On Support Groups

Hello! In this blog post, I’m going to introduce you to a couple of great support groups available to those with Celiac Disease. I’ll also explain why support groups are useful to those with Celiac Disease. You may think that support groups aren’t necessary, but it’s always a good idea to talk to someone who may be going through the same situation you are. An added bonus of a Celiac Disease support groups is not only that it allows one to connect with other people who have Celiac Disease, but it can also help one stay on a gluten-free diet by keeping each other accountable.

Following a strict gluten-free diet can be difficult, and if someone with Celiac Disease slips up it can put them at risk for a number of different complications. A support group is a very good way to avoid this.

There are both in-person and online support groups available to those with Celiac Disease. There are several different ways to find these groups; I’ll list a few of them here:

• First, one can always check at their local hospital, the doctors will often know other people who share the disease, and can help get everyone together
•   Second, one can find different support groups through various organizations such as:  
• The National Foundation for Celiac Awareness
• The Celiac Disease Foundation
• R.O.C.K (Raising Our Celiac Kids)
•  Finally, one can tap into online communities such as:
• Online blogs (like this one!)
• Newsletter subscriptions
• E-mail alerts for breaking news in the Celiac Disease  community

If you do decide to attend one of these meetings it’s a good idea to reach out to someone and ask them for any extra help you need. There may be people who are willing to show you the ropes while grocery shopping; or offer other helpful tips. Groups can also meet at restaurants so that newer members can learn how to order from restaurant menus. Another way a support group can help is to answer questions for new members.

I hope that this information is helpful in finding a support group that it right for you and your loved ones. This will be my last blog post here. I wish you and your loved ones the best in their lives. I want you to know that you can have a happy and fulfilled life even with Celiac Disease. It's been fun, bye!

App Time

There are many apps readily available that can help you save time and trouble in supermarkets and restaurants. Gluten and allergen-free information are available at your fingertips. You can use apps to scan items at grocery stores and see whether or not they contain gluten. You can also search for reputable gluten-free restaurants, or communicate your gluten-free requirements in other languages. I’ve created a list of gluten-free apps that should be helpful in yours or your loved one’s lives.

First, I’ll list several apps that can help with one’s shopping while gluten-free:

Allergy & Gluten Free Diet Tracker by Fooducate: ($4.99) With this app, one can use their device to scan a product’s barcode, search for specific products, or browse for foods by category. They can easily see whether or not a product contains allergens such as gluten, peanuts, tree nuts, fish, shellfish, egg, milk, lactose or soy. There is also an interesting “One Click” button option that allows someone to call the manufacturer directly for additional information on the product in question. fooducate.com

Gluten-Free Groceries by Triumph Dining: ($17.99) This app’s tagline is that it is known as the “yellow pages of gluten-free food.” It allows one to quickly and simply find gluten-free groceries. The app lists more than 30,000 gluten-free products from popular brands to smaller specialty companies. This app offers several different language translations as well. triumphdining.com/glutenfree/apps.php

Is That Gluten Free?: ($7.99) This app allows someone to safely grocery shop with a database of more than 20,000 manufacturer-verified gluten-free products from more than 660 brands. One can search by categories, brands, ingredients, or keyword without difficulty. bit.ly/15al1xk

Next I’ll introduce you to some apps that can be quite useful when eating out:

AllergyEats Mobile: (Free) This app provides peer-based feedback on how well (or poorly) restaurants in one’s area accommodate the needs of food-allergic diners. One can customize their search by selecting from the top 10 allergens (gluten, wheat, corn, dairy, eggs, fish, peanuts, shellfish, soy and tree nuts), entering a specific location, or by choosing the “Find Near Me” option. allergyeats.com

Dine Gluten Free: (Free) Much like the previous app, this app helps one find peer reviews of thousands of “gluten-free-friendly” businesses in the U.S. and around the world. The reviews are searchable by location and include restaurants, bakeries, markets, hotels, cruises and even colleges. glutenfreetravelsite.com

Find Me Gluten Free: (Free) With this app one can search for gluten-free dining options by entering a specific location or browse the “Popular Chains” option, which includes links to the chain restaurants’ websites and gluten-free menus. This app also has “User Reviews” which often contains valuable information and tips. findmeglutenfree.com

iCanEat OnTheGo Gluten Free & Allergen Free: ($2.99) This app is very helpful when one wants to eat at a fast-food place. The app includes 34 different U.S. chains. All one has to do is enter their allergen concerns into the 3,900-plus-item fast food menu database. glutenfreepassport.com

iEatOut Gluten & Allergen Free: ($2.99)This app is similar to the previous app, but with a focus on ethnic restaurants. It provides resources for seven different ethnic restaurant cuisines including Chinese, French, Indian, Italian, Mexican, Thai, and steak and seafood. This app allows one to easily browse through menu choices, ingredients, sauces, food preparation and cross-contamination considerations so as to avoid any combination of food allergens. glutenfreepassport.com

Finally, here a two apps which can be quite useful if someone with Celiac Disease is planning on traveling to another country:

Gluten Free and Allergy Free Travel Translation Cards: (Free) With this app one can learn to safely and effectively communicate their food concerns when ordering meals in foreign-speaking countries. It includes 13 different languages, which is very helpful when managing a gluten-free diet as well as other food allergies. glutenfreepassport.com/allergy-gluten-free-travel/gf-translation-cards

Gluten Free Restaurant Cards from CeliacTravel.com: (Free) This app has gluten-free restaurant cards in 54 different languages to use when you dine out at a restaurant, either in the U.S. or abroad. celiactravel.com

These apps are only a small sampling of what’s out there. I encourage you to do some research on your own to find the app that suits your needs the best. In my next blog post, I’ll be sharing information about Celiac Disease support groups, what they are, where they are, and how they can help you. I’ll see you then!

Wonderful Websites

Hello lovelies! In this post I'm going to introduce you to a couple good websites that will help you find even more information related to Celiac Disease. These websites will enable you to better care for yourself or a loved one who's suffering from this disease.

The first website is one called kidshealth.org. What I really love about Kid’s health is that it has three subsites: one for the parents, one for teenagers, and one for children. In each of these sections the language and information within is specifically targeted toward each age group. This makes it a lot easier for each group to understand the information within, and use it to better understand and adapt to this disease in their lives, or in the lives of their loved ones. Kid’s Health also provides free recipes and meal planners to aid in proper nutrition planning. Additionally this site has an option to switch the language to Spanish, which is very accommodating.

The next website is one called celiac.org. This site sponsors the Celiac Disease Foundation and is useful in finding support groups for Celiac Disease. They have a map with local chapters listed on it. They also assist patients with Celiac Disease in finding a doctor, as well as provide a symptoms checklist so that they can perform a cursory self-check.

Americanceliac.org describes itself as being “The unified voice of the Celiac community.” I found this website to be very helpful in providing information about Celiac Disease. I especially liked how they had specific sections for families and on living with Celiac Disease.

If what you’re looking for is gluten-free recipes I would suggest checking out pinterest.com and searching “gluten-free recipes.” Another useful site for recipes is allrecipes.com. Both these sites are extremely useful in meal planning. This meal plan below was created by the Celiac Disease Foundation and can help give you an idea for the types of meal planning that is available to you:

 

Finally, I’d like to leave you all with a link to a post made by healthcaretechnicians.org. In this post, they list the top 50 Celiac Disease blogs. I encourage you to check them out!

http://www.healthcaretechnicians.org/who-needs-wheat-anyways-the-top-50-celiac-blogs/

The more information you have the better prepared you will be to deal with your, or your loved one’s, Celiac Disease. In my next blog post I’ll share with you some apps that can also help someone with Celiac out in their daily lives. See you then!

Wanna stay healthy? Just follow these simple guidelines!

So you or someone you know has been diagnosed with Celiac Disease. I’m sure you’re wondering just how this disease is treated? I’m going to explain just that.

The simplest and most efficient way to have a vast improvement in a patient’s symptoms is to follow a strict gluten-free diet. A patient’s health care provider will typically refer their patients to a specialized dietitian or nutritionist. These people will teach their patients how to successfully avoid gluten while still maintaining a healthy and nutritious diet. These instructions include learning how to read and identify ingredients that contain gluten in food and product labels, how to make healthy choices about what type of food to eat, and how to design specialized meal plans.

People with Celiac Disease can still eat a well-balanced diet with a variety of foods. They can use potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour. They can also buy gluten-free bread, pasta, and other products from stores, or order products from special food companies. Meanwhile, meat, fish, rice, fruits, and vegetables without additives or seasoning do not contain gluten, so people with Celiac Disease can still eat these foods.

Most people with Celiac Disease can safely eat small amounts of oats as well, as long as the oats are not contaminated with wheat gluten during processing.

People with Celiac Disease should always read food labels carefully, especially canned, frozen, and processed food labels, for ingredients that contain gluten. They should also avoid ingredients such as hydrolyzed vegetable protein, also called lecithin or soy lecithin. In addition, they should ask restaurant servers and chefs about ingredients, food preparation and whether a gluten-free menu is available. The following image illustrates some recommendations for a gluten-free diet.

For most people, following a gluten-free diet will stop their symptoms, heal their existing intestinal damage, and prevent any further damage from occurring. Symptoms may improve within days to weeks of starting the diet. Complete healing of the small intestine can take several years in adults, and 3-6 months in children. Once the intestine heals, the villi will start absorbing nutrients from food into the bloodstream normally again.

In some cases, people will continue to have difficulty absorbing nutrients despite following a strict gluten-free diet. People with this condition, called Refractory Celiac Disease, have severely damaged intestines that cannot heal. Because their intestines don’t absorb enough nutrients they may need to receive nutrients via IV. Research is still being done on medications that will treat Refractory Celiac Disease. (NDDIC, 2015)

So there you have it. The only effective way to treat Celiac Disease is by not eating foods that contain gluten. Upon starting a gluten-free diet a patient’s intestines will heal over time. In my next blog post I will be taking a look at several different websites that can provide useful information to those with Celiac Disease. See you then!

Works Cited

NDDIC. (2015, June 25). Celiac Disease. Retrieved from The National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts

Celiac Symptoms and Signs

So what are some signs and symptoms of Celiac Disease? Well, a person may experience digestive signs and symptoms as well as symptoms in other parts of the body. Digestive signs and symptoms are more common in children and can include the following:

• abdominal bloating
• chronic diarrhea
• constipation
• gas
• pale, foul-smelling, or fatty stool
• stomach pain
• nausea
• vomiting

Being unable to absorb nutrients during the years when nutrition is critical to a child's normal growth and development can lead to other health problems, such as

• the failure to thrive in infants
• slowed growth and short stature
• weight loss
• irritability or change in mood
• delayed puberty
• dental enamel defects of permanent teeth

Adults are less likely to have digestive signs and symptoms and may instead have one or more of the following:

• anemia
• bone or joint pain
• canker sores inside the mouth
• depression or anxiety
• dermatitis herpetiformis, an itchy, blistering skin rash
• fatigue, or feeling tired
• infertility or recurrent miscarriage
• missed menstrual periods
• seizures
• tingling numbness in the hands and feet
• weak and brittle bones, or osteoporosis
• headaches

Intestinal inflammation can cause other symptoms, such as:

• feeling tired for long periods of time
• abdominal pain and bloating
• ulcers
• blockages in the intestine

Celiac disease can produce an autoimmune reaction, or a self-directed immune reaction, in which a person's immune system attacks healthy cells in the body. This reaction can spread outside of the gastrointestinal tract to affect other areas of the body, including the following:

• spleen
• skin
• nervous system
• bones
• joints

Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases and conditions. Celiac disease can be confused with the following:

• irritable bowel syndrome (IBS)
• iron-deficiency anemia caused by menstrual blood loss
• lactose intolerance
• inflammatory bowel disease
• diverticulitis
• intestinal infections
• chronic fatigue syndrome

As a result, celiac disease has long been underdiagnosed or misdiagnosed. As health care providers become more aware of the many varied symptoms of the disease and reliable blood tests become more available, diagnosis rates are increasing, particularly for adults.

Signs and symptoms of celiac disease vary from person to person because of numerous factors, including:

• the length of time a person was breastfed as an infant; some studies have shown that the longer an infant was breastfed, the later the symptoms of celiac disease appear
• the age a person started eating gluten
• the amount of gluten a person eats
• age—symptoms can vary between young children and adults
• the degree of damage to the small intestine

Some people with celiac disease have no signs or symptoms; however, they can still develop complications of the disease over time. Long-term complications include:

• malnutrition
• liver diseases
• intestinal cancer
• lymphoma

(NDDIC, 2015)

As you can see, the symptoms and signs of Celiac Disease can be varied and depend on several different factors. I you or somebody you know is experiencing any of the symptoms I would highly recommend scheduling an appointment with your health care provider. In my next post I will be discussing the treatment guidelines of Celiac Disease. I’ll see you then!

Works Cited

NDDIC. (2015, June 25). Celiac Disease. Retrieved from The National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts.aspx#diagnosed

Doctor's Notes:

So how is somebody diagnosed with Celiac Disease? Well, a health care provider can diagnose Celiac Disease with the following examinations:

• a medical and family history
• a physical exam
• blood tests
• an intestinal biopsy

Firstly, examining a patient’s medical and family history can assist a health care provider in diagnosing Celiac Disease by checking if the patient is already genetically predisposed to contract the disease. Celiac Disease is more common in patients who have a first degree relative who also has the disease.

Next, a physical exam can help diagnose Celiac Disease as a health care provider can see if a patient has any common symptoms. As an example; a health care provider may check for malnutrition or rashes, tap on a patient’s abdomen to check for bloating or pain, and use a stethoscope to listen to the sounds within the abdomen.

Blood tests taken at a health care provider’s office, or a commercial facility, can show the presence of certain antibodies that are common in Celiac Disease. If the results are negative but the health care provider still suspects Celiac Disease they may have a patient retake the blood tests. It is important that a patient eats a diet that includes gluten before the blood test is taken, or else the results may be a false negative.

Finally, if a blood test suggests that a patient has Celiac Disease a health care provider will perform an intestinal biopsy of the patient's small intestine to confirm the diagnosis. A biopsy is a procedure that involves taking a piece of tissue for examination with a microscope. A health care provider performs the biopsy in an outpatient center or in a hospital. They will give the patient light sedation and a local anesthetic. Some patients may receive general anesthesia.

During the biopsy, a health care provider will remove tiny pieces of tissue from the patient's small intestine using an endoscope (a small, flexible camera with a light). The health care provider will carefully feed the endoscope down the patient's esophagus and into their stomach and small intestine. A small camera mounted on the endoscope will transmit a video image to a monitor, allowing close examination of the intestinal lining. The health care provider then takes the samples using tiny tools that he or she passes through the endoscope. A pathologist will then examine the tissue in a lab. The test can show if there is damage to the villi within the small intestine. (NDDIC, 2015)

So there you have it. With these tests a health care provider can assess whether or not you or someone else has Celiac Disease. In my next post I’ll be analyzing the signs and symptoms of this disease. I’ll see you then!

Works Cited

NDDIC. (2015, June 25). Celiac Disease. Retrieved from The National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts.aspx#diagnosed

How did this happen?

                                               JupiterImages (photograph); Jen Christiansen (photoillustration)

In this post I'm going to talk about the etiology and the pathophysiology of Celiac Disease. Etiology is the cause, or set of causes, of a disease or condition. Pathophysiology is the convergence of pathology and physiology. The former describes conditions observed during a disease state, while the latter is the biological discipline that describes mechanisms and processes operating within an organism. Pathophysiology seeks to explain the physiological processes or mechanisms whereby a condition develops and progresses. 

First off, the etiology of Celiac Disease. The sad fact of the matter is that the precise cause of Celiac Disease is not known. However correlation has been shown between people with many different factors. One of these is if an infant under three months of age is exposed to gluten. Another strong correlation is if an immediate family member also has Celiac Disease. Next, a major life event, pregnancy, surgery, or emotional stress in people who are genetically predisposed will have a greater risk of developing Celiac Disease. In addition, those individuals with type 1 diabetes, thyroid disease, or other autoimmune diseases will have a greater chance of also obtaining Celiac Disease. Finally, if a person has a genetic disorder such as Down syndrome or Turner syndrome, they as well may have a higher risk of Celiac Disease developing.

The pathophysiology of Celiac Disease is that it's a multi-factorial and a multi-system disorder involving a genetic predisposition, environmental exposure of the small bowel mucosa to gluten, and an immunologic response to gluten.

Genetically, the majority (>90%) of people with Celiac Disease possess the HLA DQ2 haplotype, and 5% to 10% possess the DQ8 haplotype, conferring a negative predictive value greater than 98%. These haplotypes are encoded within the HLA class II region of the major histocompatibility complex on chromosome 6p. However, about 40% of the general population carries these haplotypes without having the disease, which makes their presence necessary but not sufficient for its development.

Environmentally there was a serendipitous observation that children with Celiac Disease improved during World War II when cereals used to make bread were scarce, and they relapsed after the war when the supply of these cereals was reinstituted. Risk for developing Celiac Disease is increased with the introduction of gluten in the diet of infants before the age of 4 months. Grains that activate the disease contain proteins that can form gluten (prolamins: glutenins and gliadins) and include wheat, barley, and rye. Grains that do not activate the disease include rice, corn, sorghum, and millet. Oats contain a very small proportion of prolamins and should be avoided initially.

Finally, with regards to immunology, exposure of the upper small bowel mucosa to gluten in susceptible people precipitates an immune mediated reaction that involves both the innate and the adaptive immune responses. Tissue trans-glutaminase, an enzyme present in the lamina propria of the small bowel, deamidates glutamine residues in gluten to form glutamic acid. Glutamic acid is a negatively charged molecule that is recognized by the antigen-precipitating cells that express the HLA DQ2/DQ8 receptors for T lymphocytes. T lymphocytes become activated and they begin to divide rapidly and secrete several immunomodulators such as immunoglobulins, cytokines, interferons, tumor necrosis factor, and interleukin 15 and 17 that cause damage to the enterocytes and result in villous atrophy.

I hope that by reading this you'll have come to understand a bit more about how it was possible for you or your loved one to develop Celiac Disease. In my next blog post I'll explain a bit more about how Celiac Disease is diagnosed. See you there!