Celiac disease

Dear Dr. Spence,
I have problems with frequent diarrhea and abdominal pain. A friend suggested I may have celiac disease. I’ve never heard of it. Could I have it?
Signed,
BM

Dear BM,

Celiac disease is an inability to digest gluten, the primary component found within wheat and wheat like products. Resultant symptoms include anything from diarrhea, bloating and abdominal pain to joint pain, extreme fatigue and infertility. Interestingly, patients may even present with functional constipation as their main symptom. Most, however, have symptoms that mimic those of irritable bowel syndrome. The prevalence of celiac disease is estimated to be at 1% of the general population, though most people have never heard of it.

Diagnosis is centered initially on blood testing, specifically antibody testing. Patients with iron deficiency anemia may have a 3-9% likelihood of celiac disease which is comparable to the 3-8% of diabetics afflicted. Diagnosis is often confirmed via intestinal biopsy. It is important to make a diagnosis early as mortality is increased if delayed greater than ten years. These patients are at risk for malignancy, specifically lymphoma.

Management of celiac disease involves elimination of gluten from the diet entirely – this includes discontinuation of wheat, rye or barley products. Most of the time, assistance from a registered dietician is crucial at maintaining adherence to the dietary restrictions. Continued problems with diarrhea etc. are usually the result of inadvertent gluten consumption. My experience is that many patients do have substantial problems in maintaining a gluten-free diet, but a positive attitude is a critical factor in success.

Do you have any medical questions or concerns that you would like addressed? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.