|
 Ask
Dr. Aron
 What
is the difference between celiac
disease and gluten intolerance?
Is one more serious than the other?
|
 The
strict definition of celiac disease
— positive antibodies to gliadin,
intestinal endomysium, and tissue
transglutaminase, together with
the presence of HLA-DQ2 or HLA-DQ8
genes and an intestinal biopsy that
shows at least 20-25 CD3 cells per
100 epithelial cells — will
account for about 75-80% of all
those sensitive to gluten.
It must be noted, however, that
there are injurious grain proteins
that cause damage and produce symptoms
by mechanisms that are as yet obscure.
As well, many other gene markers
for grain-mediated injury have been
described, thus placing many into
the category of gluten intolerant,
but not truly having celiac disease.
We do know the consequences of untreated
celiac disease — an increased
risk for lymphomas and other solid
tumors, along with a host of associated
auto-immune, neurological and endocrine
diseases.
It is unclear whether other people
who are not celiacs but clearly
cannot tolerate gluten are at risk
for any other associated diseases.
If you test negative for the strict
criteria for celiac disease, but
still cannot tolerate gluten, there
is no harm in keeping to a gluten-free
diet.
Health and happiness,
Dr. Aron, MAY
26 , 2007
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How
long does it take to get wheat or
gluten out of your system?
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No
one knows for sure, but given
the digestive rate, absorption
of gluten and glutenin peptide
fragments, and the turnover rate
of the intestinal cells, about
3-7 days would be a rational guess.
How much time it takes to recover
from damage done by gluten, however,
depends on a number of factors:
the dose of HLA DQ2, DQ8 genes
that you receive from your parents,
the position of the genes of chromosome
6 (genes on the same side of the
chromosome-”cis” position
are more potent than on opposite
sides of the chromosome-”trans”
position), the reactivity of your
innate system at the level of
the intestinal cell, and on the
adaptive immune system’s
pre-programmed drive.
That said, the more advanced your
biopsy (Marsh III), the longer
it will take to completely reverse
the disease. Marsh III’s
take about 2 years, while Marsh
I’s may take 6 months to
a year. All the more reason to
have a biopsy at the time of initial
diagnosis, and another one one
year after being free from gluten.
Health and happiness,
Dr. Aron, MAY
19 , 2007
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I
have read about LACTAGEN recently.
Is there any chance that it might
help the lactose intolerance?
I was diagnosed with Celiac Disease
after a surgery for hip replacement
three years ago. I had previously
been diagnosed with Collagenous
Colitis. I can handle the wheat
restrictions, but as a result
of the damage, I have a problem
with even minute amounts of dairy.
I have read about LACTAGEN recently.
Is there any chance that it might
help the lactose intolerance??
I really miss cottage cheese,
and cheddar cheese, and yogurt
and….you get the picture!!
I am 72 years old.
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Dear
Septagenarian with celiac: It is
not uncommon to be lactose intolerant
if you have celiac disease. With
the history of collagenous colitis,
it suggests that the gluten intolerance
was present for a long time before
the diagnosis of celiac disease
was made.
The lactogen is not a bad idea,
but you may also need to be reassessed
for inflammation in the colon, as
the addition of an aminosalicylate
may help.
You may also be getting hidden gluten
in your diet, so review your make-up,
watch out for envelope and postage
stamp glue,and other culprits.
Health and happiness,
Dr. Aron, MAY
13 , 2007
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I
have some of the symptoms that are
related to Celiac Disease. How do
I find out if I have it or not?
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Ask
your gastroenterologist or internist
to contact Prometheus Labs in
San Diego, and arrange for them
to run a panel called “CELIA
PLUS”. This will test for
all of the antibodies to gluten
and your own intestine, and, if
negative, the lab will automatically
test for the genes associated
with Celiac Disease.
If any of these tests are positive,
then obtain an intestinal biopsy
from your gastroenterologist,
and make sure that the pathologist
reading the biopsy can stain for
CD3 cells, and count the number
of these cells per 100 epithelial
cells.
Most authorities feel that more
than 20CD3/100epith cells is abnormal.
These findings occur long before
blunting of the intestinal villi
develops, which is what a less-experienced
pathologist would be looking for
on a biopsy. So if blunting of
the villi are required to make
a positive diagnosis, many celiacs
will be missed.
Health
and happiness,
Dr. Aron, MAY
5, 2007
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I
was diagnosed with Irritable Bowel
Syndrome (IBS). Is it possible that
I could actually have Celiac Disease?
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Most
certainly. Studies have shown
that about 30% of patients with
diarrhea-predominant IBS, and
a significant, but lesser percentage
who have constipation, bloating,
pain and alternating forms actually
have Celiac Disease.
There are many celiacs in my practice
who came to see me because their
“IBS” was not responding
to any treatment, but have made
complete recoveries when diagnosed
and placed on a gluten-free diet.
Health
and happiness,
Dr. Aron,
MAY
2,
2007 |
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