| Lactose Intolerance and Celiac Disease (cont..) |
Celiac Disease
DSRF Note:
There is approx.
20X higher incidence of this disease in DS.
Reference: Medical &
Surgical care for children with Down syndrome.
Woodbine Press Page 185.
Celiac disease (also called celiac sprue) is a rare disorder caused by an intolerance to gluten, a component of wheat, rye, barley, and oats. An estimated 1 in 5,0OO persons in the United States is affected. Gluten contains a protein called alpha-gliadin. In persons with celiac disease, this protein causes a reaction in the mucous lining of the intestine. The villi lining the small intestine suffer damage and destruction, which impairs the body's ability to absorb vital nutrients.
"Mal-absorption becomes a serious problem, and the loss of vitamins, minerals, and calories results in malnutrition despite an adequate diet. Diarrhea compounds the problem. Because celiac disease impairs digestion, food allergies may also appear. " DSRF emphasis
Celiac disease affects both adults and children, and can appear at any age. It often appears when a child is first introduced to cereal foods, at around three or four months of age. The first signs are usually diarrhea, weight loss, and nutritional deficiencies such as anemia. other symptoms include nausea; abdominal swelling; large, and frequently pale and/or light-yellow-colored, foul-smelling stools that float; depression; fatigue; irritability; muscle cramps and wasting; and joint and/or bone pain. Infants and children may exhibit stunted growth, vomiting, an intense burning sensation in the skin, and a red, itchy skin rash called dermatitis herpetiformis. A baby with celiac disease may gain weight more slowly than normal or may lose weight. The infant may have a poor appetite, gas, and offensive smelling bowel movements. The child is likely to have an anemic, undernourished appearance. Ulcers may develop in the mouth.
MIS-DIAGNOSIS
Since it is a rare condition and many physicians are not aware of the various symptoms associated with gluten intolerance, they may misdiagnose celiac disease. It is often misdiagnosed as irritable bowel syndrome or spastic colon, for example. There have been cases in which doctors unable to diagnose the illness have referred their patients to psychiatrists. Many people go a long time before being diagnosed correctly, and often the correct diagnosis is arrived at only because of something they have heard or read that enables them to identify the disease themselves. Yet if left untreated, celiac disease can be quite serious, even life threatening. Bone disease, central and peripheral nervous system impairment, internal hemorrhaging, pancreatic disease, infertility, miscarriages, and gynecological disorders are just some of the long-term maladies that can complicate celiac disease. It also increases the risk of developing intestinal Iymphoma and other intestinal malignancies. Certain autoimmune disorders can also be associated with celiac disease, including dermatitis herpetiformis, kidney disease (nephrosis), sarcoidosis (the formation of lesions in the lungs, bones, skin, and other places), insulin-dependent diabetes mellitus, systemic lupus erythematosus, thyroid disease, and, rarely, chronic active hepatitis, scleroderma, myasthenia gravis, Addison's disease, rheumatoid arthritis, and Sjogren's syndrome.
NUTRIENTS (Please refer to the above book for more detailed information.)
Caution: Parents using TNI for Down's syndrome will need to stop using the TNI or have it modified to allow for these recommendations especially the Vit.B injections. Consult your doctor.
Essential
Containing:
Important
N-acetylglucosamine As directed on label. (N-A-G from Source Naturals). Forms the basis of complex molecular structures of the mucous membranes of the intestinal lining.
Vitamin K As directed on label. Fat~soluble vitamins are not or absorbed well in this disorder. See under herbs below.
Zinc lozenges (Ultimate Zinc-C daily Lozenges from from Now Foods). 1, 15 mg lozenge 5 times daily. Do not exceed a total of 1OO mg (zinc) daily all supplements. Needed for immunity and healing.
Copper 3 mg daily. Needed to balance with zinc.
Helpful
Essential fatty acids, (primrose oil and salmon oil are good sources) Dose as directed on label. Needed for the villi in the intestines.
Magnesium. 750 mg daily. Helps maintain the body's normal pH balance. Deficiency is common in people with plus celiac disease.
Calcium 1,5OO mg daily. Works with magnesium.
Proteolytic enzymes. As directed on label, 3 times daily. Take between meals, on an empty stomach. Additional digestive enzymes may be needed to aid in breakdown and absorption of foods.
Psyllium seed or Aerobic Bulk Cleanse (ABC) from Aerobic Life Industries.
As directed on label or Taken separately from other supplements and medications.
A fiber product not absorbed by the intestines. Drink large amounts of water because the fiber expands to several times its dry volume.
Vitamin C 2,000-5,000 mg daily, in divided doses. Boosts immune function.
DSRF
Note:
In Down's syndrome high dose
vitamin C may be a problem because vitamin C can be a
pro-oxidant under some circumstances, (still a
controversial issue). This could add to the already
high oxidative stress in Down's syndrome, but this is
not certain. It may be advisable to contact the
experts on TNI who have more experience and who have
links on our website. Kent McLeod, Dr David Swenson,
Dr Leightman. To gain a specific insight into the
patients condition these people may ask you to get a
blood and urine analysis to review the oxidative
stress levels, and antioxidant status, a DNA damage
marker assessment would provide an indication of
actual cell damage in progress and provide an
indication of the effect of any therapy on the
metabolism. Contact us directly if you need more
information.
HERBS
Alfalfa supplies vitamin K, which is often deficient in those with celiac disease. Take 2,0OO to 3,000 mg in tablet form daily.
DIETARY RECOMMENDATIONS
Eat fresh vegetables, legumes (such as lentils, beans, and peas), rice bran, nuts, sunflower seeds, raisins, figs, and "seedy" fruits, such as strawberries, raspberries, and blackberries. Include in the diet blackstrap molasses, which is high in iron and the B vitamins. People with celiac disease need fiber and foods rich in iron and the B vitamins.
Do not eat sugary products, processed foods, dairy products, bouillon cubes, chocolate, and bottled salad dressings.
Celiac disease causes malabsorption of the B vitamins and the fat-soluble vitamins (vitamins A, D, E, and K), so take these nutrients. Note that gluten is found in many nutritional supplements. Read labels carefully, and use supplements that are hypoallergenic, wheat-free, and yeast-free.
If a child develops any of the symptoms of celiac disease, omit all gluten-containing foods from the child's diet and see if the problem clears up. Eliminate milk, as lactose intolerance can occur with celiac disease. The disease can begin in the first few months of life, depending on the child's diet.
Avoid any and all foods that contain gluten. Do not eat any products that contain barley, oats, rye, or wheat. Rice and corn can be eaten. Substitute rice, potato, cornmeal, and soy flour for wheat flour. Read all labels carefully. Watch for "hidden" sources of gluten, such as hydrolysed vegetable protein, textured vegetable protein, hydrolysed plant protein, and all derivatives of wheat, rye, oats, and barley, including malt, modified food starch, some soy sauces, grain vinegars, binders, fillers, excipients, and "natural flavorings." Do not consume hot dogs, gravies, luncheon meat, beer, mustard, catsup, nondairy creamer, white vinegar, curry powder, or seasonings. Gluten-free products are available at health food stores.
CONSIDERATIONS
If celiac disease is suspected, an intestinal biopsy should be performed to make a definitive diagnosis. A child who gets blisters and sores all over his or her body should be checked for celiac disease.
Martin F. Kagnoff, M.D., of the University of California at San Diego says that heredity is a vital factor in the development of this disease. He also says that celiac sprue often develops in childhood but may trail off in adolescence; in some cases, reappearing in adults in their thirties and forties. Factors that may trigger the onset of celiac disease are emotional stress, physical trauma, a viral infection, pregnancy, or surgery.
Vitamin K deficiency caused by celiac disease may lead to a hypoprothrombinemia (a lack of clotting factors in the blood). one form of vitamin K is manufactured by "friendly" bacteria in the intestines; another is present in certain foods, especially leafy greens, alfalfa, tomatoes, strawberries, whole grains, and yogurt. Bacteria such as those found in yogurt and acidophilus can also help to restore the intestinal flora necessary for vitamin K production.
A report published in the British medical journal The Lancet pointed to a possible connection between celiac disease and epilepsy. Theories as to how the two might be linked include the possibility that endorphin-like substances may be created from wheat gluten and may affect brain metabolism; another possibility is that celiac disease increases intestinal permeability, which in turn allows the absorption of substances that may affect brain chemistry.
It may be necessary to remove milk and milk products from the diet because of a secondary lactase deficiency ( see LACTOSE INTOLERANCE )
Schizophrenia has been observed to occur more often in those with celiac disease. (See SCHIZOPHRENIA in Part Two.)
For more information about celiac disease, you can contact the
Celiac
Disease Foundation
13251 Ventura Boulevard, Suite 3,
Studio City, CA 91604-1838
Telephone 818-990-2354.