I recently wrote an article about Celiac Disease. I think that this is an important topic for people who have difficulty gaining weight to be aware of. Celiac Disease affects everyone differently, but sometimes it can cause a person to be underweight and nable to gain weight. Before my husband was diagnosed with Celiacs he was 100 pounds. He's now a healthy 130 pounds.
Just wanted to share my article with all of you here. Hope it helps someone!

written (and posted on our message board) by sarahcpt

What You Need to Know about Celiac Disease

A few years ago hardly anyone had heard of Celiac Disease. In recent years doctors have begun to learn about the disease and diagnose patients with Celiac Disease. I became familiar with the disease when my husband was diagnosed. We quickly learned how critical eating a gluten free diet is for his long term healthy, and just how challenging eating a gluten free diet is. Since Celiac Disease is rather common everyone should become knowledgeable about it in order to decide whether or not they should be tested for it.

What is Celiac disease?
Celiac disease, or Celiac Sprue, is an inflammatory condition of the small intestines. This inflammatory condition is caused by the ingestion of the food component wheat protein gluten. When a person with Celiac Disease (CD) ingests gluten inflammation of the absorptive tissue in the small intestine will occur. The walls of the small intestines are covered with hair like projections called villi. These villi normally stand out straight from the intestinal walls. The intestinal inflammation that occurs when a person with CD ingests gluten damages these villi, so they are in a laying down position, instead of a standing up position. The job of these villi is to absorb nutrients and electrolytes. However, when they are damaged they cannot properly absorb nutrients and electrolytes, which can lead to a variety of health problems. If gluten is eliminated from the diet the small intestines will regenerate absorptive tissue surfaces and villi will stand out straight so nutrients and electrolytes can properly be absorbed and health restored.
There is speculation that CD has been around since our species first began growing and eating grains such as wheat. However it is only in recent years research on the disease and how to treat it has taken place, and the public has become aware of it. CD can become active at any age. The specific cause is unknown, but it appears that CD usually becomes active after the body has been through a physically stressful event.
Celiac Disease is genetic. An estimated 1 in 100 people have CD, and 1 in 22 people with a first degree relative diagnosed with CD will test positive for CD as well. CD is under diagnosed, in part because of a lack of knowledge among doctors about the disease. Another reason for under diagnosis is common misdiagnosis of other ailments with similar symptoms, which I will discuss later in this article.

What are the symptoms of Celiac Disease?
A person with CD can have no symptoms whatsoever. The disease manifests itself differently in each individual. The following is a list of possible symptoms. Keep in mind that not having any of these symptoms does not necessarily mean that you do not have CD.
-Nutrient, vitamin and mineral deficiencies, which can affect every organ
-abdominal pain
-diarrhea
-environmental allergies
-asthma
-short stature
-bloating and gas
-chronic bad breath
-weight gain or difficulty losing weight
-weight loss or difficulty gaining weight
-fatigue
-anemia
-irritability
-depression
-seizures
-muscle cramps
-nerve damage
-infertility
-tooth discoloration and loss of enamel
-canker sores in the mouth
-dehydration
-dry skin
-itchy rash, often diagnosed as Dermatitis Herpetiformis
Dermatitis Herpetiformis (DH) is the symptom with the strongest link to CD. DH may present itself as intensely itchy red bumps. DH can occur anywhere on the body, but is most commonly present on the elbows, knees, buttocks, scalp, posterior, back of the neck, lower back and shoulder areas. The bumps occur in groups, similar to herpes, which is where the term “herpetiformis” comes in. Like CD, DH is caused by the ingestion of gluten. It is treated with ointment for the skin and the elimination of gluten from the diet. Some individuals may develop both CD and DH, while some will develop only one of the conditions.

How could I be tested for Celiac Disease?
A blood test is the first step. Individuals with CD have a high level of autoantibodies in the blood. The autoantibodies are present at high levels because the body perceives that something is wrong. If blood tests show high levels of these autoantibodies an endoscopy will be done. An edoscopy involves a tube being inserted down the esophagus, through the stomach and in to the small intestines. During an endoscopy a small piece of the intestinal wall is removed so it can be viewed to see if there is damage to the villi. A diet containing gluten should be eaten prior to testing. Otherwise, the intestines may begin regeneration, and testing may not show the presence of CD when CD actually is present.

My symptoms are mild. Why should I bother to treat my Celiac Disease?
Individuals with CD are often misdiagnosed as having a number of ailments with similar symptoms, such as Irritable Bowel Syndrome, Krohn’s Disease, Diverticulitis, intestinal infections, or Chronic Fatigue Syndrome. It is estimated that only 3% of people with CD have been properly diagnosed.
Individuals with CD have an increased incidence of small intestinal lymphomas and adenocarcinomas as well as bowel cancer. Untreated CD can also lead to the following ailments:
-osteoporosis (due to the inability to absorb calcium),
-miscarriages and malformations (due to improper vitamin absorption),
-vitamin deficiencies,
-nervous system disorders,
-pancreatic insufficiency and
-lactose intolerance
Also keep in mind that symptoms of CD may develop later in life. CD can become active at any age.

How is Celiac Disease treated?
Celiac Disease has no cure. The only way to effectively treat and control CD is to completely eliminate gluten from the diet. Even trace amounts of gluten can be damaging to the small intestines for the person with CD, even if it does not cause any symptoms. Eliminating gluten from the diet is a complicated process that involves careful scrutiny of every food label. Gluten is found in wheat, oats, rye and barely. Other substances which contain wheat or gluten that you may see on a food label include semolina, durum, bulger, kasha, spelt, einkam, kamut, faro, tricticale and the very common modified food starch. Oats themselves do not contain gluten. However, commercial oats have more often than not contaminated with wheat.
Besides the common breads, pastas, crackers and cereals there are numerous items that may or may not contain gluten that most people are unaware of. Soy sauce, deli meats, soups, gravy, dressing, condiments, yogurt, ice cream, baked beans, dried fruit, shredded cheese, flavored coffee, hot cocoa, malt, unidentified starch, hydrolyzed vegetable protein, hydrolyzed plant protein, and textured vegetable protein are just a few to be careful of. Another detail to keep in mind is that a food labeled as “wheat free” does not mean that it is gluten free. Look for foods specifically labeled as being “gluten free.” These foods are becoming more common as awareness is being raised about CD.
Dining out can be a challenge for people with CD. Ingredient listings for menu items are not often available, and sauces used in restaurants often contain gluten. It is best to have the wait staff pass on to the cook that you cannot have wheat, oats, rye, barely, gluten or modified food starch. Most restaurant staff would rather help meet your needs than have you be unhappy with what you eat.
For people eating a gluten free diet, cross contamination will also be a concern. Cross contamination occurs when a gluten free food comes in contact with gluten and therefore is no longer gluten free. Taking a few precautions can prevent cross contamination. Gluten free toast should be made in a separate toaster. Counter space and cutting boards should be washed after food containing gluten has been prepared. Avoid double dipping of utensils. While these tips may seem over the top, even trace amounts of gluten will cause damage to the small intestines of the person with CD. When gluten free food and food containing gluten are prepared in the same household, it’s vital to be constantly aware of how gluten might spread to gluten free foods.
It is also important that doctors of patients with CD consistently check medications that they prescribe to make sure they don’t contain gluten. Medications may often contain wheat flour, modified foods starch, hydrolyzed vegetable protein, cereal solids, as well as other sources of gluten.
To be completely certain that you are eating a gluten free diet, there are wonderful resources available that list thousands of food products and indicate whether or not they contain gluten. The CSA (Celiac Sprue Association) Gluten-Free Product Listing is an invaluable resource.

So what can I eat?
Once a person with CD realizes just how many foods contain gluten, frustration may set in. Beloved foods may have to be given up, and the limitations seem endless. In time new favorite foods will be discovered along with countless gluten free food choices. More and more gluten free foods are being marketed all the time.
A diet of whole, unprocessed foods is the safest bet. Rice, potatoes, unprocessed meats, fish, vegetables and fruits are excellent choices. However, the diet does not have to be bland or boring. Gluten free alternatives are available for virtually every food that contains gluten. There are various gluten free pastas, breads, cereals, crackers, cookies, and snack bars, as well as mixes to make cakes, brownies, and pancakes. Rice flour is an excellent alternative that can be used to make practically anything. Health food stores have good selections of gluten free foods, and many grocery stores now have specialty sections which include gluten free foods. Online companies such as The Gluten Free Pantry offer a wide variety of gluten free options.

While a diagnosis of Celiac Disease can mean some very daunting life changes, it isn’t something that needs to be looked at with foreboding. Eating gluten free is a lifestyle that can be adapted to and can lead to better overall health for the person with Celiac Disease.

Bibliography

Mayo Clinic. (December 16, 2004). Celiac disease. Retrieved February 6,2006, from http://mayoclinic.com/health/celiac-disease/
Celiac Sprue Association. (February 1,2006). Gluten-free diet: grains and flours. Retrieved from February 6,2006 http://www.csaceliac.org/gluten_grains.php
Celiac Disease Foundation. (date unknown). Celiac disease. Retrieved February 5,2006, from http://www.celiac.org/cd-main.php
Columbia University gastroenterology. (date unknown). Celiac disease and gluten sensitivity. Retrieved February 5,2006 from http://cpmcnet.columbia.edu/dept/gi/celiac.html 
National Digestive Diseases Information Clearinghouse. (October 2005). Celiac Disease. Retrieved February 4,2006, from http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

written (and posted on our message board) by sarahcpt