"Celiac disease is a genetic, immunologically mediated small bowel enteropathy that causes malabsorption. The immune inflammatory response to gluten frequently causes damage to many other tissues of the body. The condition is frequently under diagnosed because of its protean presentations. New prevalence data indicate that symptomatic and latent celiac disease is present in one of 300 people of European descent. Age of onset ranges from infancy to old age." - HAROLD T. PRUESSNER, M.D., University of Texas Medical School at Houston from the American Family Physician March 1, 1998

So what does that mean???
It means many people cannot eat food products that contain gluten. Food like wheat, oats, barley & rye. This stuff is hidden in many processed and restaurant foods. The only cure is the elimination of gluten from your diet, 100% elimination.

But recent studies indicate this issue is far more widespread than anyone thought. In fact, a large number of people with certain diseases very likely have celiac sprue and DON'T KNOW IT because they are not showing obvious symptoms. There is a definite blood test today. More and more people are being tested.

Dr. Pruessner is incorrect on one point. This is not restricted to Europeans as long thought. It is widespread around the world. It is even common in Asia.

If you have certain digestive issues or showing symptoms of certain diseases you may actually have celiac sprue.

Celiac Sprue is a hereditary disease. It has nothing to do with age. Some people cannot tolerate the protein called gluten. And they pass the gene down to the next generation. Babies can have it. So can teenagers and adults. Not all people show the same symptoms, yet they still have it.

How common is this?
It is now estimated that as many as 1 person out of 133 has celiac sprue.

Women comprise approximately 75 percent of newly diagnosed adult celiac disease cases.

People with this, who have long term exposure to gluten, can seriously damage their health. Your body cannot digest gluten. The existence of gluten in your digestive system totally messes up your digestion of food, period. You do not get nutrients from eating. Lack of vital nutrients will cause all kinds of additional health issues.

Studies show that certain aliments like: Diabetes Type I, Osteopenia, Seizures, Hepatic Disease, Thyroid Disease, Down Syndrome, Diarrhea, Anemia, Bone pain, Amenorrhea, infertility, impotence, night blindness to name a few have a direct relationship to celiac sprue. Studies show that people with the above symptoms have a much higher rate of celiac sprue. They have a as much as 6X or 600% higher rate of celiac sprue than what is expected in a normal population. Bottom line is celiac sprue interferes with your digestion. Long term lack of nutrition causes diseases.

In the mid-1960s, adult celiac disease was also noted to be associated with numerous neurological disorders, including epilepsy, cerebral calcifications, and peripheral neuropathy(3)

Celiac Spruces is associated with:(3)

	Osteoporosis
	Lymphoma and Bowel Adenocarinoma
	Type 1 diabetes mellitus
	Autoimmune thyroid disease
	Rheumatoid arthritis
	Systemic lupus erythematosus
	Autoimmune hepatitis
	Autoimmune Addison's disease
	Recurrent aphthous ulcerations
	Sjögren's syndrome
	Sarcoidosis
	Vitiligo or alopecia areata
	IgA deficiency
	Psoriasis
	Anemia is the most common manifestation of celiac disease

SILENT CELIAC DISEASE

Many researchers feel that the numbers of people with celiac sprue are much higher than what is evident. Tests are not given unless a person shows a symptom. Tests should be given if a person has: a family history of celiac disease, personal history of thyroid disease or type I diabetes, irritable bowel syndrome, anemia (especially iron deficiency), chronic diarrhea, chronic fatigue, unexplained weight loss, short stature, epilepsy, infertility,18 or unexplained elevation of transaminase levels. Asymptomatic or oligosymptomatic patients are still at risk for complications of celiac disease. (3)

So people can have celiac sprue, be reacting to gluten, have messed up digestion, losing nutrients and NOT be showing obvious symptoms. You could have this condition, your health be slipping away and no one knows what is causing it. And the cause could very well be your body cannot digest or deal with gluten in the bread you are eating.

So how do you know if you have Celiac Sprue?

There are obvious symptoms. I was diagnosed with spastic colitis right out of college. Years later I found out by accident that was a symptom of celiac sprue.
Obvious Symptoms:

	Common Diarrhea - this is not a normal reaction to eating food.
	Common constipation - see above
	Flatulence, borborygmi, abdominal distention, foul-smelling stools
	Bulky, greasy stools

If you have the good luck to be experiencing any of these, pay attention to when it occurs. You ate what and what happened?

There are blood and biopsy tests that you can take to confirm it. Ask your doctor. But in doubt, simply pay attention to what you eat. Try eliminating foods with gluten and watch the results. In fact, you should do that with all your food. Gas, loose stools, constipation, stinky bowel movements, etc. are not normal reactions to eating. People that eat healthy foods DO NOT HAVE THESE SYMPTOMS. You have them because you are eating unhealthy foods and you are not digesting it. And you might have celiac sprue.

The Treatment
The treatment for celiac sprue is the removal of gluten and related proteins from the diet. Complete elimination of dietary gluten generally results in rapid and complete healing of small-bowel inflammation. So if you have it, the ONLY thing you can do it STOP EATING GLUTEN!

Due to the lack of being able to digest foods properly, quality supplements are a must for someone with celiac sprue. Your body has suffered from poor digestion and needs some help to get back to where is should be. Choose a high quality, pharmaceutical grade supplement that is not based on the minimal RDA standards.

One last note: Celiac sprue is not an allergy! It is not a disease. You cannot take any drug to fix this problem. Your body can't digest or tolerate gluten. Either you have it or you don't. If you've got it, you have to ELIMINATE all forms of gluten or your body will suffer. You have to read labels. You have to learn to eat differently. You have to take it very seriously. You have to change your lifestyle and what you eat.

I am quite familiar with this having be aware I have it for almost 30 years. Feel free to ask me questions.

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Detecting Celiac Disease in Your Patients
HAROLD T. PRUESSNER, M.D., University of Texas Medical School at Houston view link

What is Celiac Disease?
American Family of Physicians view link

(3)Gluten-Sensitive Enteropathy (Celiac Disease): More Common Than You Think
American Family Physicians view link
 

Doctors have always labeled celiac disease as a rare food allergy that, while a serious condition for those afflicted, it is generally not something the rest of us need to worry about.

Well, it seems that the underlying problem that causes celiac disease -- an autoimmune condition caused by gluten intolerance -- isn't so much rare as it is undiagnosed. Some researchers postulate that individuals often have symptoms for as many as 11 years before they are diagnosed correctly. Worse, they believe that only 2.5 percent of those who have some form of gluten intolerance ever get diagnosed at all.

This is sad, considering how serious the health consequences can be -- and that the condition can often be completely rectified through diet.

Untreated, gluten sensitivity can result in a long list of disorders, including many cancers, autoimmune disorders, neurological diseases, chronic pain syndromes, and even psychiatric and other brain disorders. The classic symptoms of celiac disease include diarrhea, weight loss, and malnutrition. However, digestive symptoms are not the only symptoms celiac can cause. Neurological disorders associated with the disease include sporadic and progressive cerebellar ataxia, cerebral atrophy and dementia, cerebral vasculitis, myopathy, peripheral neuropathy, and epilepsy.

If you suspect that you or anyone in your family might have celiac disease, or a gluten-sensitivity, you can ask your doctor to perform a tTG or tissue transgluminase test. Keep in mind that if you have already eliminated wheat or gluten products from your diet, this test will come up negative, even if you have the sensitivity. But if you have consumed any wheat products and have the sensitivity, this test will do a better job of picking it up than previous tests.

If you do have celiac disease or gluten-intolerance, eliminating grains and grain products (like rice, pasta, bread, etc.) from your diet can go a long way in helping you feel better --sometimes even better than you can imagine. You will be surprised what you have learned to accept.

Many people who have this disease report that they were so accustomed to their low level of health, they almost didn't know they had a problem -- until they went gluten-free. Suddenly, they transform into healthy people, full of energy.

Co-author of the book Dangerous Grains, Ron Hoggan, reports that he didn't realize until he eliminated gluten grains from his diet how uncomfortable and chronically ill he had been for much of his life.

To learn more about gluten sensitivity, check out Dr. Wright's article on this topic from the March 2002 issue of Nutrition & Healing. (Subscribers can download it for free at www.wrightnewsletter.com). Or check your local library or bookstore for a copy of Dangerous Grains by James Braly and Ron Hoggan.

Being aware of this condition and knowing what signs to look for may just keep you or someone you know from becoming one of those "undiagnosed" statistics.

Amanda Ross
Managing Editor, Nutrition & Healing

Sources:
Braly, James, M.D. and Ron Hoggan, M.A. Dangerous Grains: Why Gluten Cereal Grains May Be Hazardous to Your Health. New York: Avery Publishing Group, 2002

Pazianas M, Butcher GP, et al. "Calcium absorption and bone mineral density in celiacs after long term treatment with gluten-free diet and adequate calcium intake." Osteoporos Int. 2004: published online 6/17/04

Goggins M, et al. "Celiac Disease and Other Nutrient Related Injuries to the Gastrointestinal Tract." American Journal of Gastroenterology 1994; 89(8): S2-S13.

Pratesi R, Gandolfi L, et al. "Is the prevalence of celiac disease increased among epileptic patients?" Arq Neuropsiquiatr. 2003 Jun; 61(2B): 330-334
 

Gluten-Free Diet
Jackson Siegelbaum Gastroenterology view link
This is an excellent page discussing what celiac sprue is, what food contain gluten and what ones don't. Also has a list of groups, and references for more assistance. Well done. I recommend this page.

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Is Rice Really Gluten Free
The Gluten Free Kitchen view link
The concern is not the rice but the coatings the manufacturers put on the rice to enhance its nutrition.

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Gluten-free Diet
Diagnose Me view link
Another great page on this topic

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The Gluten-Free Diet
Vegetarian Society view link
Another great page
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The Coeliac Society
view link

Celiac Sprue is genetic. If you have it now you have had it all your life. It will mess up your digestive system. If you have had Celiac Sprue for years and have only just now started to remove gluten, damage has likely been done. How serious damage is hard to say. The point of bringing this up is if it took you years to get to this point, you are not going to heal the damage in a few weeks.

And on top of that, eating gluten has inhibited your ability to digest your foods for years. You probably have other things going on in addition to a damaged colon.

What to do? Healing your body

Be kind and careful with your body. It needs to heal.

	Be very wise with the foods that you are eating.
	Feed your cells with a quality multi daily supplements preferably pharmaceutical grade not off the shelf.
	Read all ingredients. Gluten hides in processed food.
	Be real careful in restaurants. When in doubt don't eat the food. The longer you go without gluten the more sensitive you will become to it if and when you accidentally eat it. And you must avoid it.
	No Milk products. Messes up your digestion of other foods and you likely can't digest it anyway.
	Right now be careful with complex carbs like grains that are hard to digest. You need carbs though. One source I have suggests "When bowel is irritated - eat only Chongee rice - very soothing and offers nutrition - it is known as the "Chinese IV" - 1 cup rice to 12 cups water - leave in slow cooker for 4-6 hours. When bowel can accept something a little stronger (not having blood or diarrhea anymore) try other non-gluten grains - also cooked in slow cooker till very, very "tame" - VERY low residue! Can also try millet this way - remember it must be cooked for HOURS so as not to irritate – yet still offer some fiber. Drink nothing cold. NO SUGAR!!! Sip on hot water all day. As your bowel heals (gradually, of course) you can move up to a plate of very, very steamed vegetables and perhaps, even a baked apple (very mushy) with NO skin!" - Alternative Solutions for healing the Colon
	Lots of water filtered is best
	I might shy away from meat or eat it infrequently for awhile to give your system a rest. It takes 8 hours to digest meat. 4 hours for carbs.
	Eat simply. No processed foods.
	Lots of fruit especially in the morning. Eat it by itself. Do not mix fruit. Not all fruit does well with other fruit. Melons are the perfect food but eat it entirely by itself. (Read about Food Combining)
	Look up Food Combining. You don't want to have your food fighting as you try to heal your colon.
	When your body can tolerate it make sure you are getting adequate fiber. Few Americans get enough fiber. I might hold off on adding any until you feel your body is healed. It is also likely your digestive system has a lot of bad things in it since your digestion has been hindered for so long. It may need cleaning. I find that a fiber like psyllium works for me, although I now use fresh ground flax seed.
	Pay attention to your Bowel Movement's. They are a reflection of what is going on with your digestion. "The stool tells you a lot about your colon health. If it's dark brown in color, and it sinks, and it stinks, that's not good. And don't feel bad, that's the way most people are. What you want to see is light brown color, which means it's full of fresh bile from the liver, very mild odor, and a stool that floats. We're talking low-density here folks. The more compaction you have the darker the color and the faster it sinks. Compaction is not good. Also, moving bowels should be SIMPLE. "

You must take care of your body. It is the only one you have. Treat it with respect. Feed it properly and it will last you a lifetime.