx?articleid=718218
Gastroenterology & Endoscopic News http://www.gastroendonews.com/ViewArticle.aspx?d=In+the+News&d_id=187&i=November+2011&i_id=789&a_id=19710
Talk About Gluten http://skepchick.org/2011/09/lets-talk-about-gluten/