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I haven�t seen any discussion on this site about Celiac disease and how people afflicted with it may have some of the symptoms associated with IBS. So I�d like to offer some information about it and my experiences over the last 11 years. What is Celiac Disease (CD)? An inherited disorder in which the small intestine has an autoimmune reaction to gluten, a protein found in several grains. The reaction damages the small intestine and leads to serious malabsorption of vital nutrients. Also called Celiac Sprue, Gluten Sensitive Enteropathy or Nontropical Sprue, it may affect over a million Americans.Is it the same as a wheat allergy? No. Food allergies result from a different physiological process. Food allergies usually produce different, more recognizable symptoms. Those allergic to wheat must avoid only wheat. Those with CD must avoid all grains that contain gluten. Where is gluten found? Primarily in wheat, but also in rye, barley, possibly in oats, and in any other forms of these grains such as spelt, kamut and triticale. In most common cakes, cookies, pastas, noodles, cereals, crackers, pretzels, candy, pizzas- in short, anything that contains a toxic grain.What are the symptoms of CD?There is no typical Celiac. Left untreated, symptoms can vary as damage to the intestine continues. In adults: Weight Loss Continued gastrointestinal distress with no known cause Unexplained anemia Nutrient deficiencies (especially of iron, calcium, folic acid, or fat soluble vitamins such as A, D, E and K) Depression Abdominal or bone pain Chronic fatigue or weakness In children: Failure to thrive A distended stomach Short stature Developmental delays Unusual behavior changes Dental enamel defectsWhat are the Common Misdiagnoses? Lactose Intolerance Irritable Bowel Syndrome Depression Simple Anemia Chronic Fatigue SyndromeHow is CD diagnosed? A special blood test that evaluates the presence of gluten antibodies. If all of the blood tests are positive, a CD diagnosis is highly accurate. There are circumstances, however, in which the tests can be inaccurate. A bowel biopsy is considered the standard to confirm a blood diagnosis, and give a 100% sure diagnosis. The blood test has been around since the 1980s. The average time to diagnose CD is 11 years.What is the treatment? A life-long gluten free diet, including all gluten-based foods, vitamins and medications (yes, it�s in some medicine, too).Why does the gluten free diet work? It allows the damaged small intestine to heal and begin proper absorption of nutrients.Which groups are at high risk? Relatives of patients already diagnosed with CD (latest estimate for 1st degree relatives � 1 in 22) Those who have Type I diabetes (failure to diagnose underlying CD complicates management of Type I diabetes and can lead to unnecessary health risks).Are there other groups in which CD might be suspected?Yes, in those individuals who are: Suffering from continued anemia or gastrointestinal distress with no known cause. In continued poor health for which no known cause can be found. Diagnosed with depression, but do not improve on antidepressants.What are the risks of not being diagnosed? Osteoporosis caused by calcium malabsorption. Fertility problems thought to be due to malabsorption and overall poor health.  Lymphoma of the small intestine. Those who are gluten sensitive but who continue to eat gluten have an increased risk of developing this uncommon form of cancer. Risk drops to that of the general population after five years on the gluten-free diet. Unceasing health problems caused by improper absorption of vital nutrients.Why is diagnosis so difficult? Many of the symptoms can be attributed to other diseases. There is an education problem: many doctors believe CD is rare and don�t look for it (the perceived U.S. prevalence is one in 3000; in some areas of Europe, it�s known to be one in 300; there are growing statistics that indicate that it is much more common in the U.S. than thought, perhaps in the area of one in 125.  Many doctors are not aware that for unknown reasons, classic CD symptoms (gas, bloating, diarrhea, weight loss) are now seen less frequently than nonclassic symptoms such as gastrointestinal problems, depression and anemia.More information on CD can be found at www.celiac.com.And now, my story. I can trace CD back to 1992 when I started having stomach problems. After a battery of GI tests discovered nothing, I was diagnosed with IBS. For the next seven years, my principal symptoms were gastrointestinal distress (bloating), depression, and fatigue that would vary in intensity and frequency but would never go away. There was no diarrhea, constipation or weight loss. In early 1999 an added symptom appeared in the form of very sharp abdominal pain several days a month. It would strike anywhere, anytime. I went through another round of diagnostic work without conclusive results. Over the last five years, I visited my GP, three GI doctors, a neurologist and a psychologist many times; taken a variety of medications ( anti-spasmodics, anti-depressants, anti-convulsant, anti-anxiety), and the situation remained unchanged. Two doctors became irritated and frustrated because they couldn�t identify the cause, and thought it was psychological. After prostate surgery last year, the abdominal pain increased in intensity and frequency. They were so bad that I visited the emergency room on two occasions. This year the symptoms got even worse, and October was particularly bad. And then the cause of this long running scourge was finally identified. On November 4, my wife was talking to a friend who said that a friend�s daughter went on a gluten free diet for her abdominal pain, and relief started within two weeks. The next day I started on it and relief was almost immediate and continuing. I thought that this might be the right path, but was cautiously optimistic given my long history. On November 6, I had a scheduled visit with a neurologist, and said that I had started on a gluten diet. He then mentioned a blood test for gluten antibodies. The results came back this week with high positive scores. At last! Just knowing what the cause is and managing it through diet is a tremendous relief. One final thought: the medical community clearly needs to give this more timely attention when a person can go undiagnosed with a well known digestive disorder for years, and then discover it on his own. In my case, many thousands were spent on doctor visits, emergency rooms, medications, and diagnostic procedures, not to mention the personal cost of long term physical and mental suffering as well as lost time, when a simple blood test is available. It doesn�t make any sense!MY ADVICE TO ANYONE DIAGNOSED WITH IBS WOULD BE TO EDUCATE ONESELF ON CD AND AGGRESSIVELY PURSUE A CD SCREENING TEST.
 
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