2.0 - Your Health
2.1 - Celiac Disease and Gluten Intolerance
2.1.1 - What is Celiac Disease?
Celiac disease, also known as "Celiac Sprue", is a condition where the lower intestine's villi are damaged as a consequence of a process that results from consuming foodstuffs containing gluten. Gluten Intolerance may arise from something other than celiac disease, but for all intents and purposes, it is treated the same way for most cases and presents the same symptoms — it's a distinction without a difference. The image at the right shows what happens; your villi are eroded and impacted. In this state, they can't do their job, which is to pass nutrients from your small intestine to your bloodstream.
At the left, we show what your villi should look like. In this state, you can think of them as waving around in your small intestine, pulling nutrients from the materials there and passing them through to your bloodstream. They're quite small, microscopic actually, so "waving" isn't exactly what they do — but that's the general idea, anyway.
Gluten occurs in certain common grains, specifically, wheat, rye and barley. As you might imagine, this means that in the course of a normal diet, it is almost impossible not to consume at least some gluten each day. Because of this, people never get relief from the symptoms, and no clue is ever presented such as you might experience with a more rarely encountered food.
For instance, most of us don't consume limes every day. Were you to eat a lime, and then have your lips swell up like a balloon as a result, you would probably have little trouble figuring out the source of the problem. But in order to experience relief from gluten-caused symptoms, you would have to not eat any bread, bun or roll, most deserts and chips, many candies, crackers, most cereals, cakes, pita, tortillas, cookies, pasta, many soups (gluten is very common in thickening additives)... the list is incredibly long. What it boils down to is that you can avoid gluten, but it is almost impossible to do so by accident.
So... because it occurs in so many food products that you encounter every day, you continuously renew your exposure to gluten. Your symptoms, of course, persist, along with that exposure. Since the symptoms never quit, you're not going to be inclined to blame them on bread; you didn't eat bread today, perhaps, but you did have a slice of cheesecake with a graham cracker crust. See the problem? That's why it is so difficult to self-diagnose gluten intolerance by accident.
2.1.2 - Could I Have Celiac Disease?
A few years ago, celiac disease was thought to affect about one out of every 2000 caucasians, or about .05% of the white population. It's pretty much a caucasian problem — if you're black, for instance, celiac disease almost certainly isn't your problem. More recent studies have determined that because of the broad range of symptoms, celiac disease has been severely under-diagnosed; the actual number is closer to about one in every 133 caucasians, or a little under 1% of the caucasian population.
So the answer is, yes, it is quite possible that you have celiac disease. The next question, of course, is... do you?
2.1.3 - Symptoms of Celiac Disease
The key reason that the original statistics on how large a segment of the population had celiac disease were off so far is that the number of symptoms is very large. As the lower intestine's ability to digest foods is directly affected, all manner of problems can arise for which the basis is nutritional — for instance, if you can't digest the nutrients you need for healthy skin, you're going to have skin problems. If you can't digest the nutrients you need for healthy joints, you're going to have joint problems; and so on for every system in your body.
All of the following amazingly diverse symptoms may be the direct result of celiac disease and the nutritional problems it causes:
- Nausea and Vomiting
- Diarrea, sometimes explosive, apparently Irritable Bowel syndrome
- Memory issues and other cognitive problems
- Swelling of the feet and legs
- Fluid in the lungs
- Gas and burping
- Joint pain and stability issues
- Swollen abdomen and/or region just under your ribs
- Bleeding gums
- Headaches and dizzyness
- Sleeping problems, both insomnia and falling asleep too often
- Sinus problems and altering of senses of taste and smell
- Bloody stool, unusually malodorous stool
- Skin rashes, rough spots, colored spots and outbreaks of pimples or boils
- Itching and flaking skin
- Vision problems (insufficient depth of field and focus issues)
- Both unusual weight loss and unusual weight gain
As you can see, that list (which is very incomplete, believe it or not) contains symptoms that could lead one in many other directions — not just you, but your doctor as well. For instance, swollen feet and ankles combined with fluid in the lungs led to a diagnosis for this author as having congestive heart failure. When I resolved my gluten problem, these symptoms went away in under two days and never recurred. This was both a major relief (I mean, who wants congestive heart failure?) and a wake up call — my doctor had no idea what was wrong with me... not a clue.
2.1.4 - Do I Need a Lab Test?
Well, you could get a lab test, but no, you almost certainly don't need one. Unless the disease is really very far advanced — and it usually isn't... severe syptoms don't mean the disease has gone that far, they just mean that your body is really annoyed it's not getting the nutrients it needs, and possibly it is also being attacked by your immune system, which isn't good, either — your lower intestine will recover from gluten exposure within just a few days, sometimes as fast as one day. Upon recovery, many symptoms dissapear right away. This suggests a perfectly reasonable, zero-cost course of action:
For about a week, simply stop eating any food with gluten. Don't worry about your calorie intake or your waistline, don't worry about "balanced" meals, just concentrate on staying far away from gluten. You can figure out an appropriate diet next week, based upon your results; what we want to do here is simply determine if you're sensitive to gluten, or not. Of course, if your'e diabetic or have other issues that force you to make certain diet choices, you have to pay attention to those issues, but you don't have to pay attention to your vanity.
Substitute potatoes and rice for breads and rolls. Eat rice- and/or corn-based cereal (without malt flavoring!) for breakfast if you must have cereal. Otherwise, eggs, bacon, potatoes, orange juice... have a breakfast feast! Eat fruits and fruit sherbet for desert, and have yourself a few steaks and salads. Read labels! No MSG. No gluten (obviously.) No wheat, rye or barley. Stay away from soups, and watch out for salad dressing and mayonaise; you'd be quite surprised to learn how many contain gluten. If within a couple of days, you begin to notice your symptoms easing up, then you're one of the lucky people (yes, lucky!) who has identified a very sneaky and troublesome problem. One that can escalate to the point where it can outright ruin your life or even kill you.
A bit more on testing: My understanding is that testing is invasive, painful, inconvenient and expensive. Still, if you're insured (or simply very well off) and you really want to go that route, you should be aware that you should not go on a gluten-free diet prior to being tested, or it will screw up the results of the test.
2.1.5 - The Good News
So, let's say you've determined that you are definitely intolerant of gluten. I have good news, and lots of it. Now please keep in mind I'm not trying to sell you anything, I'm simply speaking as someone just like you who can't tolerate gluten either. My life was awful until I figured this out. I can't emphasize enough the relief I enjoy living without gluten. I am physically active (I am a martial arts instructor) and I am overall quite healthy now. But you should have seen the wreck I had become until I got this straightened out. I was eating "right", exercising regularly — and falling apart. I had most of the symptoms on that list, above. And I just could not understand what the heck was going on. I knew I was living, eating, and exercising better than most anyone else I knew, and yet, I was falling apart physically and to some degree mentally. So the fact is, if you've discovered that you are gluten intolerant, your life can take a huge turn for the better. I, for one, am nothing less than delighted for you.
The best news (from my perspective), first. My two favorite foods, spaghetti and pizza, which I had initially thought were going to be lost to me forever, have excellent gluten-free equivalants.
For spaghetti, the gluten free version is actually better than the wheat-based version. Taste and texture. A company up in Canada called Tinkyáda makes a rice-based spaghetti with a tiny bit of spinach added (yes, it's green pasta... you can get over that, trust me) which is actually better than "normal" spaghetti. Seriously. It's just amazing stuff; and the difference in how you feel after you eat it is night and day. A comfortable, full tummy and a stupid grin signal a spaghetti dinner for me these days.
For pizza, you can use a gluten-free rice-based mix for the crust, drop a pizza sauce to your taste on top, drizzle mozzerella all over that, and you have the basis for a very good pizza indeed. Now, I'm a genuine pizza gourmet. I grew up on the east coast and I've had plenty of New York pizza and Chicago pizza, I've had all manner of "special" pizzas, and I am telling you from that perspective that you're going to be OK for pizza.
I do have a tip, though: There is a pizza cooking product called "Pizzazz" that will make any pizza you eat a much more pleasant experience. It is very important that pizza be cooked in the right fashion, and these people are the only ones I know of to actually get that done outside of a traditional pizza oven. Run, do not walk, to your local mega-store and grab one of these. They're cheap (about $45.00 US or so), and you'll be delighted with the results, I promise.
Ouside of these two foods which I find so important, there are many, many gluten free foods and food components. Consider: if 1% of the US population is affected, then the market for these things is millions of people. So of course, there is a serious industry that serves the needs of the gluten intolerant. There is definitely an up-side to having a problem that is so common!
If you are curious as to what might be available, I would encourage you to check out the top right area of this page. There you will find lots of links to food and food components, as well as more information on celiac disease (sprue) and gluten intolerance in general. I wish you the best of luck!
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