Celiac disease is a genetically inherited condition of the small intestine, triggered by gluten contained in grains such as wheat, (durum, kamut, and spelt), barley, rye and triticale). Celiac disease affects one in 100 people and is triggered by reactions of the gastrointestinal tract’s immune system to gluten, damaging the lining of the intestinal tract. This damage reduces absorption of a variety of such as to iron, folic acid, calcium, vitamin D, protein, fat and the water soluble B-Vitamins. Crohn’s disease, ulcerative colitis and irritable bowel syndrome are conditions that may also be genetic and high risk for malabsorption issues.
Signs, Symptoms and Associated Conditions
Although symptoms may vary from patient to patient, the most common symptoms of these GI diseases may include weight loss, fatigue, chronic diarrhea, cramps, bloating, irritability and anemia. While weight loss is the most common symptom, weight gain and constipation can also be experienced by some. Other patients experience no intestinal symptoms and only complain of weight loss or fatigue. A wide variety of additional symptoms may include mouth ulcers, bone pain, Vitamin B12, Vitamin K and Vitamin D deficiency, nausea, vomiting, peripheral neuropathy, and skin rashes.
While a biopsy of the intestinal wall is usually required to confirm a diagnosis of celiac disease, blood tests are now available to detect its presence and can differentiate it from these other intestinal disorders. These tests look for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). Because there is often a family link to celiac disease and Crohn’s disease, family members of either should undergo testing to identify if they have a low-grade or symptom-free version these intestinal diseases. If these tests are negative and a biopsy is negative, it is still possible to have a gluten sensitivity, and IgG4 testing can identify patients in the sensitivity spectrum.
Hidden Gluten in Common Foods and Dietary Management
Gluten in flour is a binder in baked goods and prevents crumbling making gluten an attractive addition to many processed and packaged foods which means that the celiac and gluten sensitive person need to read labels of all packaged and processed foods to ensure they are gluten-free. This is especially true for soups, luncheon meats and sausages. Paying attention to food labels is vital, because the only truly effective treatment for celiac disease is staying gluten-free. Once diagnosed, staying on a gluten-free diet allows damaged tissues to heal, reducing the risk of developing complications of this disease such as neuropathy, heart disease, lymphoma, infertility and osteopenia or osteoporosis.
The Benefits of B Vitamins
A 2009 study published in the World Journal of Gastroenterology identified suboptimal nutritional status of certain B vitamins (folic acid, vitamin B6, vitamin B12) with celiac patients. Because these vitamins are required to keep the amino acid homocysteine in a normal range, many celiac patients have high levels of homocysteine, increasing their risk for heart disease, stroke and other vascular complications.2,3,4 When researchers gave celiac disease patients a B-vitamin supplement (including vitamin B6, folic acid and vitamin B12), homocysteine levels declined into the normal and safer range.
This study emphasizes the need for celiac patients, or any patient who has chronic GI issues to be evaluated for B vitamin deficiencies, preferable BEFORE they have cardiac or neurologic issues from long term depletion of these critical nutrients. For those patients in whom low levels of B vitamins or high levels of homocysteine are found, nutritional supplementation is a necessary short term care plan to reduce symptoms quickly and efficiently. Gluten avoidance and the identifying and improving other digestive issues are a longer term part of the care plan with a goal of enabling the gut lining to heal adequately so that nutrient absorption can be optimized. The long term care plan should involve stool testing to determine what beneficial gut bacteria are needed to enable more effective healing of the gut lining, and to identify what microbes may be in an overgrowth situation that needs rectifying. IgG4 testing may also be explored in order to determine what other food sensitivities/allergies may have developed as a result of chronic poor gut function and gut. Food sensitivities, over time, may actual hinder the ability for the gut lining to heal adequately.
The doctors at Crosby Chiropractic & Acupuncture Centre are well versed in identifying nutritional deficiencies, gut health issues and food sensitivities. You may contact them at (636) 928-5588.