hgazette.com, Haverhill, MA


May 9, 2013

How to successfully deal with the digestive celiac disease


Standard treatment calls for a gluten-free diet to prevent intestinal damage and the malabsorption of nutrients, which can lead to health conditions such as anemia from lack of iron and osteoporosis from lack of calcium.

In children, symptoms can include signs of malnourishment, growth problems, failure to gain weight, decreased appetite, chronic diarrhea or constipation, vomiting, abdominal bloating and pain, fatigue and irritability. In teenagers, additional symptoms can be delayed puberty, depression, dermatitis, hair loss, dental problems and mouth sores.

When adults are diagnosed, they sometimes have osteoporosis and/or anemia, Although adults sometimes have fewer gastrointestinal symptoms, other symptoms include infertility, miscarriages, erratic menstrual cycles, bone or joint pain, arthritis, depression or anxiety, dermatitis and mouth sores.

To avoid gluten, remove the obvious foods such as regular breads, cereals, waffles, pancakes, bagels, pasta, cookies, cakes, muffins and pastries. But there are other hidden sources of gluten, so read the list of ingredients on the label of foods. Oats can be contaminated when processed in equipment that also processes wheat products.

Gluten is also commonly found in processed foods as a thickening or binding agent in canned soups and stews, salad dressings, ice cream, candy bars, instant coffee, processed meats, condiments, sausages, and even dairy products. Medicine and vitamin tablets commonly use wheat starch as a binding agent. Gluten is also found in makeup, lipstick and alcohol products.

Once on a gluten-free diet, many patients said their symptoms improved within a few weeks or even days, but complete improvement can take up to a year.

For children, the response can be dramatic: Diarrhea and abdominal discomfort subside, behavior improves and growth resumes. Improvements in symptoms are followed by reappearance of intestinal villi, though complete healing can take months. But in many adults, the improvement in symptoms is followed by only partial regeneration of the villi. Consultation with a nutritionist can also help patients manage their disease.

Even patients with mild symptoms should be treated to avoid possible long-term effects such as malnutrition, liver disease and cancer. People with celiac disease are felt to have a slightly higher risk of developing small intestinal lymphoma and adenocarcinoma than the general population.

Gastroenterologist Bridget Jennings Seymour, MD, is on staff at Merrimack Valley Hospital.

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