Celiac Disease Goes Underdiagnosed

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The longer it takes to diagnose celiac disease, a disorder of the small intestine that doesn't allow for proper digestion and absorption of foods due to an allergic-type reaction to a protein called gluten, the longer someone who has it suffers with its symptoms. These include diarrhea, abdominal cramping, bloating, fatigue, weight loss, nutrient deficiencies, and, if things get bad enough, osteoporosis, nerve damage, and even intestinal lymphoma.

Unfortunately, diagnosis takes an average of 10 years. And the disease is new thought to affect 10 times as many people as previously thought-up to 3 million Americans as opposed to 300,000.

To help deal with the problem, a consensus panel recently convened by the National institutes of Health announced recommendations for appropriate diagnosis and management of celiac disease.

The first step is a blood test to check for a specific antibody. If the blood test is positive, the small intestine should be biopsied for a more definitive diagnosis.

Who should be tested? Anyone with celiac disease symptoms like diarrhea, weight loss, or anemia that can't otherwise be explained would make a reasonable candidate. And since the prevalence among those with a first-degree relative with the condition is between 4 and 12 percent, close blood family members might consider testing, too, even if they don't have symptoms; the disease can cause serious damage to the gastrointestinal tract whether or not it creates obvious problems. Others at elevated risk who might consider testing are people with type 1 diabetes and those with Down syndrome.

If you are diagnosed, the solution is to avoid any foods with gluten, which is present in wheat and several other grains. But what's forbidden adds up to a much longer list than just breads and cereals because grains are added in small amounts to many foods, including everything from different canned soups and salad dressings to ice creams, beer, canned tuna, hot dogs, and a host of other items.

The person with celiac disease is left essentially to diet of fresh meats, fish, and poultry; milk, eggs, and unprocessed cheeses; dried beans; and plain, fresh or frozen fruits and vegetables. Corn and rice are okay, too.

It's not an easy plan to follow, but it's a very effective solution that can insure lifelong health. Once gluten is removed from the diet of someone with celiac disease, the intestinal lining, where the illness manifests itself, can start to heal within days.

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