hgazette.com, Haverhill, MA

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May 9, 2013

How to successfully deal with the digestive celiac disease

The Gazette publishes occasional columns from local doctors. One appears below.

Haverhill residents have probably noticed a small store on Groveland Street across from Merrimack Valley Hospital called Just for Me Gluten Free.

The store opened in response to the needs of the many local people affected with celiac disease, a digestive disorder that occurs in reaction to gluten, a protein found in grains such as rye, barley, wheat and the hundreds of foods made with them.

When the body’s immune system reacts to gluten, it causes inflammation and destruction of the intestinal villi, finger-like projections that increase the surface area of the intestines for better absorption of nutrients.

Symptoms are numerous and similar to other disorders such as irritable bowel syndrome and lactose intolerance. Symptoms vary from person to person. Diagnosis can be comprised of several steps. A blood test for antibodies provides effective screening, which is later confirmed with a small bowel biopsy during endoscopy. Implementation of a gluten free diet with symptomatic improvement can also be suggestive of celiac disease.

Celiac disease patients vary in their tolerance of gluten. Some can ingest small amounts without symptoms, while others experience severe symptoms from the tiniest amount.

The severity of symptoms is affected by factors such as how much gluten is in the patient’s diet, how much damage was done before diagnosis, and the age of the patient when gluten was first introduced.

Celiac disease is fairly common.

Based on the largest U.S. studies comprised of more than 13,000 asymptomatic patients, one in every 133 patients has celiac disease, a number that I have seen replicated in my my Haverhill practice. This number increases to one in 22 for patients with first-degree relatives diagnosed with the disease.

Celiac disease is also associated with other autoimmune disorders such as thyroid disease, type 1 diabetes, autoimmune liver disease and skin disorders.

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