Celiac Disease, Part 1: What Is Going On Here?

By Ruth Werner, LMP, NCTMB
May 29, 2009

Celiac Disease, Part 1: What Is Going On Here?

By Ruth Werner, LMP, NCTMB
May 29, 2009

Dear Readers,

One of the interesting aspects of my job is that I get to keep my ear to the ground to find out what is being discussed as the "disease of the week." Celiac disease, also called celiac sprue, has been garnering a lot of attention recently. It's a surprisingly common digestive disorder that has many confusing signs and symptoms that overlap some of the most common conditions our clients deal with. This is the first of a two-part article on the specific information currently available about celiac disease.

When I asked readers about their experiences with this problem, I got some heartfelt responses I felt could be of general interest. Here are some samples:

From a therapist in Colorado:

I was recently diagnosed (at 40) with gluten sensitivity, an inherited disorder that on average takes 10 to 15 years after symptoms appear for a sufferer to be diagnosed (in this country). It's below the radar of most physicians, and even of many gastroenterologists. I don't understand this. It is so very common, and so easily treatable. No drugs, no surgery required - just don't eat foods that contain the protein gluten. Information needs to get out! Typically, symptoms affect all our systems of elimination - after all, it's an immune disorder. Allergy symptoms, skin disorders, digestive difficulties, joint pain, chronic fatigue and fibromyalgia-type pain symptoms can happen - things we massage therapists see over and over again.

From another in Virginia:

I would love for you to discuss celiac disease or gluten sensitivity disorder. A year ago, my chiropractor/naturopath did a food allergy test on me and discovered that I have a sensitivity to gluten/gliadin. I stopped eating it and my whole life changed. I have to let you know that I am also allergic to dairy and eggs. My medical doctor had never said anything about this, nor was there ever any mention about the possibility that there may be an allergy to anything! By my elimination of the three allergens, my blood pressure dropped and my blood sugar stabilized. I feel 100% better and have energy to spare compared to when I was on drugs for what my doctor called "metabolic syndrome." An added bonus is that I finally was able to lose weight (40 lbs so far). I see many of my clients suffer with my old symptoms. Someday I hope that they, too, will be tested for food allergies, because I believe there are so many people out there who have a wheat allergy and are just not aware of it.

These therapists have identified one of the most frustrating situations for people who live with long-term, low-grade, "I know I could feel better than this" kinds of conditions. The overlap in symptomatology between celiac sprue, fibromyalgia, chronic fatigue syndrome, hypothyroidism, metabolic syndrome, depression, candida, and half a dozen other common complaints makes wading through the possibilities a daunting task. Furthermore, any combination of these disorders can occur simultaneously. Add a medical community that is only now awakening to the subtleties of many of these disorders, and it's clear why so many people miss out on accurate diagnoses and useful treatment options.

Celiac disease is unique among these disorders, however, because of the way it affects the body, and strategies to reverse the damage are relatively clear-cut. Read on for the details.

What Is Celiac Disease?

Celiac disease, also called sprue or gluten-sensitivity enteropathy, is a condition in which the intestinal villi are damaged as part of an immune system reaction in the presence of gluten. Gluten is a protein present in wheat, rye, barley, spelt, triticale, kamut and other grains. Amaranth, buckwheat and quinoa don't have gluten, but they are often stored in containers where gluten-containing grains have been stored, so many people are sensitive to them as well. Gluten is used as a thickener or binder in prepared foods, makeup, vitamins and other pills. Oats don't have gluten, but they do have gluten-like proteins. Some people with celiac disease are sensitive to oats as well, but this is not true for every patient.

The incidence of celiac disease in the U.S. is a topic of some controversy. While once considered rare and diagnosed only in its most extreme form among infants who failed to thrive, recent studies indicate it might affect about one out of every 133 people. Not everyone has it in an extreme form, and many adults find that symptoms only develop after a traumatic event, such as an injury, childbirth or surgery. A genetic link for celiac disease is clear; it occurs in 5 percent to 10 percent of all first-degree relatives (children, parents, siblings) of diagnosed people.

When a person has celiac disease, the gluten in triggering foods is broken into its components, including an amino acid chain called gliadin. The absorption of gliadin in the small intestine triggers an inflammatory response that damages or completely disables the villi. The lack of functioning villi results in problems with the absorption of any nutrient - not just gluten products. Poor uptake leads to signs of malabsorption and malnutrition, although the diet of a person with celiac disease may be identical to that of someone who is healthy. Many people with celiac disease have a particular sensitivity to dairy products; they might be diagnosed as "lactose intolerant," while missing the larger problem.

Celiac disease frequently occurs concurrently with other autoimmune disorders, including lupus, rheumatoid arthritis and type 1 diabetes.

In addition, many people with celiac disease develop a painful rash called dermatitis herpetiformis ("skin inflammation that looks like herpes") and mouth sores called aphthous stomatitis ("inflamed mouth ulcers").

To be continued ...

In Celiac Disease, Part 2, we will discuss the symptoms and complications of celiac disease, the very hopeful and positive prognosis for this disorder, and the special role of massage in the context of gastrointestinal problems in general. In the meantime, if you have other experiences with celiac disease that you'd like to share with Massage Today readers, by all means write and let me know: What's on your table?

Many thanks and many blessings.