Understanding Celiac Disease, Pt. 1

Besides the fact that my cholesterol is about 120 mg/dl, my blood pressure hovers around 90/60 mm/Hg, and my body fat is about 17.4%, I have celiac disease (CD). This article explains what CD is and how it relates to me.

 “WHAT DO YOU EAT, JEANNE?”

Although I eat healthy and am thin, my diet might not be the right one for you. The way I eat won’t necessarily be the answer to a healthy body composition for you. There are too many things to consider, before copying my diet. So, this article was written not only to teach you about another aspect of health, but also to share with you my pursuit of a healthy lifestyle.

CD is a genetic condition in which damage to the lining (mucosal surface) of the small intestine is caused by an immunologically toxic reaction to gluten. That is, after gluten is consumed, it makes its way to the small intestines where it attaches to abnormally formed antibodies. Then, a number of reactions occur, leaving the intestinal lining damaged. Usually, it is the first (duodenum) and/or second (jejunum) of three sections of the small intestines that is affected. Gluten usually doesn’t make it any farther than that.

The fact that there are some abnormal antibodies makes CD an autoimmune disorder, too. Normally antibodies are “good guys” that attack antigens or “bad guys.” Those who have any autoimmune disease have some antibodies that bond with antigens instead of attacking them. The result is damaged healthy tissue.

In CD, the tissue that is damaged is called villi (singular-villus). They are finger-like projections that make up the lining of the small intestines. Imagine each piece of grass in your lawn as being a villus. Your lawn would look like a healthy mucosal surface. Now imagine having each piece of grass gone so that only dirt is showing. That is what my mucosal lining looked like when I was first diagnosed. There was nothing sticking out anymore-no villi. Villi are important because nutrients are absorbed through them to the blood stream and digestive substances pass through them to break down food in the small intestines. Think of it as a two-way street. Gluten is the bomb that takes out the street.

CD is similar to diabetes (mainly Type 1) in that there is a genetic predisposition to it and that it is not necessarily “activated” right from birth. It “kicks in” later in life. When? It’s different for each person. With CD, it’s usually a mentally or physically stressful event that starts it. For me, I think the mononucleosis that I had in May 1993 started it. Also like diabetes, there is no cure, but CD has a good prognosis. One can be completely healthy, if gluten is 100% out of the diet for life.

After gluten is eliminated from the diet, it can take one to two years for the mucosa to heal. If one does not stay gluten free for five years or more at a time, there is an increased chance for lymphoma (cancer). Also, nutritional deficiencies and other complications can occur.

Gluten is a protein found in all forms of wheat (including durham, semolina and spelt), rye, barley, and related hybrids such as triticale and kamut. Gluten is the antigen. Or, I can say that I have an intolerance or sensitivity to a normally harmless protein. Gluten is in everything. It can be used to make “starch,” “natural flavors,” “hydrolyzed vegetable protein,” “malt flavoring,” “caramel coloring,” etc. I can’t eat oats, either, because in the U. S. many oat products are contaminated by wheat. You can imagine how hard it is to find gluten-free foods at a store or what it’s like to eat out. Many times I have to call food manufacturers and talk to chefs.

After getting medical insurance in April 1994, I had a physical with a general practitioner. I asked her to do two “routine” blood tests, fortunately, because she had not planned on it. Two of the several values were abnormal, leading her to think I was deficient in vitamin B12 and folic acid (another B vitamin). She confirmed her suspicion with another blood test.

After eight months (mostly spent with a gastroenterologist) of testing to figure out why I was deficient, CD was diagnosed. A pan-endoscopy was the prevailing “winner” that led to the answer. The scope allows the doctor to look at the mucosal lining and take a biopsy. After the diagnosis, I was referred to a registered dietitian (R. D.) who not only didn’t know why I was there, but also didn’t know anything about gluten or CD. That’s when I started my own research. I read a book called “The Gluten-Free Gourmet” by Bette Hagman and joined several support groups.

For more information, you can call or write the Celiac Sprue Association/USA, P. O. Box 31700, Omaha, NE 68131-0700, 877-272-4272.

About the Author

Jeanne “Bean“ Murdock, is the owner Beanfit Health and Fitness Services. She is the host/producer of Celiac Radio and the author of “Ask Bean“, an online column and “Successful Dating at Last! A Workbook for Understanding Each Other“ and “The Every Excuse in the Book Book: How to Benefit from Exercising, by Overcoming Your Excuses.“ Contact Jeanne for more information at 408-203-7643 or through her website at www.beanfit.com.

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These resources are for the purpose of personal trainer growth and development through Continuing Education which advances the knowledge of fitness professionals. This article is written for NFPT Certified Personal Trainers to receive Continuing Education Credit (CEC). Please contact NFPT at 800.729.6378 or [email protected] with questions or for more information.