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Wheat
Feb 14, 2009 10:40:51 GMT -7
Post by Rene on Feb 14, 2009 10:40:51 GMT -7
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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Wheat
Feb 14, 2009 10:42:08 GMT -7
Post by Rene on Feb 14, 2009 10:42:08 GMT -7
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.
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Wheat
Feb 14, 2009 10:43:50 GMT -7
Post by Rene on Feb 14, 2009 10:43:50 GMT -7
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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Wheat
Feb 14, 2009 10:45:54 GMT -7
Post by Rene on Feb 14, 2009 10:45:54 GMT -7
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.”
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.”
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.”
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.”
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.”
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.”
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.”
But Ms. Lee called gluten-free restaurants “a surrogate support group.”
“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.”
From NYTimes.com
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Wheat
Feb 14, 2009 10:47:21 GMT -7
Post by Rene on Feb 14, 2009 10:47:21 GMT -7
What’s Wrong With Wheat?
By Sally Lehrman
Cynthia Kupper didn’t know what was wrong, but she was pretty sure it was killing her. She had lost 40 pounds and felt exhausted all the time. She winced at the touch of a hand and had trouble walking. She hardly dared to eat because it meant running in and out of the bathroom for the rest of the day. “I looked like I was about to die and I felt like it, too,” says Kupper, a dietitian in Seattle.
After two years of pressing her family doctor for answers, she had turned up nothing but frustration. “He invited me to take a vacation on the mental health ward, he accused me of anorexia, and he tried to put me on antidepressants,” Kupper says. He finally agreed to a blood analysis, and the results came back the day Kupper landed in a hospital bed. Her small intestine had partially closed off after she ate lunch and her abdomen was swelling with pain. The blood test, combined with an intestinal biopsy, showed she had something she’d heard of but never imagined she would come down with: celiac disease.
Every time she ate anything containing wheat—that beautiful, wholesome food, those “amber waves of grain”—her body responded as if it were poison. Indeed, experts are increasingly coming to view wheat as the culprit behind all sorts of common health problems, from asthma to eczema to indigestion. Five to seven million people may suffer from mild to moderate intolerance to gluten (a protein in wheat as well as barley and rye), while a landmark study last spring indicated that more than two million Americans have full-blown celiac disease, the most severe form of the intolerance. (See box below regarding yet another problem, wheat allergies.)
Many sufferers, however, have no idea what the problem is—and neither do most physicians. While doctors in Europe are familiar with gluten sensitivity and celiac, the conventional wisdom here has long been that these ailments are extremely rare. That helps explain why it takes an average of 11 years for a celiac patient to get a correct diagnosis. People with milder forms may never find out what’s ailing them.
That can spell big trouble, because left to itself, celiac disease is likely to get worse, which can raise the risk of major health problems like osteoporosis, infertility, nerve damage, diabetes, and even intestinal cancer.
How is it that such an innocuous-seeming food, a staple found in everything from biscuits to beer, could cause such problems? The cultivation of grains like wheat, after all, helped contribute to the rise of civilization.
But humans may never have fully adapted to the major role wheat plays in our diet today, experts say.
“Nobody needs wheat,” says Stefano Guandalini, a gastroenterologist and director of the University of Chicago Celiac Disease Program. Its sterling reputation notwithstanding, it offers little of nutritional value that you can’t get from other sources. “I love my bread; I eat pizza and spaghetti on an almost daily basis,” he says. “But that’s because I’m Italian, not because it’s necessary in my diet.”
For some people wheat is worse than unnecessary; it’s an actual irritant. In a research paper, Mayo Clinic gastroenterologist Joseph Murray describes celiac disease as “an evolutionary collision between the cultivation of wheat and the immune system.” Certain people have inherited an especially vigilant immune system that does not identify gluten as a digestible molecule. Instead their cells attack the invader and turn on the intestine, too.
For some people, the first sign of a problem may not be digestive symptoms like those Kupper experienced but an itchy rash that erupts when they eat wheat. Others may suffer from tingling hands and difficulty walking. Still others go along with no noticeable symptoms until surgery, an illness, or some other form of stress triggers full-blown celiac disease.
Just what goes wrong? Normally, the inside of an intestine looks like a shag rug, its lining studded with tall, thin projections, called villi, that absorb nutrients. But as the assault by immune cells continues, the surface flattens to look more like linoleum, making the absorption of nutrients extremely difficult.
Short term, the effects can be merely miserable: diarrhea, constipation, cramping, bloating, weight loss, and fatigue. The long-term harm can be quite serious. Osteoporosis can develop, for instance, when the body is unable to absorb sufficient calcium; extreme weight loss can make women infertile; and chronic inflammation can trigger nerve damage and raise the risk of intestinal cancer.
University of Maryland physician Alessio Fasano first began to wonder if celiac was more common than his American colleagues believed after he moved here from Italy about a decade ago. He knew the gene for susceptibility was here, since one-third of people of European ancestry carry it. “It didn’t make sense that the disease wouldn’t be here,” he says. “I was very suspicious.”
The landmark study he coauthored last spring proved his suspicions correct. After analyzing blood samples from more than 13,000 people in 32 states, he concluded that about one in every 133 Americans has celiac.
That’s the bad news. The good news is that it’s getting easier to get to the root of the problem, particularly if you work with alternative practitioners. “They were visionary in seeing this coming,” says Fasano. “They got this long before traditional medicine understood it.”
It’s not surprising, says Jamey Wallace, a naturopath and clinic medical director for the Bastyr Center for Natural Health, in Seattle; alternative practitioners are accustomed to looking first to diet when responding to all sorts of complaints. “For thousands of years, Chinese medicine has held that all health revolves around the digestive tract,” he says. And a big part of alternative medicine involves helping people adjust their lifestyles to deal with chronic conditions.
Whether you suspect your problem with wheat is major or minor, you’re faced with the same choice about how to diagnose and treat it. Some practitioners may want to test you for sensitivity by putting you on a wheat-free diet right away. But before you throw out your noodles and pancake mix, you may want to get a blood test to check for celiac first. The screening will be accurate only after gluten has been in your system for some time. So anyone who has been off wheat for a while would have to go back on it for at least two months for the test results to be valid. A biopsy to check the small intestine for injury must confirm the diagnosis.
Guandalini strongly urges anyone who is thinking about cutting wheat from her diet to get the test first. If you’re not certain you have the disease, it’s common to lose motivation to stick with the plan over time. “You go out to eat with friends, you feel embarrassed about being picky, so you eat a piece of bread,” he says. “That’s asking for trouble. If you’ve got celiac disease, one-eighth of a slice of bread is enough to damage your intestine.”
Once you identify the problem—whether with a confirmed celiac test, or by discovering that you feel better after you change your diet—the solution is clear but not always easy: no more barley, rye, or wheat.
When Kupper learned she had celiac 12 years ago, she thought her training as a dietitian would make it easy for her to handle the changes to her eating habits. But when she got home from the hospital, she says, she cried for six months. As the glue that holds many foods together, gluten is everywhere. Learning to live without it required a complete dietary overhaul, and reeducating family members and friends. (Even after all she’s been through, Kupper’s father still offers her cookies.)
“I went from being a champion bread maker to baking hockey pucks,” she says.
After a few such false starts, she got involved with a gluten intolerance support group, which helped immensely: Not only did she get cooking tips, she was able to get moral support from others struggling with the disease.
Over 18 months of going without wheat, rye, or barley, Kupper gradually got better. She and others with an intolerance tend to say the sacrifices are worth it. That’s because they quickly begin feeling more energetic, clearheaded, and comfortable after meals.
If she makes a small mistake, eating the wrong cracker, say, Kupper might get bloated and a little foggy-brained. But if she accidentally eats a full helping of noodles that contain gluten, she’ll be sick for days.
Avoiding such slipups will soon get easier for people like her: Starting in January of 2006, food manufacturers will be required to plainly list whether their products contain any of eight common allergens, including wheat.
Fasano and Guandalini are also working to get the word out among mainstream practitioners, with an awareness campaign about celiac disease directed at physicians, patients, and researchers. They’ve helped produce a CD-ROM for primary care doctors and have developed lectures for medical schools around the country.
Now that celiac itself is getting more attention, Kupper thinks people who fall within the gray area of gluten intolerance also deserve a definition for their condition and clear guidelines for treatment. “I have become an activist,” she says. “That means I’m the doctors’ pain in the tush, asking, ‘What are we going to do now?’ The more we ask doctors questions, the more they have to start answering them.”
From: [http://www.naturalsolutionsmag.com/]
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