VIEWS: 0 PAGES: 2 POSTED ON: 4/12/2013
Who should be screened for celiac disease? By Jennifer Wood, Gundersen Lutheran registered dietitian Everyone! As many as one in every 133 people may have celiac disease, which is an autoimmune disorder effecting the absorption of nutrients from food. In celiac disease, damage to the gut is caused by an immune reaction to gluten, a protein found in wheat, rye, barley and in many processed foods as an additive. Celiac disease is a genetic disease and runs in families so the incidence of occurrence in this population may be as high as one in 22. Down syndrome also correlates with a higher incidence of celiac disease. In many countries children are routinely screened for celiac disease. In the United States routine screening is not done, therefore many people may have it and not know it. Symptoms of celiac disease vary widely. Since symptoms are suggestive of other stomach or bowel disorders, many people are often misdiagnosed. Common symptoms include gas and bloating, abdominal pain, diarrhea or constipation, and pale, foul smelling and/or fatty stools. Symptoms may also be vague and seemingly unrelated such as fatigue, anemia, osteoporosis, bone or joint pain, rashes, seizures, gynecological disorders, growth problems, dental problems, vitamin deficiency, and even behavioral and neurological disorders. Some people have no obvious symptoms at all, yet are still at risk for long-term complications from the disease. Screening for celiac disease is a simple blood test checking for antibodies. A positive blood test is followed by a biopsy of the small bowel for confirmation. However, some people have negative antibody tests and still have a positive biopsy with subsequent remission following a gluten-free diet. So, if symptoms don’t clear up, a biopsy may be suggested even if the blood test was negative. A common skin rash called dermatitis herpetiformis is also a common gluten-intolerance disorder and can be confused with eczema. This skin rash clears up with a gluten eliminating diet. Dermatitis herpetiformis is diagnosed through a biopsy of the rash. Other common autoimmune diseases with a connection to celiac disease include thyroid disease, lupus, type 1 diabetes, liver disease, vascular disease, rheumatoid arthritis and Sjogren’s syndrome (dry eyes). People who have celiac disease who don’t eliminate gluten from their diet are at increased risk for lymphoma, gastrointestinal cancers and other malnutrition problems. The National Institute of Health issued a celiac awareness campaign in 2005 to shed light on this often undiagnosed or misdiagnosed disease. Despite this effort, it still takes more than four years on average to get correctly diagnosed through symptoms alone. So, everyone should get screened, especially those with a family history, to eliminate needless treatments that stem from this underlying autoimmune disorder. The only treatment for celiac disease is to follow a strict gluten-free diet. However it is important not to start a gluten-free diet prior to being screened as this may cause a false negative screen. For most patients, a gluten-free diet stops symptoms, heals existing intestinal damage and prevents further damage. Although the gluten-free diet means avoiding food made with wheat, rye and barley, other flours can be substituted in recipes. People with celiac disease can eat meat, fish, fruits and vegetables. However, they must watch for hidden gluten in sauces, gravy, salad dressings and processed food. A registered dietitian can help with meal planning.
Pages to are hidden for
"Who should be screened for celiac disease - Gundersen Lutheran "Please download to view full document