A Big Apple Guide for People with Celiac Sprue and Others on a Gluten-Free Diet
Besides being stubbornly independent, GFNYC tries to be accurate and up-to-date, but feels obligated to offer this disclaimer: None of this information is medical advice. Also, GFNYC cannot take responsibility for errors or misinformation that might appear here. GFNYC encourages all readers to confirm information to their own satisfaction.
Showing posts with label Crohn's Disease. Show all posts
Showing posts with label Crohn's Disease. Show all posts
People with conditions such as Crohn's disease, celiac disease, ulcerative colitis or Reiter's syndrome are more commonly affected. Factors that can contribute to the development of canker sores are stress, trauma and deficiencies of iron, folate, zinc and vitamin B12.
Here's a recent study that found that "The epidemiological association found between coeliac disease and aphthous-like ulcers suggests that recurrent aphthous-like ulcers should be considered a risk indicator for coeliac disease, and that gluten-free diet leads to ulcer amelioration." In other words, canker sores can be a sign of celiac disease, and a gluten-free diet can treat canker sores in people with celiac disease.
Do you wonder if you have celiac disease? Before trying to to go gluten-free, seek a conventional diagnosis by consulting with an informed doctor about getting the blood panel used to test for the condition.
In my previous post I touched on distilled vinegar and its lack of gluten, the point being that, contrary to myth, distilled vinegar is appropriate on a gluten-free diet, and that any problems one might have with the vast majority of vinegars would not be due to gluten. Rather than assume that a vinegar has gluten in it, it is reasonable to assume that there's a good chance that any vinegar that is not a malt vinegar is free of gluten, and it would not be a hopeless gesture to check ingredients and contact food producers to clear up any lingering doubts you might have about any vinegar you'd like to try.
Anyway, today I figured that I might as well go ahead and say the same thing about distilled alcohol—spirits such as plain gin, vodka, and whiskey. The distillation would eliminate any gluten that might be in the ingredients of those hard liquors.
Gluten-Free Living states, "Distilled alcoholic beverages are gluten free because distillation effectively removes gluten from wheat. They are not gluten free if gluten-containing ingredients are added after distillation, but this rarely, if ever, happens."
And Celiac Disease: A Hidden Epidemic states, "The distilling process eliminates the gliadin fragment from spirits made from wheat, rye, and barley (e.g. bourbon, vodka, scotch). If spirits contain flavoring that is added in after the alcohol is distilled, it is not necessarily safe." (Gliadin is a fraction of gluten that is toxic for people with celiac disease.)
So, if such spirits make you sick, it's extraordinarily unlikely that the problem would be due to gluten or the smaller gliadin in the booze. Many people with celiac disease do drink hard liquor safely (and, of course, always in moderation). Perhaps your intestines are insufficiently healed from eating gluten elsewhere. Or perhaps there is a co-existing condition. Both scenarios are far more likely.
For instance, consider this, from the National Institute of Health: "There are no known foods that cause Crohn’s disease. However, when people are suffering a flare in disease, foods such as bulky grains, hot spices, alcohol, and milk products may increase diarrhea and cramping." Some people do have Crohn's disease as well as celiac disease.
And also remember that hard liquor, like vinegar, is a "strong" substance. Many people do react poorly to it—especially in large quantities. I don't use the stuff to clear drains, but just look at this list and this list of uses for vodka! Some of them have to be for real, right?
Two recent items on Medscape underscore the value of sustained vigilance when it comes to identifying cases of celiac disease—even in people who have previously tested negative for the condition. And one of the articles can be viewed as also illustrating how symptoms that might be assumed to be reactions to "hidden" gluten by a gluten-free person with celiac disease might actually be due to another medical condition such as ulcerative colitis, with no "hidden" gluten involved.
A gluten-free diet can help protect people with celiac disease against cancer, according to an Italian paper, published in BioMedCentral Gastroenterology (September 2007) and available on Medscape, that encourages doctors of adults diagnosed with celiac disease to be on the lookout for tumors. So the nearly two million Americans estimated to have undiagnosed celiac disease may well be at an increasing risk for malignancies—especially gastro-intestinal cancer.
The study includes the following statements, verbatim:
Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age.
This paper confirms that the gluten-free diet is likely to protect from the development of malignancies in CD patients, since higher is the age at diagnosis of CD, higher is the risk of developing a malignancy, Therefore, the importance of a prompt diagnosis of CD is emphasized. Our data require to be confirmed by larger population based studies, but some implications for an accurate screening for cancers in people with CD are added.
Another recent Medscape item is a case study about a 65-year-old woman who tested negative for celiac disease and received a diagnosis of diverticulosis, then several years later tested positive for celiac disease and showed improvement on a gluten-free diet, then suffered diarrhea that eventually led to an additional diagnosis of ulcerative colitis.
Patients can develop, or present with, celiac disease at any stage in life. Previous negative test results do not preclude the diagnosis of celiac disease at a later date. The possibility of additional pathology should be considered, particularly in older patients whose symptoms fail to respond, or who later relapse, despite the exclusion of gluten from their diet. Diarrhea and anemia, in particular, should prompt colonoscopy. In patients with celiac disease there is an increased prevalence of not only microscopic colitis, but also ulcerative colitis and Crohn's disease.
The article advises that "Colonoscopy should, therefore, be part of the initial work-up in patients who are 40 years of age or older who present with iron-deficiency anemia or diarrhea, even if initial tests indicate celiac disease."
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