Coeliac Disease

prevalence1
Symptoms of Celiac Disease and Food Intolerances

About 4 years ago I noticed a significant difference in my health. I started deteriorating unknowns to me, I was very yellow in the face and my family were really worried about me. Then one day my little brother asked me was I pregnant  I looked down and nearly fainted because my stomach had swollen out so much and I had only eaten. At first I thought I might be due to hormonal reasons and that it would pass. While on a photo shoot I started swelling for no reason and I soon noticed it was happening a lot more. I always had a flat tummy and was fit. I’ve never really swelled after eating. I couldn’t understand why all of a sudden I was swelling so badly,the thing was my stomach felt like it was filled with cement, it was very painful and uncomfortable for me after eating meals because I felt really ill constantly. While out with my boyfriend one afternoon I had to come home and lye down as I felt so unwell I was crippled with pains in my stomach, had a severe  temperature and spent half the day lying on the bathroom floor. gluten-intolerance-symptoms For the life of me I didn’t know what was happening and spent a few months being very run down, Suffered with sickness flu’s,infections, skin irritations and  I even ended up getting the shingles which was horrific as was so painful my whole immune was being attacked. It was frustrating as I constantly felt sick and weak. The doctor had originally diagnosed me with Irritable Bowel Syndrome also known as IBS but I didn’t suffer with IBS symptoms some IBS sufferers have a problem with keeping their bowel movements I was the opposite after taken tablets he prescribed me it made me feel worse. I soon learned that I was severely malnourished as my body wasn’t breaking down my food correctly. I found this so odd as I never dieted in my life was natural slim and ate whatever I pleased. I also was getting re-flux regularly and would vomit. Because of this my stomach wasn’t processing nutrients or storing them or getting rid of toxins so my stomach was on shut down. I gained over a stone in weight  in less than 3 months which wasn’t normal. Being slim my whole life I initially didn’t mind the weight gain as I think every woman looks well with weight on them than being skin and bone, to be honest I needed to gain a little weight as I was too slim. I liked the extra curves but constantly swelling and resembling a pregnant woman, was becoming very uncomfortable for me as the pressure on my stomach was so painful. I had to have a treatment of Colon hydrotherapy where they flush your colon with luke warm water to remove any blockages in your Colon. I didn’t really want to because I felt uncomfortable about the thought of it but the doctor told me that it would help me speed up my movements and that to make sure I didn’t develop any infections. I instantly felt better and my immune started to pick up. My stomach went back to being flat thank god but I soon learnt after it that I also had celiac disease and food intolerance that I never knew you could develop. Where basically I’d become really unwell after eating them I’d swell and would get reflux. Some people do gluten-free diets to lose weight but don’t understand that there is people who have severe intolerance to these foods also and physically can’t eat foods with these ingredients in it.

If you suspect you may be suffering from IBS, it’s recommended that you see your doctor. IBS is a fairly common condition and your GP will see cases like yours on a weekly basis, so talk to him or her for advice if you have some or all of the symptoms below.

The National Institute of Clinical Excellence advises GP’s to check for IBS if you experience any of the ’ABC’ symptoms listed below for at least 6 months1:

  • Abdominal pain or cramps
  • Bloating
  • Change in bowel movements – diarrhoea, constipation or both

Other less common symptoms include:

  • Excess wind and gas
  • Feeling like you haven’t fully emptied your bowels
  • Occasional other symptoms like nausea, tiredness, muscle, back or joint pain

CAUSES OF IBS

There are many theories about the causes of IBS, and people’s experiences vary widely. For some people, certain kinds of foods can trigger an attack. For others it’s a stressful situation at home or in the workplace. And still for others, IBS can be caused by a bout of gastroenteritis or food poisoning.

Food and drink

Intolerances to food and drink can be unpredictable, temporary or develop only later in life in otherwise healthy adults. Some of the food groups most commonly known to trigger IBS symptoms include:

  • Wheat Products
  • Dairy Products
  • Onions
  • Caffeine-containing drinks like tea, coffee, and cola
  • Chocolate

Many people find that keeping a Food Diary to track what they eat and see how their body reacts can help them spot problematic patterns of consumption, allowing them to prepare an IBS diet to control their symptoms.

Stress and anxiety

The pace and pressure of modern life can be overwhelming at times. And while stress and anxiety don’t directly cause IBS, they can certainly trigger the symptoms. A small amount of stress is good – it keeps us aware and active – but when it gets out of hand it can leave you feeling anxious and out-of-control. This stress can come from a single difficult issue – at home or in the workplace – or be the cumulative effect of many minor irritations. And when IBS appears, it very often makes things even worse.

The problems of a modern life

As with food and drink, many people find that keeping a diary of their feelings of stress and anxiety can help. Being able to see stress (and potentially another attack of IBS) coming can be the first step in managing IBS successfully.

Gastroenteritis

Tummy upset caused by gastroenteritis or food poisoning is all too common, and some IBS sufferers can trace their first instance of IBS symptoms back to a bad bout of it. Medical professionals now believe that a major disruption to the bacterial balance in your intestines can sometimes lead to longer-term problems with IBS1.

Celiac-Disease-e1352656695233 A gluten-free diet (GF diet) is a diet that excludes foods containing gluten. Gluten is a protein composite found in wheat (including kamutand spelt), barley, rye and triticale. A gluten-free diet is the only medically accepted treatment for celiac disease.[1] Celiac disease is an autoimmune disease attacking the small intestine due to the presence of gluten.[2][3] Dermatitis herpetiformis (DH) is a form of celiac disease in which gluten causes the immune system to attack the skin; therefore a gluten-free diet is essential. People with these diseases are considered gluten intolerant.[2] There is a minority of people who suffer from wheat intolerance alone and are tolerant to gluten. Gluten sensitivity is another reason people will choose to go gluten-free.[2] 3771A0CF-621F-43EC-8ECF10B11FF7B88B What is Celiac Disease celiac word in letterpress type Celiac disease, also known as gluten intolerance, is a genetic disorder that affects at least 1 in 133  Americans. Symptoms of celiac disease can range from the classic features, such as diarrhea, weight loss, and malnutrition, weight gain, skin irritations, fatigue to latent  symptoms such as isolated nutrient deficiencies but no gastrointestinal symptoms. The disease mostly affects people of European (especially Northern European) descent. Those affected suffer damage to the villi (shortening and villous flattening) in the lamina propria and crypt regions of their intestines when they eat specific food-grain antigens (toxic amino acid sequences) found in wheat, rye, and barley. Oats  have traditionally been considered to be toxic to celiac, but recent scientific studies have shown otherwise. This research is ongoing, however, and it may be too early to draw solid conclusions.

Coeliac Disease

Coeliac disease (pronounced see-lee-yak) is a condition causing some adults and children to react to the gluten, the protein found in wheat, barley and rye. Some coeliacs are also sensitive to the protein found in oats. If a coeliac eats gluten the lining of the small intestine becomes damaged reducing the coeliac’s ability to absorb the nutrients from food. This can lead to various symptoms and complications if undiagnosed.

It’s an autoimmune disease and it’s not contagious. The only treatment is adhering to a gluten-free diet for life after a positive diagnosis has been made. Medicine or drugs are not required.

In the small intestine there are small finger-like structures called villi which absorb the nutrients from food. When the villi are damaged (or atrophic) they can no longer absorb nutrients properly.

Graphic of healthy and damaged villi

Here are some photographic images of healthy villi compared with damaged villi.

Gluten is in bread, biscuits, cakes, pasta, beer, pizza and in many manufactured foods where gluten is contained in the ingredients such as soups, sauces, gravy, salad dressings, crisps, chocolate, sweets and ready-meals. Coeliacs have to think ahead if they want to eat at a restaurant, need to take extra time reading labels when shopping and need to take care in their personal food preparation to avoid cross-contamination with gluten. Even a grain of gluten can cause harm and cause diarrhoea and other symptoms which can last for several days.

Symptoms

Woman on a toilet feeling sick

Symptoms start to occur when coeliac disease is triggered. Find out more about what causes the onset of coeliac disease.

Coeliacs can experience one or more of these problems:

  • diarrhoea
  • constipation
  • weight loss
  • chronic tiredness
  • anaemia
  • failure to thrive in children
  • chronic mouth ulcers
  • stomach pain and bloating
  • indigestion
  • bone pain
  • moodiness or depression
  • infertility
  • recurrent miscarriages

Also flatulence, nausea, vomiting and Irritable Bowel Syndrome (IBS) can indicate a need to be tested.

Symptoms vary from person to person and may be constant or only occur from time to time. Some people will experience an itchy rash which can be caused by an associated condition called Dermatitis Herpetiformis.

Getting Diagnosed

Coloured test tubes on top of test results

The first step towards diagnosis is a blood test. Following a positive blood test, the most conclusive way to diagnose coeliac disease is by taking a biopsy from the small intestine.

It is important to be on a gluten containing diet before testing in order to ensure the most accurate result. Four slices of ordinary bread a day for six weeks or more should be sufficient.

It is important not to self diagnose. A life long gluten-free diet is a big commitment which should only be undertaken if necessary. An official diagnosis is required to take advantage of the financial support available.

Blood tests

Your GP can take a blood test for antibodies – Immunoglobulin A (IgA) anti-tissue transglutaminase antibodies(IgA tTGA) and anti-endomysial antibodies (IgA EMA). If results show raised tTG or positive EMA then you should be referred to a consultant gastroenterologist for a biopsy. Bear in mind that negative screening blood tests do not always exclude coeliac disease, as a small minority of coeliacs may also have IgA deficiency and the screening test results will be misleading. In children under the age of three the blood tests can be particularly unreliable.

There are some do it yourself test blood test kits available from abroad. The Coeliac Society recommend that you have a blood test organised by your doctor.

Biopsy

The biopsy procedure is called an upper gastro-intestinal endoscopy or oesophagastroduodenoscopy (OGD). A gastroscope (a small tube) is passed through the mouth and down into the duodenum or jejunum. A very small piece of tissue is taken from the wall of the intestine. The tissue is examined under a microscope to check for damage to the villi.

Having the Biopsy

The biopsy is usually carried out in an outpatient clinic. You will be asked to fast overnight beforehand and the procedure itself takes 10 – 15 minutes (excluding waiting and preparation time). In adults it is usually carried out under light sedation, children are given a general anaesthetic. There is no pain when the biopsy is taken.

All of the above information can be found at http://www.coeliac.ie

So after my experience I would urge anyone with any problems with your stomach to visit your gp immediately as it’s not worth putting off and you could end up severely ill. Truth is Irish food has become so overly processed in the past few years, that a lot of our foods are now filled with ingredients that actually aren’t good for us, it’s important to find the problem and cut all of it from your diet.
Elizabeth
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