Guest guest Posted February 27, 2005 Report Share Posted February 27, 2005 , David Elfstrom <listbox@e...> wrote: I have had allergy to wheat for year or so. Most recently gluten has shown up to avoid----does that mean I have celiac disease? Just recently experiencing pain in stomach area. Have had tummy weight for years, but this is the first time the pains?? Thanks, Sara W. > > Understanding Celiac Disease > http://www.wholefoodsmarket.com/healthinfo/celiacdisease.html > > * Celiac disease defined > * Cause of celiac disease > * Prevalence of celiac disease > * Symptoms of celiac disease > * Medical conditions associated with celiac disease > * Diagnosing celiac disease > * History of celiac disease research > * What is gluten? > * Safe grains for celiacs > * Sources of gluten > * Gluten contamination > * Gluten and Baking > * Additional considerations > > Celiac disease defined > > Celiac disease, also known as coeliac disease, gluten-sensitive > enteropathy, non-tropical sprue, celiac sprue, and gluten intolerant > enteropathy, is a chronic digestive disorder found in individuals who > experience a toxic immune response when they ingest gluten. Dermatitis > herpetiformis is a related skin condition experienced by some celiacs. > There is no cure for celiac disease. The only known treatment is lifelong > adherence to a gluten-free diet. Ingesting gluten affects the function of > the small intestine of celiacs by damaging and/or destroying the absorptive > villi. The body then becomes unable to properly absorb nutrients, resulting > in potentially life-threatening nutritional deficiencies and even > intestinal lymphoma. > Cause of celiac disease > > Celiac disease is thought to have a strong genetic component. The onset of > celiac disease has been associated with genes on Chromosome 6 called Human > Leukocyte Antigens (HLA) class II. HLA II genes affect an individual's > susceptibility to disease by mediating the interactions between cells of > the immune system. An individual may be genetically predisposed to celiac > disease, but the actual mechanism of onset is not fully understood. > Emotional stress, physical trauma, viral infection, pregnancy, and surgery > are some of the factors implicated in the onset of celiac disease. > Prevalence of celiac disease > > Celiac disease is the most common genetic disease in Europe. In Italy about > 1 in 250 people and in Ireland about 1 in 300 people have celiac disease1. > A University of Maryland study of over 13,000 subjects demonstrated the > prevalence at 1 in every 133 Americans have celiac disease. This study was > released in February 2003. > > Celiac disease is most common in whites, but has been diagnosed in Asians > from India and Pakistan. It is rarely diagnosed in Japanese, Chinese or > Africans. Because of the genetic component of the disease, it is found in 5 > to 15 percent of siblings and offspring of celiacs. There is a 70 percent > concordance among identical twins. > Symptoms of celiac disease > The term " celiac " or coeliac is of Greek origin and means " of or in the > cavity of the abdomen. " The condition known as celiac disease was so named > because many of the cardinal symptoms and effects of the disorder are > related to the gastrointestinal tract. > > However, the full range of symptoms of celiac disease are varied and may > occur at any time in the life of an individual who is genetically > predisposed to the disorder. A significant number of people show no > clinical symptoms, but are still incurring intestinal damage. Some symptoms > include: > > * diarrhea > * intestinal bloating or " pot belly " > * intestinal gas > * steatorrhea (fatty, floating and voluminous stools) > * fatigue > * weakness > * lack of energy > * bone or joint pain > * depression or irritability > * dental enamel defects > * anemia > * folate deficiency > * osteopenia and osteoporosis (bone mineral loss) > * infertility problems in women > * failure to thrive in children > * vomiting > * weight loss or wasting > > Dermatitis Herpetiformis (DH) is a related skin condition characterized by > blistering, itchy rashes on the back, legs, buttocks, and arms. Between 60 > and 80 percent of those who suffer from DH also incur damage to the > intestinal villi. > > Medical conditions associated with celiac disease > (Note: the nature of the association between these conditions and celiac > disease is unknown. Celiac disease does not necessarily cause these > disorders or vice versa. Factors that predispose a person to contracting > celiac disease may also make them vulnerable to these other immunological > disorders.) > > * neurological complications > * kidney and liver disease > * insulin dependent diabetes mellitus > * systemic lupus erythematosus > * selective IgA deficiency > * thyroid disease > * lactose intolerance > * chronic active hepatitis > * scleroderma > * myasthenia gravis > * Addison's disease > * rheumatoid arthritis > * Sjogren's syndrome > > Diagnosing celiac disease > Definitive diagnosis of celiac disease is complicated by the similarity of > many of the symptoms to other conditions. Individuals may be screened for > celiac disease using antigliadin, antireticulin, and antiendomysium > antibody tests. Raised blood serum levels of these antibodies in patients > with active celiac disease have been shown to correlate well with the > degree of damage occurring in the small intestine. However, intestinal > biopsy is still considered the most reliable diagnostic tool. A biopsy > before and after the adoption of a strict gluten-free diet allows the > physician to observe the pre- and post-exposure status of the intestinal > villi. The complete diagnosis may take quite a long time because healing of > the villi may take months or years on a gluten-free diet. DH is diagnosed > by performing a biopsy of the affected skin and staining for the presence > of IgA. > > Despite the difficulty in diagnosing celiac disease, early recognition of > the disorder may reduce the risk of the development of malignant intestinal > lymphomas, as well as serious bone mineral loss. Even celiac disease > sufferers who experience no observable symptoms are at risk for suffering > these problems. > > History of celiac disease research > The symptoms of celiac disease, including the wasting and characteristic > stools, were described as early as the first century A.D. Celiac disease > and it's dietary component was detailed in the medical literature in 1888. > In 1950, a Dutch pediatrician named Dicke proposed wheat gluten to be the > cause of the disease. He based this theory on his observations that celiac > children improved during World War II when wheat was scarce in Holland. > Subsequent research isolated gliadin and the other peptides mentioned above > as the portion of the gluten that triggered the intestinal damage. In 1989, > research indicated a significant reduction in malignancies when celiac > disease was treated with a gluten-free diet. Researchers continue to > investigate celiac disease, honing in on the exact causes and implications > for treatment. > > What is gluten? > " Gluten " is the general term for a mixture of many protein fragments > (called peptide chains or polypeptides) found in common cereal grains. > Wheat is the only grain considered to contain true gluten. The peptides > which predominate wheat gluten are gliadin and glutenin. Gliadin is thought > to be the peptide chain that instigates the toxic immune response and > subsequent intestinal damage in celiacs. However, other protein fragments > thought to be toxic to celiacs occur in rye, barley, and oats. They are > secalins, hordeins, and avenins, respectively. Even though some research > suggests that the avenins are not toxic, most celiacs still avoid oats just > to be safe. Minute amounts of any of these protein fragments can cause > intestinal damage in people with celiac disease. Because the disease is not > fully understood, it is thought there may be other peptide chains including > some derived from glutenin, that are also toxic. Because of the lack of > definitive research on the disease, celiacs must often live by the saying, > " when in doubt, leave it out. " > > Safe grains for celiacs > Current scientific consensus is that rice and corn (maize) are considered > safe for celiacs. In addition, millet, sorghum, Job's Tears, teff, and ragi > are thought to be close enough to corn in their genetic make-up to be safe. > More research is needed to substantiate this. Other grains suspected, but > not proven, to be safe for celiacs include buckwheat, amaranth, quinoa and > rape. Although their safety is debated, they are only very distantly > related to wheat. Thus, it is unlikely their peptide chains are the same as > the problematic chains found in wheat, rye, barley, and oats. > > Sources of gluten > Primary sources: > > * wheat (including semolina, durum, spelt, triticale, and kamut) > * rye > * barley > * oats > > Hidden sources: (ingredients/additives which may contain gluten) > The source of many of these ingredients must be carefully scrutinized to > ascertain whether or not any gluten is present. For example, modified food > starch from corn is acceptable, as long as no wheat starch is included. > Apple cider vinegar is acceptable, but distilled vinegars may contain > gluten. Pure buckwheat or buckwheat flour is acceptable, but many buckwheat > flours are contaminated with or have wheat flour added. > > * Binders > * Bleu cheese > * Brown Rice syrup (if barley malt enzyme is used) > * Caramel coloring (made from barley malt enzymes) > * Coatings > * Colorings > * Dextrins > * Dispersing agents > * Emulsifiers > * Excipients (added to prescription medications to achieve desired > consistency) > * Extracts (in grain alcohol) > * Fillers > * Flavorings (in grain alcohol) > * Flours, Breads, Cereals, Crackers, Pasta, Sauces & Condiments made > with the above listed grains or their derivatives. > * Grain alcohol (beer, ale, rye, scotch, bourbon, grain vodka)2 > * Homeopathic remedies > * Hydrolyzed protein, hydrolyzed plant protein (HPP) hydrolyzed > vegetable protein (HVP) > * Malt or Malt Flavoring (Barley malt) > * Modified starch, modified food starch (when derived from wheat) > * Mono- and di-glycerides (made using a wheat starch carrier) > * Oils (wheat germ oil & any oil with gluten additives) > * Preservatives > * Soy Sauce (when fermented using wheat) > * Spices (if containing anti-caking agents) > * Starch (made from grains listed above) > * Vegetable gum (when made from oats) > * Vegetable protein > * Vinegars (distilled clear and white or with a mash starter) > * Vitamin E oil > > Gluten contamination > When gluten-free grains are milled or processed, they may be contaminated > with other grains processed on the same machinery. Gluten contamination may > occur via baking pans, grills, utensils, cutting boards, toasters, etc., > when foods are baked, cooked, or otherwise processed. Deep frying foods in > oils or fats that have been used for gluten containing foods may also lead > to gluten contamination. Many fast food chains fry french fries in the same > oil as wheat battered onion rings. > > Additional considerations > Many over the counter and prescription medications may contain gluten. > Pills may be dusted with flour during manufacturing and capsules may have > gluten present in the oil inside. > > Non-food products such as toothpaste and lipstick may also contain gluten. > Other non-ingested products such as skin lotion may contain gluten and may > be accidentally ingested when fingers come into contact with the mouth. > Ingredients in packaged foods can change without warning. Celiacs must be > constantly vigilant even with foods that have been previously deemed safe. > > > Footnotes > 1 NIH Publication No. 02-4269 October 2001 > 2Although alcohol that is distilled does not contain gluten because the > gluten cannot pass over during the distillation process, many celiacs do > report problems with ingestion. Beer (fermented) also must be avoided > because malt (usually from barley) is an ingredient. Rice beers also use malt. > References > Bernard, B., M.D., " Gluten Sensitive Disorders/celiac Disease and > Dermatitis Herpetiformis, " (1995). Department of Pediatrics, University of > Southern California > > Celiac Disease Foundation Newsletter, (1997). Volume 7-3. > > Chartrand, L.J. & Seidman, E.G., " Celiac disease is a lifelong disorder, " > (1996). Clinical Investigation in Medicine, 19(5): 357-61. > > Chartrand et al., " Wheat starch intolerance in patients with celiac > disease, " (1997). Journal of the American Dietetic Association, 97 (6): 612-618. > > Maki, M. & Collin , P., " Coeliac Disease, " (1997). The Lancet, 349: 1755-1759. > > Malnick, S.D. et al., " Celiac disease: diagnostic clues to unmask an > impostor, " (1997). Postgraduate Medicine, 101(6): 239-244. > > Alford, Jeffrey & Duguid, Naomi, " Flatbreads and Flavors; A Baker's > Atlas, " 1995, William and Morrow and Company, Inc. > > Clayton, Bernard Jr.. " Bernard Clayton's New Complete Book of Breads, " > 1987, Simon & Schuster. > > Hagman, Bette, " The Gluten-Free Gourmet Cooks Fast and Healthy, " 1996, > Henry Holt & Company, NY. > > McGee, Harold, " On Food and Cooking: The Science and Lore of the Kitchen, " > 1984, MacMillen Publishing Company, NY. > > Wittenberg, Margaret M., " Good Food: The Comprehensive Food and Nutrition > Resource, " 1995, The Crossing Press, CA. > > More info: > > * The Celiac Disease Foundation > * Gluten Intolerance Group > * Celiac Sprue Association > * Univ. of Maryland Center for Celiac Research > * The Food Allergy & Anaphylaxis Network > * National Digestive Diseases Information Clearinghouse > > > Last updated on July 23, 2004 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 8, 2005 Report Share Posted March 8, 2005 >Under standing Celiac Disease >http://www.wholefoodsmarket.com/healthinfo/celiacdisease.html > > * Celiac disease defined > * Cause of celiac disease > * Prevalence of celiac disease > * Symptoms of celiac disease > * Medical conditions associated with celiac disease > * Diagnosing celiac disease > * History of celiac disease research > * What is gluten? > * Safe grains for celiacs > * Sources of gluten > * Gluten contamination > * Gluten and Baking > * Additional considerations > >Celiac disease defined > >Celiac disease, also known as coeliac disease, gluten-sensitive >enteropathy, non-tropical sprue, celiac sprue, and gluten intolerant >enteropathy, is a chronic digestive disorder found in individuals who >experience a toxic immune response when they ingest gluten. Dermatitis >herpetiformis is a related skin condition experienced by some celiacs. >There is no cure for celiac disease. The only known treatment is lifelong >adherence to a gluten-free diet. Ingesting gluten affects the function of >the small intestine of celiacs by damaging and/or destroying the absorptive >villi. The body then becomes unable to properly absorb nutrients, resulting >in potentially life-threatening nutritional deficiencies and even >intestinal lymphoma. >Cause of celiac disease > >Celiac disease is thought to have a strong genetic component. The onset of >celiac disease has been associated with genes on Chromosome 6 called Human >Leukocyte Antigens (HLA) class II. HLA II genes affect an individual's >susceptibility to disease by mediating the interactions between cells of >the immune system. An individual may be genetically predisposed to celiac >disease, but the actual mechanism of onset is not fully understood. >Emotional stress, physical trauma, viral infection, pregnancy, and surgery >are some of the factors implicated in the onset of celiac disease. >Prevalence of celiac disease > >Celiac disease is the most common genetic disease in Europe. In Italy about >1 in 250 people and in Ireland about 1 in 300 people have celiac disease1. >A University of Maryland study of over 13,000 subjects demonstrated the >prevalence at 1 in every 133 Americans have celiac disease. This study was >released in February 2003. > >Celiac disease is most common in whites, but has been diagnosed in Asians >from India and Pakistan. It is rarely diagnosed in Japanese, Chinese or >Africans. Because of the genetic component of the disease, it is found in 5 >to 15 percent of siblings and offspring of celiacs. There is a 70 percent >concordance among identical twins. >Symptoms of celiac disease >The term " celiac " or coeliac is of Greek origin and means " of or in the >cavity of the abdomen. " The condition known as celiac disease was so named >because many of the cardinal symptoms and effects of the disorder are >related to the gastrointestinal tract. > >However, the full range of symptoms of celiac disease are varied and may >occur at any time in the life of an individual who is genetically >predisposed to the disorder. A significant number of people show no >clinical symptoms, but are still incurring intestinal damage. Some symptoms >include: > > * diarrhea > * intestinal bloating or " pot belly " > * intestinal gas > * steatorrhea (fatty, floating and voluminous stools) > * fatigue > * weakness > * lack of energy > * bone or joint pain > * depression or irritability > * dental enamel defects > * anemia > * folate deficiency > * osteopenia and osteoporosis (bone mineral loss) > * infertility problems in women > * failure to thrive in children > * vomiting > * weight loss or wasting > >Dermatitis Herpetiformis (DH) is a related skin condition characterized by >blistering, itchy rashes on the back, legs, buttocks, and arms. Between 60 >and 80 percent of those who suffer from DH also incur damage to the >intestinal villi. > >Medical conditions associated with celiac disease >(Note: the nature of the association between these conditions and celiac >disease is unknown. Celiac disease does not necessarily cause these >disorders or vice versa. Factors that predispose a person to contracting >celiac disease may also make them vulnerable to these other immunological >disorders.) > > * neurological complications > * kidney and liver disease > * insulin dependent diabetes mellitus > * systemic lupus erythematosus > * selective IgA deficiency > * thyroid disease > * lactose intolerance > * chronic active hepatitis > * scleroderma > * myasthenia gravis > * Addison's disease > * rheumatoid arthritis > * Sjogren's syndrome > >Diagnosing celiac disease >Definitive diagnosis of celiac disease is complicated by the similarity of >many of the symptoms to other conditions. Individuals may be screened for >celiac disease using antigliadin, antireticulin, and antiendomysium >antibody tests. Raised blood serum levels of these antibodies in patients >with active celiac disease have been shown to correlate well with the >degree of damage occurring in the small intestine. However, intestinal >biopsy is still considered the most reliable diagnostic tool. A biopsy >before and after the adoption of a strict gluten-free diet allows the >physician to observe the pre- and post-exposure status of the intestinal >villi. The complete diagnosis may take quite a long time because healing of >the villi may take months or years on a gluten-free diet. DH is diagnosed >by performing a biopsy of the affected skin and staining for the presence >of IgA. > >Despite the difficulty in diagnosing celiac disease, early recognition of >the disorder may reduce the risk of the development of malignant intestinal >lymphomas, as well as serious bone mineral loss. Even celiac disease >sufferers who experience no observable symptoms are at risk for suffering >these problems. > >History of celiac disease research >The symptoms of celiac disease, including the wasting and characteristic >stools, were described as early as the first century A.D. Celiac disease >and it's dietary component was detailed in the medical literature in 1888. >In 1950, a Dutch pediatrician named Dicke proposed wheat gluten to be the >cause of the disease. He based this theory on his observations that celiac >children improved during World War II when wheat was scarce in Holland. >Subsequent research isolated gliadin and the other peptides mentioned above >as the portion of the gluten that triggered the intestinal damage. In 1989, >research indicated a significant reduction in malignancies when celiac >disease was treated with a gluten-free diet. Researchers continue to >investigate celiac disease, honing in on the exact causes and implications >for treatment. > >What is gluten? > " Gluten " is the general term for a mixture of many protein fragments >(called peptide chains or polypeptides) found in common cereal grains. >Wheat is the only grain considered to contain true gluten. The peptides >which predominate wheat gluten are gliadin and glutenin. Gliadin is thought >to be the peptide chain that instigates the toxic immune response and >subsequent intestinal damage in celiacs. However, other protein fragments >thought to be toxic to celiacs occur in rye, barley, and oats. They are >secalins, hordeins, and avenins, respectively. Even though some research >suggests that the avenins are not toxic, most celiacs still avoid oats just >to be safe. Minute amounts of any of these protein fragments can cause >intestinal damage in people with celiac disease. Because the disease is not >fully understood, it is thought there may be other peptide chains including >some derived from glutenin, that are also toxic. Because of the lack of >definitive research on the disease, celiacs must often live by the saying, > " when in doubt, leave it out. " > >Safe grains for celiacs >Current scientific consensus is that rice and corn (maize) are considered >safe for celiacs. In addition, millet, sorghum, Job's Tears, teff, and ragi >are thought to be close enough to corn in their genetic make-up to be safe. >More research is needed to substantiate this. Other grains suspected, but >not proven, to be safe for celiacs include buckwheat, amaranth, quinoa and >rape. Although their safety is debated, they are only very distantly >related to wheat. Thus, it is unlikely their peptide chains are the same as >the problematic chains found in wheat, rye, barley, and oats. > >Sources of gluten >Primary sources: > > * wheat (including semolina, durum, spelt, triticale, and kamut) > * rye > * barley > * oats > >Hidden sources: (ingredients/additives which may contain gluten) >The source of many of these ingredients must be carefully scrutinized to >ascertain whether or not any gluten is present. For example, modified food >starch from corn is acceptable, as long as no wheat starch is included. >Apple cider vinegar is acceptable, but distilled vinegars may contain >gluten. Pure buckwheat or buckwheat flour is acceptable, but many buckwheat >flours are contaminated with or have wheat flour added. > > * Binders > * Bleu cheese > * Brown Rice syrup (if barley malt enzyme is used) > * Caramel coloring (made from barley malt enzymes) > * Coatings > * Colorings > * Dextrins > * Dispersing agents > * Emulsifiers > * Excipients (added to prescription medications to achieve desired >consistency) > * Extracts (in grain alcohol) > * Fillers > * Flavorings (in grain alcohol) > * Flours, Breads, Cereals, Crackers, Pasta, Sauces & Condiments made >with the above listed grains or their derivatives. > * Grain alcohol (beer, ale, rye, scotch, bourbon, grain vodka)2 > * Homeopathic remedies > * Hydrolyzed protein, hydrolyzed plant protein (HPP) hydrolyzed >vegetable protein (HVP) > * Malt or Malt Flavoring (Barley malt) > * Modified starch, modified food starch (when derived from wheat) > * Mono- and di-glycerides (made using a wheat starch carrier) > * Oils (wheat germ oil & any oil with gluten additives) > * Preservatives > * Soy Sauce (when fermented using wheat) > * Spices (if containing anti-caking agents) > * Starch (made from grains listed above) > * Vegetable gum (when made from oats) > * Vegetable protein > * Vinegars (distilled clear and white or with a mash starter) > * Vitamin E oil > >Gluten contamination >When gluten-free grains are milled or processed, they may be contaminated >with other grains processed on the same machinery. Gluten contamination may >occur via baking pans, grills, utensils, cutting boards, toasters, etc., >when foods are baked, cooked, or otherwise processed. Deep frying foods in >oils or fats that have been used for gluten containing foods may also lead >to gluten contamination. Many fast food chains fry french fries in the same >oil as wheat battered onion rings. > >Additional considerations >Many over the counter and prescription medications may contain gluten. >Pills may be dusted with flour during manufacturing and capsules may have >gluten present in the oil inside. > >Non-food products such as toothpaste and lipstick may also contain gluten. >Other non-ingested products such as skin lotion may contain gluten and may >be accidentally ingested when fingers come into contact with the mouth. >Ingredients in packaged foods can change without warning. Celiacs must be >constantly vigilant even with foods that have been previously deemed safe. > > >Footnotes >1 NIH Publication No. 02-4269 October 2001 >2Although alcohol that is distilled does not contain gluten because the >gluten cannot pass over during the distillation process, many celiacs do >report problems with ingestion. Beer (fermented) also must be avoided >because malt (usually from barley) is an ingredient. Rice beers also use malt. >References >Bernard, B., M.D., " Gluten Sensitive Disorders/celiac Disease and >Dermatitis Herpetiformis, " (1995). Department of Pediatrics, University of >Southern California > >Celiac Disease Foundation Newsletter, (1997). Volume 7-3. > >Chartrand, L.J. & Seidman, E.G., " Celiac disease is a lifelong disorder, " >(1996). Clinical Investigation in Medicine, 19(5): 357-61. > >Chartrand et al., " Wheat starch intolerance in patients with celiac >disease, " (1997). Journal of the American Dietetic Association, 97(6): 612-618. > >Maki, M. & Collin , P., " Coeliac Disease, " (1997). The Lancet, 349: 1755-1759. > >Malnick, S.D. et al., " Celiac disease: diagnostic clues to unmask an >impostor, " (1997). Postgraduate Medicine, 101(6): 239-244. > >Alford, Jeffrey & Duguid, Naomi, " Flatbreads and Flavors; A Baker's >Atlas, " 1995, William and Morrow and Company, Inc. > >Clayton, Bernard Jr.. " Bernard Clayton's New Complete Book of Breads, " >1987, Simon & Schuster. > >Hagman, Bette, " The Gluten-Free Gourmet Cooks Fast and Healthy, " 1996, >Henry Holt & Company, NY. > >McGee, Harold, " On Food and Cooking: The Science and Lore of the Kitchen, " >1984, MacMillen Publishing Company, NY. > >Wittenberg, Margaret M., " Good Food: The Comprehensive Food and Nutrition >Resource, " 1995, The Crossing Press, CA. > >More info: > > * The Celiac Disease Foundation > * Gluten Intolerance Group > * Celiac Sprue Association > * Univ. of Maryland Center for Celiac Research > * The Food Allergy & Anaphylaxis Network > * National Digestive Diseases Information Clearinghouse > > >Last updated on July 23, 2004 > > > > > Quote Link to comment Share on other sites More sharing options...
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