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From: Janice on 13 Jul 2008 21:06
Celiac disease: an elusive 'iceberg'

Fatigue, weakness, joint pain and migraines are frequently overlooked as
symptoms of the disorder

LESLIE BECK

From Wednesday's Globe and Mail

July 9, 2008 at 9:19 AM EDT

Although as many as 300,000 Canadians suffer from celiac disease, many of
them don't know it.

Celiac disease, a lifelong, genetically based disorder, occurs when gluten

- a protein found in wheat, rye and barley - triggers an abnormal immune
response that damages the lining of the small intestine interfering with the
absorption of nutrients. Often the condition goes undiagnosed.

Experts commonly refer to it as an "iceberg" disease. Visible at the tip are
individuals whose symptoms include diarrhea, abdominal pain, weight loss
and, in children, delayed growth. The rest of the iceberg consists of those
with more subtle symptoms, such as bloating or excess gas. Although these
may go unrecognized as signs of celiac disease, the damage continues.

While most people think celiac disease afflicts mainly children, it can
occur at any age. In fact, two-thirds of those diagnosed are adults. Later
in life, the disease can be triggered by pregnancy, surgery,
gastrointestinal infection or severe emotional stress.

According to a 2007 survey of the Canadian Celiac Association's more than
5,000 members, the average time it took to get diagnosed was 12 years. Many
respondents had consulted three or more doctors before getting their
diagnosis.

While stomach pain, abdominal distention and diarrhea are considered the
classic symptoms of celiac disease, in adults they're often not present.
Constipation and bloating may be the only outward signs. Symptoms such as
fatigue, weakness, joint pain and migraines - ones typically not recognized
as gut-related - are commonly reported, and the diagnosis is often anemia,
stress, irritable bowel syndrome or chronic fatigue syndrome.

If left untreated, celiac disease increases the risk of osteoporosis
(because of poor absorption of calcium and vitamin D), infertility, certain
digestive tract cancers and other autoimmune disorders such as Type 1
diabetes and thyroid disease.

Screening tests that measure the level of antibodies in the blood are
available. (People with celiac disease have higher than normal levels of
antibodies to gluten.)

Health Canada recently approved the Biocard Celiac Test Kit, an at-home test
that measures gluten antibodies from a fingertip blood sample. The Biocard
is currently available in British Columbia and is expected to be available
for $50 in pharmacies across the country by the end of this year.

A blood test, however, is only the first step in diagnosing celiac disease;
it's used to detect people who are likely to have the condition. Confirming
a diagnosis requires a small bowel biopsy in which an endoscope is passed
through the mouth into the stomach and upper intestine so that the lining
can be examined and a biopsy taken.

The only treatment for celiac disease is a gluten-free diet for life. That
means eliminating all foods and food ingredients made from wheat, rye and
barley. Included in the wheat family are spelt, kamut, semolina, durum,
einkorn and faro. The main sources of gluten are breads, cereals, crackers
and pastas, but it's also found in luncheon meats, yogurt, seasonings, salad
dressings, sauces, marinades, soy sauce, soups and beer.

Even if you think you are following a gluten-free diet, you may be
unknowingly consuming gluten as a hidden ingredient in food products,
medications or vitamin supplements. Ingredients to question or avoid include
graham flour, malt, dextrin, modified food starch, hydrolyzed vegetable
protein, MSG, emulsifiers, stabilizers, caramel colour and natural flavour.

Oats, previously on the list of gluten-containing foods to avoid, have now
been given the green light for people with celiac disease. The Canadian
Celiac Association maintains that eating pure, uncontaminated oats - up to �
cup dry oats a day for adults and � cup for children - is safe.

The problem is that oats may become contaminated with other
gluten-containing grains during processing. Pure, uncontaminated oats are
trademarked "Pavena" to ensure accurate identification. Still, a small
number of people may not be able to tolerate oats and should follow up with
their doctor when adding them to a gluten-free diet.

(People with untreated celiac disease may also have difficulty digesting
lactose in milk products. That problem usually disappears when gluten is
removed from the diet, allowing the gut to heal.),

Today, it's getting easier to follow a gluten-free diet with the influx of
products in supermarkets and natural food stores. Manufacturers of
gluten-free products include El Peto, Glutino, Kinnikinnick, Enjoy Life,
Kaybee, Rizopia and Tinkyada. And it's important to consult with a
registered dietitian who can advise you on gluten-free alternatives and the
need for vitamin and mineral supplements.

If you suspect you have celiac disease, don't put yourself on a gluten-free
diet until you are properly diagnosed. If you do have the disease, the
Canadian Celiac Association (celiac.ca) can provide more information and
support.

Leslie Beck, a Toronto-based

dietitian at the Medcan Clinic,

is on CTV's Canada AM every Wednesday. Her website is

lesliebeck.com.

***

Gluten-free grains and flours

Amaranth

Arrowroot flour

Buckwheat

Chickpea flour

Cornmeal

Flaxseed

Green pea flour

Millet

Oats, pure uncontaminated

Quinoa

Popcorn

Potato flour

Rice

Rice flour

Soy flour


** Posted from http://www.teranews.com **
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