The Columbus Dispatch

Strict avoidance of gluten a must for celiac patients

- DR. KEITH ROACH Dr. Roach answers letters only in his North America Syndicate column but provides an order form of available health newsletter­s at www.rbmamall. com. Write him at 628 Virginia Dr., Orlando, FL 32853-6475; or ToYourGood­Health@ med.cornell.e

I am a 78-year-old woman who was diagnosed with celiac disease. I had an endoscopy in 2007 because I was anemic, and the doctor told me I had an ulcer that had healed itself.

This year I had an endoscopy because I again was anemic, but this time he did a biopsy, which came back as celiac disease.

I have no dysentery or stomach pains, which are red lights for celiac; I have had inflamed joints for years, accompanie­d by dry skin.

Is it possible that I have had this disease for years and was never diagnosed? My doctor told me not to eat wheat but never went further than that. I also have been short of breath for years, but heart and pulmonary tests come back normal. Could celiac be the cause?

Celiac disease, also called “glutensens­itive enteropath­y” or “nontropica­l sprue,” is an uncommon but increasing­ly recognized condition caused by a reaction to gliadin, a protein found in glutencont­aining grains, especially wheat, rye and barley.

Not everyone with celiac disease has gastrointe­stinal symptoms, such as diarrhea and weight loss. Some people get mild abdominal pain and mood changes, and never put these together with their diet.

It’s likely that you have had celiac disease for many years. The anemia possibly was celiac-related, through iron deficiency. People with celiac disease are more likely to develop arthritis as well, and one skin condition, dermatitis herpetifor­mis, is so characteri­stic of celiac that a biopsy is not needed.

Shortness of breath is uncommon with celiac disease, but severe anemia can cause it, as can one rare lung disease, pulmonary hemosidero­sis, which often goes away on a gluten-free diet. Disease of the heart muscle is rare but more common in people with celiac disease.

I would recommend a visit with a registered dietician nutritioni­st, who can give you more informatio­n. Don’t eat wheat: Proper care of this disease depends on meticulous avoidance of gluten, and even small amounts count.

My doctor just tested me for high calcium, and my vitamin D was low. He put me on 12 weeks of 50,000 IU once a week. You said something in a recent article about high vitamin D. Why the difference?

I am confused by your vitamin D treatment: I suspect the vitamin D has nothing to do with the calcium. A high calcium level can be caused by many things, including faulty technique in obtaining blood, but I mentioned excess vitamin D (a rare cause) and elevated parathyroi­d hormone levels in my recent column. A repeated high calcium level should get your doctor to check a PTH hormone level. A high PTH level almost always means a benign tumor of the parathyroi­d gland.

— Anon. — A.K. Answer:

 ??  ??
 ??  ??
 ??  ??
 ??  ??
 ??  ?? Dear Dr. Roach:
Dear Dr. Roach:

Newspapers in English

Newspapers from United States