Question and Answers - Page 8

Q. Dear Roberta,

My brother (50) was told he has chrons, but is getting no relief from his steroids or medicine. I came across the Celiac web sites as well as the wheat intolerance sites.

Do they mistake wheat intolerance or celiac for chrons?

Is there a test you can take to see if you have celiac or wheat intolerance? If so what are those tests called.

Thanks so much!

A. Yes, some doctors mistake the symptoms of celiac disease for crohns because for so many years celiac was under diagnosed. Your brother might want to ask his doctor to order the celiac panel (blood tests) and if he has positive results he may undergo a biopsy of his small intestine which is the "gold standard" for diagnosis of celiac disease.

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

I enjoy plain dark chocolate sometimes and I noticed that gluten-free chocolate is sold. This made me wonder if regular chocolate, without any wheat products listed on the label, is gluten-free.

I have the same question about baking powder, when the ingredients listed are sodium bicarbonate, cornstarch, monocalcium phosphate.

Does caramel colour have gluten?

Thank you for clarifying.

A. If the product was made and sold in the United States the new labeling laws require wheat to be listed as an ingredient if it is contained in the product. However, barley does not have to be listed and could still be in a product that claims to be wheat free.

I'll tell you what I do and you can decide for yourself: I consider plain dark chocolate to be gluten free but I have purchased a baking powder that is labeled as gluten free. I suppose I could use "regular" baking powder since it does not contain gluten in the ingredient list, but I have decided to be on the safe side with it.

Caramel coloring made and sold in the United States does not contain gluten but if it is made and sold in another country you should contact the manufacturer.

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

I was just diagnosed with celiac disease. I am a type 1 diabetic and have been for 35 years. My symptoms were huge hives anytime I ate gluten extremely tired all the time and bruised easily.

I have been asking my doctor for a celiac test but was told you don't have it. I am overweight so my doctor thought since I am overweight there is no way I could have it.

My question is: the rest of my family are not a celiac and I am wondering should I buy a separate toaster?

A. I personally do not have a separate toaster but I put aluminum foil down in my toaster oven before I toast. You can also use Toast It Bags.

Physicians are beginning to realize that even overweight people can have celiac disease. If the damage is not in the portion of your small intestine that absorbs calories you'll still absorb calories and gain weight if you take in more than you burn up. If you have decided to be on a gluten free diet for life and can live with not knowing definitely if you have the diagnosis that is your decision.

If it makes you feel better and you have accepted that it is necessary it should make the decision simple.

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

Hi my daughter has ensinophiliac oesophagitis (sorry about spelling) and coeliac. She is finding it difficult when eating as she gets a lot of reflux to the point of bringing back fresh blood.

I am trying to find foods that will help ease her problem, but to no avail. Can you please help me?

A. Has your doctor prescribed any medications such as Pepcid, Prilosec, or Zantac? These are all available over the counter in the US but I'm not sure about other countries. I would say if she has reflux to this extent she will probably require some medication. She should also try avoiding citrus (orange, grapefruit) and tomato products, coffee and tea and peppermint.

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

I was diagnosed with celiac disease by biopsy and blood work in January 2007. I have been on a very strict GF diet ever since then. My bowel movements were very loose and frothy looking before the diagnosis and after I went GF they had returned back to normal again. This past month I have noticed that my bowel movements have been loose again. I also noticed what looks like an oil slick in the toilet after I move my bowels.

I have not changed anything in my diet or have used anything with gluten in it such as cosmetics, shampoos or lotions. I don't think that I have been exposing myself to gluten because the few times that I came across gluten my first signs were muscle and joint pain followed by the loose stools.

I guess my question is is it common to have these kinds of bowel movements after being GF for four months? My villi were blunted not flattened at the time of my diagnosis. I am worried that my intestines are further damaged because I don't seem to be absorbing my foods very well.

Your help is greatly appreciated.

A. You may want to go back to your doctor and ask to have your blood re-tested for celiac (while following what you feel is a gluten free diet). If it is indeed gluten free your blood tests should come back negative. If they don't, it sounds like you may be inadvertently consuming gluten. This could be from lip balm, medications, vitamins, or other sources you wouldn't immediately think of containing gluten.

Do you ever eat fried foods that were fried in oil that had previously been used to fry something containing gluten? How about popcorn at the movies (seasoned with "natural flavors") or not washing your hands well after feeding your pets food that contains gluten? Do you have a dedicated toaster at home that is only used for gluten free products?

These are just some possibilities–see if you can get your tTg tested to see what's really going on.

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

I have all of the symptoms of someone with celiac. Moderate to severe abdominal cramping after eating, boughts of diarhea, and a bloated upper stomach.

My doctor has said it is unlikely that I have it because of my race. I am mostly African-American with other races mixed in. Is that true?

A. According to the study published in February 2003 by Dr. Alessio Fasano, approximately 1 in 236 people of African American, Hispanic, or Asian American descent have celiac disease. This contrasts with the 1 in 132 statistic for the general population in the United States. Therefore it is entirely possible that you have CD.

You should ask to have a celiac panel (several blood tests) done to see if you test positive and an intestinal biopsy would be warranted to conclusively diagnose you before going on a gluten free diet.

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

I was diagnosed in March 2007 with Celiac (small intestine completely bald) and have been learning about this disease and trying to go wheat free/gluten free ever since.

I have a full time job - 12 hours a day 5 days a week -one 8 hour day and baby-sit my grandchild on my day off. This leaves me very little time to cook and try the recipes.

I am also, on Coumadin -blood thinner due to a heart valve replacement which means I have to watch my vitamin K. Which makes the gluten free/wheat free diet very hard for me. A lot of the recipes I have looked are are very time consuming.

Any suggestions? Also there are a lot of ingredients and additives in foods that I do not know what they are and what they are for. Is there a list and what a CD person should avoid?

I have been on this diet for a couple months and am feeling some better. I don't "run" to the bathroom after eating now but still have the bloating and really bad gas problem along with aches, pains, and just a really bad feeling of tiredness.

Am I still picking up some wheat/gluten residue from somewhere?

Am, enjoying your site and thank you for any help you can give me.

A. Have you tried avoiding lactose? The enzyme that digests lactose (from dairy) is produced on the villi so if there is damage to the villi the enzyme may not be produced.

The symptoms of lactose intolerance can include bloating, gas, diarrhea, pain, etc. However, you may be right in that you are "getting glutened" somehow inadvertently. There are several companies that make gluten free frozen convenience foods that can be microwaved. It might be worth it for you to purchase a case of these meals to have in your freezer for when you don't have time to cook.

One company that comes to mind is Amy's. Not all their foods are gluten free but those that are are clearly labeled as such. There is another company, www.glutenfreemeals.com that sells frozen meals on line and there are even companies that deliver fresh gluten free meals in some areas.

As far as Vitamin K, we tell our patients on blood thinners to keep their intake of Vitamin K steady. In other words, don't sit down one day to a big bowl of beans, spinach and coleslaw and then don't eat that way for a few weeks.

I am attaching a good "Quick Start Diet Guide" that will hopefully help you.

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

Do you happen to know what is causing this swollen belly syndrome after going on a gf diet?

I went to a gyn dr. yesterday for other problems and she said my stomach has nothing but air in it and it's coming from the bowel. Before I found out I had celiac I lost down to 120 lbs and that is very small for me. when I started eating gf I slowly gained back and now am up to 165 lbs at 5'2". I can't even stand to look in the mirror. is their anything I can do or a dr. can do about this. I look like I am 7 months pregnant. please help!

A. If you are sure you are on a completely gluten free diet you may have lactose intolerance. Try avoiding anything with lactose in it (avoid dairy products or use something like Lactaid). This can be common in celiacs for a while after diagnosis even if they are on a strict gluten free diet.

Another possibility is that you are consuming what we call "fermentable carbohydrates". When something you eat isn't completely digested (such as beans, for example) the carbohydrate travels down your intestine to your colon where it is fermented, and fermentation produces gas as a by-product. Broccoli, brussel sprouts, cabbage, and cauliflower can also cause this.

There is a product called Beano that can help with this. Both Lactaid and Beano are over the counter products.

Some people have the problem you are describing when they eat artificial sweeteners. There are some artificial sweeteners that contain substances that are not fully digested and…you guessed it, end up fermenting in your large intestine.

As far as your weight gain you may be eating too many gluten free but high calorie treats such as cookies, cakes, candy, etc. Try to avoid fried food and sweets or at least limit their consumption. It is possible to increase your fiber intake by eating brown rice and products made from brown rice and corn. Fiber should help you feel full and hopefully you will then end up eating fewer calories. Since too much fiber can cause gas as well, increase your fiber gradually if you are not eating much now.

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

I love your web site & find it very helpful to me the newly diagnosed celiac.

I have a question which I hope you can help get things straight. Even though I am doing gluten free diet & cooking, I am finding that at least twice a week, sometimes more, I am having a celiac attack dispite doing everything correctly & that includes no cross contamination.

This is driving me quite crazy & of course losing weight which I cannot afford to be doing - down to 104-106# at present.

I am taking probiotics prescribed by my gastroenterologist to help with the healing of my gut. But dispite everything I am doing, I am still getting sick, too often to suit me.

Can you shed any light on this problem & have others had this problem also? I know that my doctor has told me I am a very severe celiac so getting well is going to take a long time……1+yr to be exact.

Thank you for your help.

A. These are some things you might want to try (not all at once so you can pinpoint which one works if any of them do):

–avoid lactose. When your villi are damaged the cells that produce the enzyme that digests lactose are damaged. Lactose is contained in dairy products unless they are labeled as lactose free.

–avoid eating out for the time being (that is if you are eating out in restaurants) just to make sure your food is not "glutened"

If these don't help you may be inadvertently consuming gluten. Make sure you are avoiding all foods that might contain gluten including those with food starch, dextrin, and oats (only pure uncontaminated oats are recommended).

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

Since 1998 I've gained almost 100 lbs. I have a lot of the symptoms of Celiac. I went though a small bowel biopsy 5 years ago. The doctor said it was negative, but I should try staying away from gluten for a while anyway.

I tried for a year and half. It didn't seem to change anything, so I went off the diet. The symptoms didn't get any worse until lately.

I don't eat much, but I just keep gaining weight. I'm tried all the time, my stomach is in pain and gassy from all the bloating. I'm 48 years old I can't remember things any more. I don't know what to do.
I read an article a couple weeks ago from some magazine (can't remember) but it said something about a unknown food allergy that could be making you fat.

They said it was gluten, and that the gluten could be causing food to just stick to you like glue.
Everywhere I've read about Celiac's says that it cause's people to lose weight. Then why am I fat? Can you help?

A. If it were only that easy! No, gluten doesn't make food "stick to you like glue" but if your intestinal villi are damaged from gluten because you have celiac disease you are probably not absorbing the necessary nutrients your body needs for proper metabolism. This is why some people with CD are overweight while others are underweight.

You should probably ask your doctor to order a celiac panel (blood tests) and if they are positive for CD you may be told to have an intestinal biopsy to determine if you do have celiac disease.

Sometimes when the biopsies are performed the area that is biopsied is not damaged while another area in your small intestine does have damaged villi (that would explain why your previous biopsy was negative if another one turns out to be positive in the future).

Roberta

———————————————————————————————————————————————————————

Q. Dear Roberta,

Roberta you answered one of my questions a week or 2 ago. Tt was about the swollen belly syndrome. I have done some research on my own but still don't know what to do.

Instead of lact aid or gas aid I need a digestive enzyme and there is so much to choose from on the internet. Do you have any suggestions on whether to colon and liver cleanse then take a digestive enzyme or what? What digestive enzymes would you recommend? Thanks

A. At the present time none of the digestive enzymes that are on the market that purport to "break down gluten" before it gets to your small intestine have been found to conclusively work through scientific studies.

On the other hand, I haven't heard anything about them having ill effects, either.

I would recommend to try to eliminate gluten from your diet as much as possible but if you are worried about trace amounts through contamination, etc you could also try one of the products available and see if it helps.

Roberta

———————————————————————————————————————————————————————

Question and Answer Pages

Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12