Celiac Disease - Gluten Intolerance
Dr. Albert Robbins
www.Allergycenter.com
954-421-1929
Gluten is a storage protein that is present in certain grains such as wheat, rye and barley but not oats, rice or corn. Potato and soybean flour may also be substitued. Gluten enteropathy is a T cell mediated immune response in the intestinal submucosa . It is considered an autoimmune response.
The major clinical features of celiac disease can include gastrointestinal symptoms like diarrhea, intestinal gas, glossitis, recurrent oral ulcers, aphthus ulcers, and sores at the corners of the mouth.
Generalized symptoms of weakness, malaise, and weight loss may occur. Also dermatitis herpetiformis may be present. Symptoms of vasculitis, vitamin K deficiency and malabsorption syndrome may be present. Nausea and vomitting may also be present in the severely gluten sensitive individual.
Vague neurological disorders, cognitive dysfunction and even psychosis may be present due to gluten’s effect on neuron opiate receptors in the brain.
It is common to find calcium and vitamin D deficiency as well as folic acid deficiency in celiac patients. Many patients also present with anemia due to malabsorption. Selective IgA deficiency is common.
An association between celiac disease and asthma, eczema and urticaria has been well established. Positive skin tests to foods and other environmental allergens were more common in celiac patients than in controls in medical studies. Celiac disease may be associated with other autoimmune disorders including Addison’s disease, Graves disease, diabetes type 1, myasthenia gravis, scleroderma, Sjogren.s syndrome, atrophic gastritis and pancreatic insufficiency.
A gluten free diet may be dramatic in effecting symptom control.
Most patients with celiac disease also have lactose intolerance and/or cows milk allergy and should avoid all dairy products until all intestinal symptoms have improved on a gluten free diet. Improvement in symptoms should be evident within a few weeks on a gluten/milk free diet. The most common reason for treatment failure is incomplete removal of gluten from the diet.
Nutrient supplementation by injection of B12, folic acid, calcium and vitamin C can be provided in the initial stages of the elimination diet. Vitamin D should also be provided.
Gluten or wheat can cause symptoms that mimic irritable bowel syndrome in otherwise healthy people. Anyone with symptoms of diarrhea, colicky abdominal pain, intestinal gas may benefit from a trial of a gluten free diet. Crohn’s disease patients should be tested for celiac disease.
Autism patients are routinely placed on an allergy elimation diet as a trial to see if symptoms improve. On a combined milk free and gluten free diet many are helped.
RECOMMENDED TESTING:
1) HLA Typing for celiac disease
2) Antigliadin antibodies
3) Total IgG, IgM, IgA, IgE
4) Antiendomesial Antibodies
5) Skin testing for histamine , wheat and milk and other food allergens
6) Blood tests for casein, milk, wheat and gluten antibodies
7) Stool study evaluation for leaky gut syndrome
8) Candida antibodies (IgE, IgA,IgG and IgM)
9) Blood Nutrient Analysis
WHO SHOULD BE TESTED? Individuals with ADHD, autism, diabetes, vitiligo, individuals with borderline personality and mood disorders, chronic fatigue syndrome, IBS, Crohn’s disease, fibromyalgia, thyroid disease, and autoimmune diseases with unknown etiology.
