Friday, October 11, 2019

Oh pasta, I miss you!


For the majority of my life I have not been Celiac. A few months ago, after experiencing extreme stomach cramps, nausea, and diarrhea, I was diagnosed with a severe form of viral gastroenteritis.

Once the infection cleared, I still noticed the presence of severe stomach cramps after consuming food. I sought insight from a gastroenterologist. Still concerned he ordered an abdominal CT scan with contrast.

I was not allowed to eat prior to the exam, and after arrival I was expected to intake four bottles of oral contrast. This liquid slows down the function of the microvilli in my intestines to allow for radiologists to obtain a clear image.  The results from the CT scan demonstrated signs of damaged microvilli indicating Celiac disease. The doctor explained I have always had this condition, but the viral infection cleaned out my intestinal microbiome, which resulted in heighten reactions to gluten.

Celiac is a genetic autoimmune disease, triggered by the consumption of gluten and affects roughly 1 in 100 people. When a person with Celiac consumes gluten, the protein interferes with the normal absorption of nutrients from food by damaging the villi located in the small intestine. This makes it difficult for proper nutrient absorption. There is no cure for Celiac and the only treatment is a life-long gluten free diet.

Celiac resulted in cutting the consumption of all wheat, barely, and rye. I have become completely reliant on nutrient labels to provide me correct nutrimental information; however, I have learned labels are not necessarily a gluten-free guarantee. The FDA states labeling for “gluten-free” can occur if the food is relatively free from gluten (fruits and vegetables) or does not contain anything derived from gluten proteins.  Food manufactures are responsible for ensuring that food products bearing a gluten-free claim meets the FDA requirements. They are not required to test the gluten levels in individual ingredients they obtained from outside locations. Finally, the FDA does not include a gluten-free seal. So instead food manufactures may include the logo of gluten-free certificate programs on their packaging. The FDA, however, does not endorse or recommend any particular parties. Programs like The Gluten-Free Certification Organization have offered these seals of Gluten-Free approval providing a trusted source for all individuals struggling with Celiac.

References:

Green, P. H. R. (2008, February 14). Celiac Disease: NEJM. Retrieved October 10, 2019, from https://www.nejm.org/doi/full/10.1056/nejmra071600.

Cassie, Larry, George, Sara, Marie, & Strain, V. (2018, September 28). Is That Gluten-Free Product Really Gluten-Free? Retrieved October 10, 2019, from https://lilynicholsrdn.com/gluten-free-product-really-gluten-free/.

3 comments:

  1. When I was having stomach problems, I was advised by my doctor twice to try a gluten free test before having a celiac test done (it was negative). Finally I went to see a GI doctor (suspecting at this point that gluten was no the root of my stomach issues). He told me the ONLY reason to do gluten free diet is celiacs! It's interesting to see how the public's perception of gluten being the "bad guy" has worked it's way into the medical community as well, with my primary care doctor suggesting a gluten free diet before doing any preliminary tests or bloodwork. It was so frustrating to be told twice to cut out gluten when I knew I didn't have celiacs.

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  3. So the viral gastroenteritis activated your gluten-intolerance? That's really intriguing, I had always assumed that it was more black and white than that. The only other person I know with Celiac has been like that for her whole life. Your situation sounds like a really interesting example of phenotype plasticity. If I'm correct, you always had the potential for gluten-intolerance, but it took a severe infection to flip the switch to Celiac. It makes me wonder if, without the gastroenteritis, you would have never developed Celiac, or if something else would have caused it later on.

    Another interesting piece to consider is treatment of Celiac. I know that right now, there is no cure. There is, however, research into various treatments for Celiac that could potentially allow Celiac patients to consume gluten. Currently, scientists are looking into pills that when taken before a meal containing gluten, could break down gluten before it gets to the small intestine, therefore eliminating its toxicity. There is another potential pill that could make the small intestine less permeable to gluten. There is also talk of drugs that could reduce the inflammatory response to gluten, and a vaccine that could restore tolerance to gluten completely.

    Living without gluten would be so difficult, especially having developed it in college. Changing your diet so drastically would have a huge impact on your life, and I'm sorry you've had to experience that! Hopefully treatments for Celiac continue to develop, and maybe one day you can be reunited with pasta!

    Treatment of Celiac Disease. (2019). Retrieved October 13, 2019, from https://www.cureceliacdisease.org/treatment/.

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