Celiac Disease
Celiac Disease is a digestive disorder affecting people who are sensitive to gluten, a protein commonly found in the grains wheat, barley, and rye. When a sensitive individual consumes gluten the gluten triggers an abhorrent response from the immune system, leading to damage of the small intestine. This damage inhibits the small intestine from fully absorbing all of the nutrients from consumed food. Medical science has been as of yet unable to determine the exact cause of celiac disease. However possessing certain genes (inherited from a close relative such as mother, father, brother, sister, etc.) increases the likelihood of acquiring the disease, mostly from environmental considerations such as infections which can initiate changes in the makeup of the small intestine of a person with said genes, leading to problems with nutrient absorption. Common symptoms include stomach bloating and gassiness, fatigue, weakness, sudden and rapid weight loss, and changes in bowel movement consistency. In children stunted growth and calcium deficiency in the bones are common, along with bouts of diarrhea, rapid weight loss, and otherwise inexplicable fatigue.
To diagnosis the condition, your doctor will conduct a physical exam along with a blood test to detect the presence of specific antibodies common to celiac disease. They may also conduct an endoscopy, in which a thin lighted tube is used to look inside the small intestine. Once the diagnosis is confirmed supplementary blood tests to check for anemia, as well as a bone density test to check for osteoporosis, may be conducted by your doctor.
If You Have Been Diagnosed with Celiac Disease
The primary treatment option for Celiac disease is the adoption of a gluten free diet. All foods containing wheat, rye, and barely are to be avoided, as well as beer and ale. Meats, fruits, and vegetables can still be consumed along with foods made with such gluten free flours as buckwheat, cornmeal, millet, flax, potatoes, quinoa, rice, and soybeans. Dairy products should be avoided at the beginning of implementing the new diet, but can be resumed once the intestines have had time to heal.
A Whole Health Perspective
Looking at Celiac Disease through a Whole Health model, we explore the individual’s unique presentation from the 5 Aspects of Whole Health™ perspective.
1. Physically – In those with Celiac disease, damage to the small intestine occurs with consumption of gluten and the resulting autoimmune response which can inflame and destroy portions of the small intestine. This response may cause destruction of the villi (small finger-like projections on the small intestine which are responsible for nutrient absorption), thus those with Celiac often exhibit signs of malnourishment. Along with symptoms such as fatigue and weight loss, malnourishment may also result in vitamin and nutrient deficiencies, such as anemia and osteoporosis. Additionally, some with Celiac disease initially exhibit signs of lactose intolerance. The expression of Celiac disease can potentially be triggered by events such as childbirth, surgery, infection, and/or emotional distress.
The major function of the gastrointestinal tract is to digest and assimilate nutrients and fluid from consumed food and drink into the body, and to expel waste. However, the GI tract also contains immunological tissue designed to detect and respond to foreign invaders such as allergens, bacteria, or virus particles before they reach the rest of the body. Thus the health of the intestinal mucosal barrier and the microbiome of the gut is important in controlling systemic inflammation and immune reactions, especially in people whose GI systems have been compromised by Celiac disease. Supporting the health of the gut microbiome and intestinal lining may help deter the widespread effects of diseases such as Celiac. This can be accomplished in part through proper diet (especially the strict avoidance of gluten), avoiding irritants such as caffeine, sugar, alcohol and cigarette smoke, limiting use of certain medications which affect the gut lining, and addressing chronic stress and psychological health. Some studies suggest a beneficial link between particular herbal remedies and intestinal barrier health.
Because Celiac disease affects the immune system response, symptoms are frequently widespread and not limited simply to the gastrointestinal tract. Other body systems affected by Celiac disease include the liver, skin, joints/connective tissue, heart, nerves, and the endocrine system. Women with Celiac may have reproductive problems such as infertility and/or miscarriage. Celiac disease often co-occurs with other immune disorders. Encouraging healthy immune response may potentially assist in limiting these symptoms and in the recovery process. Chronic stress, such as a job change, relationship difficulties, or chronic illness, may cause dysfunction of the immune system, in part through its interaction with the adrenal glands. The adrenal glands function as the body’s stress response system, and when chronically stimulated by stress, the hormones they release may become dysregulated and negatively affect the immune system and cause increased inflammation. Modulating the stress response, therefore, may positively affect the immune system and help in the recovery and healing process. Other organs important for healthy immune response include the thymus gland, skeletal system, gastrointestinal system, the liver, the spleen, and the skin. Adequate hydration, nutrition, and sleep, will support these organs and assist in the healing process. Some research exists suggesting that traditional Chinese medicine may improve gastrointestinal and immune health.
2. Nutritional: The treatment of Celiac disease involves abstinence from all sources of gluten. This includes but may not be limited to: wheat and all its derivatives, barley, rye, triticale, malt, and some yeasts and starches. A list of dietary restrictions and foods to avoid can be found here. Because gluten-free foods can often be contaminated by gluten containing ingredients, purchasing dedicated gluten free foods may be beneficial.
In general, consumed food has the potential to communicate wellness or illness to the rest of body. This is in part due to the gastrointestinal nervous system (also called the enteric nervous system) and the immune tissue in the GI tract. A diet high in organic plant based foods, unsaturated fats, quality protein such as fish, and whole grains not containing gluten can benefit health. This type of diet offers multiple vitamin, mineral, and antioxidant benefits. Because Celiac can lead to chronic inflammatory problems, choosing foods which can decrease inflammation can be helpful. Foods which may cause further irritation and inflammation of the GI tract include alcohol, caffeine, highly processed foods, trans-fatty acids, and chemical additives, toxins, and colorings. During times of illness, to appropriately support the body’s healing process and reaction to the stress of illness, attention to particular vitamins and mineral is important. These include cholesterol, protein, vitamins A, C, E, and B complex, essential fatty acids, and essential minerals. Keeping a food diary may assist in tracking sources of gluten as well as determining other foods/drinks which exacerbate symptoms.
3. Emotional: The gastrointestinal tract and the brain communicate closely. The function of the GI tract may be altered by emotions such as anger, fear, and frustration, and by the experience of psychological stress. Additionally, emotional stress may be a trigger for exacerbations of Celiac disease. What is consumed may affect neurochemical/emotional responses within the brain and beyond. Being aware of emotional eating patterns helps bring awareness to food choices and reinforces decisions to limit foods which produce gastrointestinal symptoms. Because of this gut-brain connection it may be beneficial for Celiac patients to engage in activities which assist in the regulation of emotion and stress. Activities such as meditation and/or mindfulness may be helpful in symptom reduction by reducing overall stress and by rebalancing the nervous system response to stress. Other stress reduction techniques include activities such as yoga, prayer, support group participation, and talking with a mental health professional. Treating co-existing anxiety and depression may also assist in amelioration of symptoms and reduction of stress.
4. Environmental – Environmental pollutants can contribute to dysfunction within the gastrointestinal tract. For those with Celiac, whose GI systems already may be irritated and inflamed, limiting exposure to pollutants in the soil, air, and water is important (such as heavy metals, household cleaners, etc.). Direct or passive exposure to cigarette smoke is known to negatively affect the gastrointestinal tract and its function. Increased exposure to stress in the environment, whether through difficult relationships, loud noises, bright lights or abrupt changes in weather, can affect the GI tract in general. Exposure to nature, even visual or auditory, can decrease stress and have a positive effect on health. Spending time out of doors in forest environments decreases stress hormones and can improve immune system function. Moderate weight bearing exercise, such as walking or weight lifting, will assist in bone strength and integrity, especially for those who may have experienced decreased calcium and nutrient absorption.
5. Beliefs, Values and Worldview – also identified as Spirituality: Cultural or religious traditions regarding food and dietary choices may be involved in gastrointestinal function. Spiritual expression and development, whether through prayer, meditation, yoga, etc., has been shown to be an important factor in health. Possible feelings of isolation, living in discordance with one’s values, or inability to connect with support and the natural surroundings due to illness or other factors could increase stress and exacerbate symptoms.