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| | | From: Rene (Original Message) | Sent: 4/7/2005 6:26 PM |
Against the Grain: Finding Silent Celiac Disease by Christine Haran Until recently, celiac disease has been considered a children's disorder marked only by gastrointestinal (GI) problems. But more and more adults, including those without GI problems, are being diagnosed with this autoimmune disorder, which is trigged by eating wheat, rye and barley. An understanding of the links between celiac disease, also known as celiac sprue, and associated conditions, such as osteoporosis, is helping doctors identify more people with celiac disease. Worked-up by Wheat
In people who are genetically susceptible to this disorder, celiac disease is triggered by a protein component in wheat called gluten. Similar proteins in rye and barley can also set off celiac disease in this group of people. "Basically, there is an immune response to the gluten proteins, which eventually leads to inflammation and damage to the villi in the small intestine," explains Armin Adaedini, PhD, an assistant professor of neuroscience at Weill Cornell Medical College of Cornell University. Millions of these finger-like villi line the small intestine and play an important role in absorbing nutrients in food. It's not exactly clear how the wheat gluten, which never gets fully digested in anyone, enters the lining of the small intestine, provoking the reaction. It may occur when someone has a gastrointestinal infection; GI infections have been found to increase risk of the development of celiac disease in children. (Breastfeeding, however, has been found to protect children from celiac disease.) Once the immune system reacts to the gluten in the gut lining, it produces antibodies that mistakenly attack the lining of the small intestines, contributing to inflammation and the wearing away of the villi. Not everyone who reacts to wheat has celiac disease, however. People with irritable bowel syndrome, who may have trouble tolerating a lot of grains, may have similar symptoms. And celiac disease should not be confused with a wheat allergy, which will produce allergic reactions that can range from hives and a rash to life-threatening anaphylactic shock. When Should You Suspect Celiac Disease?
In adults and children, the villi damage caused by celiac disease can lead to symptoms such as abdominal pain, diarrhea, pale, foul-smelling stool, weight loss and weakness. Some people may develop an itchy, blistering rash called dermatitis herpetiformis. And irritability and depression may be seen in people with celiac disease. One reason the celiac disease diagnosis is challenging, however, is that the vague GI symptoms can also be caused by a number of other intestinal conditions, including irritable bowel syndrome, gastric ulcers and Crohn's disease. Celiac disease can also lead to long-term problems. Because the small intestines are no longer able to absorb needed nutrients from food, over time people can suffer from vitamin and mineral deficiencies. And in children, malabsorption can lead to growth problems. The one thing about celiac disease that is clear is that it affects people to varying degrees. "Some people can be critically ill with severe malabsorption, and others can be completely well," says Peter Green, MD, director of the Celiac Disease Center at Columbia University. "So there's an enormous spectrum, and we don't know why one person can nearly die and another person is without symptoms." Today, more and more people who do not have the "classic" GI symptoms of celiac disease are being diagnosed because they have conditions that arise from nutrient deficiencies. For example, if you don't absorb iron, you may develop anemia, and if you're not absorbing calcium, you might develop the bone thinning disease osteoporosis. New research confirms that people with osteoporosis are at very high risk for celiac disease and vice versa. A study published in February in the Archives of Internal Medicine found that all patients with osteoporosis should be screened for celiac disease, though the editorial suggested that more research is needed. In the study of 840 people, 12 of 266 participants with osteoporosis and 6 of the 574 people without the disease had celiac disease. In other words, celiac disease occurred in 3.4 percent of people with osteoporosis versus 0.2 percent of people without osteoporosis. Other people who are now considered at high risk for celiac disease are those with other associated disorders, including hormonal diseases such type 1 diabetes, thyroid disease and some reproductive disorders in women. The connection between celiac disease and these conditions is not well understood, but there may be a genetic link. Certain neurological conditions, such epilepsy, migraine headaches and peripheral neuropathy, which causes tingling in the hands and feet, are also associated with celiac disease for unknown reasons. Likewise, certain cancers are also somehow linked to celiac disease. For example, people with celiac disease are at increased risk for non-Hodgkin's lymphoma, small-intestine adenocarcinoma and esophageal cancer. A gluten-free diet seems to protect people with celiac disease from these cancers. Another group at high risk for celiac disease is the first-degree relatives of people with celiac disease. According to National Digestive Diseases Information Clearinghouse, you have a 10 percent chance of having celiac disease if someone if your immediate family has it. Celiac disease is thought to be most common in Caucasian people, and people of Asian or African origin are considered to be at a lower risk. But Dr. Adaedini observed that celiac disease needs to be studied more carefully in these populations. Delving into Diagnosis
To detect celiac disease, doctors give a blood test that looks for anti-transglutaminase antibodies or anti-endometrial antibodies, which people with celiac disease produce as part of their autoimmune response to the wheat gluten protein. If the test is positive—or if the test is negative but your symptoms strongly suggest celiac disease—you should undergo an intestinal biopsy, in which a piece of the intestine is removed and studied under the microscope to look for signs of celiac disease-related damage. But a diagnosis of celiac disease is not final until someone responds well to a gluten-free diet, which reverses villi damage; the diet is currently the only way to treat celiac disease, though some people may go on steroids to reduce inflammation if diet by itself does not improve symptoms. In some cases, people will try a gluten-free diet instead of undergoing an intestinal biopsy. If you go on a gluten-free diet and symptoms subside with 6 to 12 months, you probably have celiac disease. Getting on the Gluten-free Diet
The gluten-free diet involves avoiding anything that contains wheat, rye or barley, so that includes many pastas, grains and cereals. To obtain carbohydrates, people with celiac disease might substitute with rice, quinoa, corn, buckwheat and potatoes. Dr. Adaedini warns that wheat gluten may lurk in many foods you would not expect to contain it, such as some salad dressings, yogurt drinks, soy sauces, certain medications, mouthwash and processed foods. It's not easy to stick with a gluten-free diet, but a dietician can help you plan your meals so that you get relief from most of your symptoms. "A lot of the problems that are directly related to the damage to the intestine go away," Dr. Adaedini says, "but, currently, it doesn't seem that a gluten-free diet has a big effect on some of the other problems, such as the neurological symptoms, or the associated autoimmune disorders." Still, if you are suffering from GI discomfort or have an associated condition, getting tested for celiac disease might help your body get the nutrition it needs—and help restore your health.  Copyright © 2005 ABC News
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| | | From: Rene | Sent: 4/12/2005 5:27 PM |
This little excerpt appeared in a much longer article Allergic to what? Imagine waiting 12 years to be diagnosed with a disease. That's what happens to many people who suffer from celiac disease, a disorder that makes them allergic to gluten, a protein found in wheat and other grains. Although an estimated 1 in 150 Americans have celiac disease, doctors aren't likely to test for it, says Dr. Alessio Fasano, co-director of the University of Maryland Center for Celiac Research. Celiac sufferers cannot digest gluten, found in bread, beer, some salad dressings and the backing of sticky items like stamps and labels. Symptoms include bloating, diarrhea and abdominal pain. Celiac disease prevents the absorption of some nutrients and can cause cancer, Fasano says. What this means to you: Celiac disease makes itself known in peculiar ways in women, Fasano says. Signs include recurrent spontaneous abortions, depression, mood swings and chronic fatigue. If you suspect you might have celiac disease, ask your doctor to run the tests, which costs $120 to $150 and may be covered by your health insurance. "We didn't used to [run tests] because the disease was considered rare, but now we know it's not," Fasano says. http://lifestyle.sympatico.msn.ca/FoodandNutrition/Articles/Tomato+Talk.htm |
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| | | From: Rene | Sent: 7/18/2007 7:04 PM |
Another Reason to Eat Less Bread May 7, 2007:- It's often hard to pin down just what's causing common gastrointestinal complaints such as gas, bloating, diarrhea or abdominal pain. Add to that some fatigue and a vague sense of not feeling quite right, and what do you have? Possibly gluten intolerance -- an intolerance of a protein (gluten) in wheat, barley and rye, suggests Daily Health News consulting medical editor, Andrew L. Rubman, ND. In his experience, some degree of gluten intolerance is virtually pandemic in the population, and commonly under-diagnosed. GLUTEN SENSITIVITY RANGES FROM MILD TO SEVERE Gluten intolerance is actually a condition encompassing a variety of symptoms. In people with this condition, gluten causes some degree of change in the mucosal tissue lining the small intestine, says Dr. Rubman. Severity of symptoms relates directly to the degree of that change... when it reaches a certain threshold, most people start looking for something to blame. Quite often, when the severity of gluten intolerance progresses beyond a certain point of frequency, duration and intensity, it is called celiac disease. Celiac disease affects one in 133 Americans, damaging their small intestine and causing lasting problems with nutrient absorption (for more on celiac disease, see Daily Health News article from February 5, 2004 [http://link.dhn.bottomlinesecrets.com/h/X0OA/M37Z/YT/8746P]. Other reactions that may be associated with gluten intolerance include discomfort that is mild and fleeting, such as cramps or a feeling of uncomfortable fullness... sudden mid-meal bloat... chronic diarrhea. When people go to the doctor complaining of these problems -- especially those on the milder end of the spectrum -- it may be very difficult to diagnose the cause, since mild gluten sensitivities don't always show up on blood tests. Physicians may explain the symptoms away as a by-product of the passing years, anxiety or hereditary digestive difficulties. Typically medications are prescribed, including OTC remedies for gas or diarrhea -- so the problem gets mistreated, and the cycle continues, usually getting worse. Complicating matters further, symptoms are not always gastrointestinal, notes Dr. Rubman. Regular readers of Daily Health News know that he believes digestion has an enormous impact on the body's overall functioning. In this case, gluten intolerance may manifest itself in intestinal symptoms -- and/or in subtle ways elsewhere in the body. Possible intestinal symptoms of gluten intolerance are abdominal pain... bloating... gas... diarrhea... constipation... changes in appetite... nausea... vomiting... lactose intolerance... unexplained weight loss... and bloody, fatty or foul-smelling stools. As the problem persists, these symptoms may become chronic. Possible non-intestinal symptoms include fatigue... depression... irritability... bone and joint pain... and behavioral changes. There may be skin problems, such as dermatitis herpetiformis, causing unattractive, uncomfortable rashes and water blister eruptions. Some hair loss is another possibility. Some suspect wheat proteins may be involved in degenerative diseases like MS, just as diet also plays a role in autoimmune diseases such as diabetes. Often triggered by a period of high stress, many people experience a sudden realization that the discomfort they've been living with is not necessarily "normal," leading them to look for the cause of their misery. GOING AGAINST THE GRAIN People diagnosed with celiac disease must maintain a gluten-free diet for the rest of their lives to allow the small intestine to heal and function efficiently once again. For those with a mild form of gluten intolerance, abstention isn't necessary, but moderating your intake is, says Dr. Rubman. And, he adds, cutting back on gluten is something we can all benefit from. People with mild gluten intolerance suffer intestinal damage to a certain degree, and often times reducing gluten, rather than eliminating it, may be protective enough. However, this needs to be closely monitored by a physician. Admittedly, this is easier said than done, since foods that contain gluten are all around us, in products such as bread, cereal, pasta, pizza, cookies, cake and pies. Even more insidious is the fact that many processed foods -- such as cold cuts, soy sauce, salad dressings, frozen yogurt and licorice -- also contain gluten, and gluten content is not required on labels in the US. A consumer's best bet may be to look for products that are specifically marked as "gluten-free." And -- gluten is found in some medications (as an additive) so people should ask their pharmacist about any medications they are taking as well. I know from experience, however, that cutting back substantially on gluten is doable and the results are worth the effort. WHAT YOU CAN DO If you frequently experience uncomfortable symptoms such as stomach upset, gas, irritability and fatigue, consider that the cause may be gluten intolerance. Stop eating all foods that contain wheat, barley or rye for 10 days, advises Dr. Rubman. Instead, choose naturally gluten-free alternatives such as potatoes or rice, or grains such as amaranth, buckwheat and quinoa. Additionally, make it a point to consume more whole, fresh foods and fewer processed products. As time goes on and your digestion improves, you'll be amazed at how much better you feel, says Dr. Rubman. Not only will your intestinal symptoms diminish, you may also enjoy a better mood, experience more productive workouts... and better nutrient absorption may be protective of eyesight and strengthen your immunity. If you don't have celiac disease, it's fine to slowly reincorporate two or three weekly servings of gluten back into the diet, enjoying foods such as pasta, cereal and sandwiches in moderation. Adds Dr. Rubman, "Even if you don't think you experience any of these symptoms, you'll benefit from reducing gluten in your diet." Try it -- you might like it. Note: People with severe symptoms that suggest celiac disease, including those with symptoms of IBS, bloating, and appetite issues should consult their health-care providers before removing gluten from their diet. Otherwise, they may inadvertently cover up symptoms and further complicate later diagnosis by avoiding prompt medical care and diagnosis. Be well, Carole Jackson ; Bottom Line's Daily Health News Source(s): Andrew L. Rubman, ND, director, Southbury Clinic for Traditional Medicines, Southbury, CT. National Digestive Diseases Information Clearinghouse, [http://digestive.niddk.nih.gov] |
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| | | From: Rene | Sent: 7/27/2007 5:48 PM |
For the Gluten-Averse, a Menu That Works
By JENNIFER ROMOLINI
July 25, 2007:- JOSEPH PACE’S rice-centered Risotteria, in Greenwich Village, was never what would be called an experimental restaurant, until he began developing a special gluten-free menu. It started with a gluten-free cookie. A simple step, it might seem, but gluten, a protein in wheat, barley and rye, gives baked goods elasticity. Without it, cakes, breads and pastries can be leaden, dry and crumbly. “It took more than 40 dozen batches,�?he said. “My background in organic chemistry definitely helped.�?/DIV> The work paid off. Risotteria is a nationally known hub for people with celiac disease, an autoimmune disorder affecting about 1 in 100 Americans that can cause serious problems if even a bit of gluten is ingested. Visitors frequently arrive at the restaurant straight from the airport, suitcases in tow, and dinner can seem like a celiac support group as regulars swivel in their chairs to talk about their hunt for food they can eat. On a recent Tuesday night at Mr. Pace’s restaurant a preppy couple asked the people at the next table about the Sicilian pizza they were trying from the specials list. Farther down the packed, narrow space, diners exchanged guidebooks to gluten-free restaurants, and compliments flew around the room about the breadsticks; the light beer, made from sorghum instead of malted barley; and the rich brownies and cookies. At the door a leather-jacketed couple discussed menu options and waited impatiently to get in. “Are you going to get the gluten-free pizza?�?the woman asked. “Of course,�?her companion replied. “You have to understand, this is like a chance of a lifetime for me.�?/DIV> Like Mr. Pace, a growing number of restaurateurs have decided it’s worth catering to the gluten-free crowd. Chains like Outback Steakhouse and P. F. Chang’s now offer dishes without gluten. New bakeries and pizzerias have popped up all over New York City, and restaurants that were already celiac-friendly have expanded their menus. There’s vegan at Candle 79, fusion food at Asia de Cuba, Italian at Sambuca, Greek at Gus�?Place and comfort food at Peters�?Gourmet Diner �?all gluten-free.
Gluten-averse diners avidly track such sympathetic places with online help from glutenfreerestaurants.org and the tribe of celiac blogs that include, in New York, Gluten-free NYC (glutenfreenyc.blogspot.com), Gluten Free Guide (glutenguide.blogspot.com) and Please Don’t Pass the Nuts (allergicgirl.blogspot.com). Aside from safe food, they can find a camaraderie that’s unusual on New York’s jaded dining scene.
The pleasures of dining out are often denied people who avoid gluten because they are sensitive to it or have celiac disease. Menus are a source of anxiety and self-consciousness because �?besides its presence in obvious culprits like bread, sauce thickeners, pasta and desserts �?gluten also lurks in soy sauce, brewer’s yeast, bourbon, vegetable starch, vinegars, salad dressings, processed cheeses and some spices.
Creating a gluten-free menu is more difficult than, say, offering vegetarian options at a steakhouse. Chefs have to master special techniques and follow stringent regulations. Mr. Pace said each menu item �?pizza, focaccia, breadsticks, cakes �?took six months to develop, with the ingredients costing nearly five times as much as conventional ones. Baking can be tricky without gluten, which creates a lattice of air pockets that binds doughs and batters while giving a moist, supple texture. To overcome the challenge, chefs turn to additives like xanthan gum to bind the flour together, guar gum to thicken and stabilize doughs and batters, and gelatin powder to moisten them. Breads are baked at very high temperatures to keep crusts crisp and insides soft. While gluten-free dining is spreading in the United States, Dr. Peter H. R. Green, director of the Celiac Disease Center at Columbia University, said it is more common elsewhere in the world. “In Buenos Aires,�?Dr. Green said, “you’d have little trouble getting a gluten-free ice cream cone. In Helsinki you can order a gluten-free Big Mac at McDonald’s. In Dublin most menus are clearly marked ‘Safe for celiacs.�?This is the way to live a normal existence with this disease. In a city as big as New York, for there to be so few safe restaurants, that’s just really bad.�?/DIV> Cooking gluten-free isn’t an entirely altruistic act by chefs. A new base of customers can attract big business to a fledging location or revive an established spot. “I’ve definitely seen a spike in business,�?said Anthony Avellino, owner of Bistango, a 16-year-old Italian restaurant in Murray Hill. Mr. Avellino recently added dishes made with Tinkyada brown rice pasta, and dishes from Everybody Eats bakery in Brooklyn like celiac-safe bruschetta, served on gluten-free bread, and after-dinner biscotti. “When you’re a neighborhood place like we are, it’s always nice to see new customers and fresh faces,�?he said. In February Gourmet Land, a Chinese restaurant on the Upper East Side, opened with a menu including a separate 50-item gluten-free listing with items like soy sauce and other sauces made without wheat, crisp cheng du chicken breaded with cornstarch instead of flour, and gluten-free egg rolls rolled in ... well, egg. The place has been packed nearly every night since its opening, no small feat for a neighborhood Chinese restaurant in Manhattan. Many customers, of course, have celiac disease. “They’ve had meet-ups here, and honestly, some nights every table in the restaurant is someone who’s celiac,�?said the manager, Laura DeAngelis. Anne Roland Lee, the nutritionist at the Columbia Celiac Disease Center, said that finding gluten-free menus can be a great relief. “I’ve had patients go to some of the city’s most famous restaurants,�?she said, “only to leave after being told they could only safely have a Coke.�?/DIV> Catherine Oddenino, a 29-year-old Manhattan marketing manager with celiac disease, which can cause serious digestive problems, anemia and nutritional deficiencies, knows the frustration. “I’ve been to so many places where the managers and waiters have been irritated and annoyed,�?Ms. Oddenino said. “Too often, they don’t understand the gravity of the situation. Last year I had to go to a work holiday dinner at an upscale restaurant. I called ahead and triple-checked what I could and couldn’t eat with the management and still wound up with a huge crouton at the bottom of my salad. It’s extremely frustrating.�?/DIV> For those who don’t have celiac disease, though, the gluten-free restaurant experience can be a bit odd. “It felt a little cultish,�?said Ridge Carpenter, a Manhattan waiter and student who worked at Risotteria briefly in 2005. “And as a server, there was so much pressure to get everything right. In a regular restaurant you’d get the occasional allergy you had to be careful about, but this was around 75 percent of my customers. It was really stressful.�?/DIV> The experience can also be a strain on celiac-nonceliac relationships. Kelly Courson, 36, a receptionist at an investment firm in Midtown and a founder of a popular blog, celiacchicks.com, dines exclusively gluten-free, sometimes to the chagrin of her boyfriend, John Mountain. “He’s always rolling his eyes when I talk to the other tables,�?Ms. Courson said. “But I can understand how it can be a little annoying: we’ll have dinner at Sambuca on Thursday night and see the same people at brunch at Peters�?Gourmet Diner on Sunday.�?/DIV> But Ms. Lee called gluten-free restaurants “a surrogate support group.�?/DIV> “When everyone is on the same page, and you know you’re going to eat a meal safely,�?she said, “you can finally relax and just be social.�?/DIV>
From NYTimes.com
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| | | From: Rene | Sent: 9/3/2008 6:46 PM |
The Gluten Syndrome Part 8 - Millions Restored to Health by Dr. Rodney Ford, MBBS, FRACP Millions affected
There are millions of people badly affected by gluten but completely unaware of this. The big question is, how long will it take for the medical establishment to recognize and start testing for this gluten epidemic? Can a food cause harm?
I challenge my colleagues to seriously and openly examine the facts about gluten reactions (including coeliac disease). There is no key pharmaceutical company championing the cause of gluten, moreover medical skepticism remains high whenever foods are implicated as the possible cause of disease. Scientific truth often flies in the face of tradition, and so I fear that the gluten problem will continue to be ignored, or even suppressed, for a long time yet. Blinkered eyes
Unfortunately, the results of the crucial IgG-gliadin blood test have been examined with blinkered eyes, and its relevance overlooked. This narrow focus has led to a search for a diagnostic test for coeliac disease without stopping to think about what the gluten blood tests really mean in the wider clinical context. The tTG test is highly predictive for coeliac disease, however the IgG-gliadin test is not. Bad behaviour on gluten
Kimberley is 12 years old. She has The Gluten Syndrome and her behaviour gets disturbed with gluten. She does not have coeliac disease but she does have a high gluten test (her IgG-gliadin level was 55 units �?should be less than 20). Her mum said: "It is interesting about how behaviour troubles are linked to gluten! Our youngest, Kimberley, is now 12 years old. She had her IgG-gliadin measured and it was high. She was clearly a lot better when she was off gluten. However then she decided to 'try' gluten again. Rodney suggested a small amount but she went for it - big time!" By the end of a week, two other parents had asked what was wrong with her. Another parent asked "what on earth's the matter with her" she seemed so different and stroppy. She admitted she felt "absolutely awful" but really didn’t want to admit it as she knew it meant she'd have to completely give up gluten." Anyway, after a lot of talking, she agreed it wasn't in her best interests to eat gluten. From that day she has been GF ever since, with the odd very long envious glance at French bread! With our support she’s very compliant with being GF now, which I think is remarkable for her age. Clearly she now understands and gets the benefits of GF. But I was really shocked at how affected her behaviour was after a reintroduction of gluten." Global movement
A strong gluten-free movement is developing globally in response to the knowledge that going gluten-free can be so beneficial to so many people. What has been missing up until now is a name that captures the gluten problem. The missing name is The Gluten Syndrome. Could you have The Gluten Syndrome?
One in every ten people is affected by gluten. If you have chronic symptom (feeling sick, tired and grumpy) then you should get checked for The Gluten Syndrome.
ABOUT THE AUTHOR
DR. RODNEY FORD is a Pediatric Gastroenterologist, Allergist and Nutrition Consultant. He was Associate Professor of Pediatrics at the Christchurch School of Medicine, University of Otago. He runs a busy Children’s Gastroenterology and Allergy Clinic in Christchurch, New Zealand. He has written over a hundred scientific papers including book chapters and books. This includes a series of seven books on gluten. He has been studying the gluten problem for over 15 years and has found that symptoms from gluten arise from brain and nerve damage. His books in the gluten series are: Are You Gluten Sensitive? Your Questions Answered; The Book for the Sick, Tired and Grumpy (Gluten-Free Kids); Full Of It! The Shocking Truth About Gluten (The Brain-Grain Connection); Gluten-Free Parties and Picnics (full color for children); and The Gluten Syndrome: Is Wheat Causing You Harm? Much more information and these books are available at the website [www.doctorgluten.com]. In the USA, books can also be purchased from [www.celiac.com] From: [http://www.childrenofthenewearth.com/free.php?page=articles_free/ford_rodney/article8] |
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