While pink ribbons abound in October, breast cancer is not the only disease observed this month. October also marks National Celiac Awareness Month.
Celiac disease (CD), a disorder of the small intestine, affects one in every 133 Americans, or roughly two million people. Shockingly, less then five percent of sufferers are currently diagnosed.
The disease stems from an abnormal reaction to gluten, a protein commonly found in many grains, including wheat, barley, rye and, in smaller amounts, oats. In people afflicted with CD, the body's immune system misrepresents the protein as a foreign object and launches an attack on the small intestine. The ensuing assault leads to intestinal damage and an inability to absorb vital nutrients from food.
Symptoms of Celiac disease are slow in coming and are often confused with those of other gastrointestinal disorders such as irritable bowel syndrome and lactose intolerance. Such common misdiagnoses only compound the problem, as unknowing sufferers continue to consume the responsible gluten protein (in the form of breads, pastas and cereals) and prolong the cycle of damage.
While many people with CD have the disease for years - even decades - without symptoms, others are plagued with daily reminders. Symptoms can vary greatly, but commonly include fatigue, unusual weight loss or weight gain, chronic diarrhea, constipation and fatty, odorous stool. Warning signs may appear at any age.
The disease also damages the body's villi - small fingerlike protrusions that line the small intestine and aid in nutrient absorption. With injured villi, people with CD are unable to utilize the nutrients in their food and often develop symptoms of malnutrition. Malabsorption of calcium, for example, puts undiagnosed Celiac sufferers at greater risk for osteoporosis later in life. An increased risk of certain intestinal cancers has also been noted.
Blood analysis for the presence of certain antibodies related to the disease is a first step in diagnosing CD; stool analysis is also common. More definitive testing involves a biopsy of the small intestine to check for villi damage. In many cases, however, Celiac disease is often diagnosed by process of elimination. If eliminating the offending gluten protein from one's diet alleviates the symptoms, the patient is often encouraged to continue a gluten-free lifestyle. Luckily, previous damage to the small intestine is usually completely reversible within three to six months after the protein is eliminated from the diet.
Adopting a life-long gluten-free diet is currently the only viable treatment for celiac disease. Gluten-free diets typically feature corn and rice-based products in place of wheat, barley, or rye and encourage the use of alternative flours, like soy. (The extent to which oats must be excluded from the diet is contested; commercially processed oats may be cross-contaminated with other gluten-containing grains. Most CD organizations currently recommend excluding oats as the only "risk-free" choice.) And while processed foods have usually been a no-no for Celiac sufferers, the gluten-free food market has improved significantly in just the past few years. (Annie's Homegrown, for example, now offers a gluten-free macaroni and cheese.) Restaurants are also showing awareness by offering gluten-free menu options - Porter Square's Elephant Walk features an entire Celiac menu!
People with CD are advised to read labels carefully. In addition to food, many vitamins and prescription drugs are also manufactured with gluten.
