A biopsy of the small intestine often is performed to confirm the diagnosis. While diagnosing celiac disease has improved, many hurdles still remain. For example, the signs and symptoms of celiac disease mimic those of other conditions, including irritable bowel syndrome IBS , inflammatory bowel disease, diverticulitis, intestinal infections, iron-deficiency anemia caused by menstrual blood loss, and chronic fatigue syndrome, so misdiagnoses are common.
RDs on the Front Lines Dietitians and other nutrition professionals are poised to help identify and treat people with silent or atypical celiac disease. Do they have a history of nutritional deficiencies or autoimmune disease? What is their family history? Ask very pointed questions. Has she been tested for celiac disease?
Since celiac disease is genetic, looking for familial patterns also can help. Are there any unusual autoimmune diseases in the family? In the book Gluten-Free, Hassle Free , Brown created an extensive list of signs, symptoms, and conditions that can be related to celiac disease see sidebar for an excerpt. If a client has three or more symptoms, she directs them to a gastroenterologist for an evaluation. Most people notice improvement in symptoms within days of starting the diet, although it may take several years for the intestines to completely heal in adults.
Find substitutes for carbohydrates, like amaranth, noncontaminated buckwheat, garbanzo bean flour, and wild rice. These high-fiber foods are satisfying, help with regulation, and provide the whole grain nutrition patients need.
There are also more and more gluten-free products out there that you can incorporate. Knowing the grains that are gluten free and incorporating them into a well-balanced and wholesome diet can really make the diet doable. Still, there are special challenges involved in treating silent celiac disease.
Knowing the unusual places where gluten can hide, such as in medications, communion wafers, bouillon cubes, brown rice syrup, imitation crabmeat, and self-basting turkeys, and avoiding these foods is imperative for silent celiac disease patients.
Begun recommends that patients join a local celiac disease support group and sometimes introduces them to a gluten-free mentor. Their intestines are undergoing the same damage when eating gluten as the person who does experience symptoms. Left untreated, celiac disease can lead to severe complications and nutritional deficiencies. According to research by Daniel Leffler, MD, MS, an international authority on celiac disease and assistant professor of medicine at Harvard Medical School, the closer people adhere to a gluten-free diet, the more likely they are to gain weight.
This can put added stress on a recent gluten-free foods convert, which is a good reason to begin counseling celiac and gluten-sensitive patients about weight management immediately after their diagnosis and for the long term.
There are several reasons why people who begin eating gluten-free foods gain weight. Discouragement as a result of gaining weight is a common reason many patients stop following the diet.
I try to put it in a positive light. This problem is one of the main celiac disease symptoms in children. But this is not the whole story for either children or adults. Another reason why celiac disease is associated with being thin is that the disease damages the lining of the small intestine. Celiac disease can cause malnutrition due to malabsorption , in which nutrients can't be absorbed properly by the body. People with malabsorption are often underweight, which is why healthcare providers did not usually consider a diagnosis of celiac disease in people who are overweight.
Now, however, medical research has been showing that people with celiac disease are not always thin. For example, in a study published in the Journal of Clinical Gastroenterology , This is still a far smaller number of overweight and obese people than in the general population, but it shows that it is not rare for a person with celiac disease to be overweight. A review focused on overweight and obese people with celiac disease and found that a variety of factors could cause the link, including greater absorption of calories by more developed intestines, the potential lack of nutritional balance in strict gluten-free diets, and the worldwide trend toward weight gain and obesity.
More and more healthcare providers are realizing that the diagnosis of celiac disease should be considered in patients who are overweight, too. One benefit to going gluten-free if you have celiac disease: Studies have shown that weight tends to normalize, or revert to normal, once people with this condition adopt a gluten-free diet. It is possible to be overweight and have celiac disease. While most people with celiac disease have one or more digestive symptoms, some do not.
Screening for celiac disease is not done routinely if you don't have symptoms. Discuss any problems you have with your healthcare provider so you can receive the appropriate tests, diagnosis, and treatment. Following a gluten-free diet can be challenging. We're here to help. Sign up and receive our free recipe guide for delicious gluten-free meals!
Updated June Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol.
0コメント