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DIAGNOSIS

The primary diagnosis for both patients in Forever is celiac (or coeliac) disease, also known as celiac sprue and gluten enteropathy. Celiac disease is an autoimmune disorder present in about 1% of the Indo-European population, including one out of every 113 Americans.

According to Wikipedia, "coeliac disease is caused by a reaction to gliadin, a gluten protein found in wheat (and similar proteins of the tribe Triticeae, which includes other cultivars such as barley and rye). Upon exposure to gliadin, the enzyme tissue transglutaminase modifies the protein, and the immune system cross-reacts with the bowel tissue, causing an inflammatory reaction. That leads to flattening of the lining of the small intestine, which interferes with the absorption of nutrients."

In layman's terms, the person's intestines can no longer work as an internal sponge to absorb all the good nutrients in food and instead expel all food and nutrients, leading to malnutrition. Gluten, a protein most people can process perfectly well, is like poison to celiac patients, causing a wide array of symptoms throughout the body, but especially in the intestines.

There is no cure for celiac disease. The only treatment is to never consume gluten, which is present in about 85% of all processed foods. Patients with celiac cannot eat any foods containing wheat, barley, rye, most oats, malt, spelt, semolina, durum, triticale, or any other grains. They can, however, eat corn, potatoes, soy, and rice, among others.

SYMPTOMS

The most common symptoms of celiac disease are:
  • Abdominal bloating and pain
  • Dramatic weight loss or gain
  • Chronic diarrhea and/or constipation
  • Pale, foul-smelling, or fatty stool
  • Infertility or menstrual irregularity, including miscarriage
  • Fatigue, malaise, and exhaustion
  • Gas, especially foul-smelling
  • Anemia or other vitamin deficiencies
  • Delayed growth or failure to thrive in children
  • Skin rashes, including dermatitis herpetiformis and keratosis pilaris
  • Bone or joint pain
  • Dental problems
  • Osteoporosis
  • Peripheral neuropathy or general neuropathic pain
  • Muscle cramping
  • Seizures
  • Mood and behavioral changes
  • Mouth ulcers (aphthous ulcers)

TREATMENT

The only treatment for celiac disease is to not consume gluten. Associated conditions caused by untreated celiac disease can require medical intervention, especially if long-term damage has been done to the body due to the consumption of gluten. If you suspect you might have celiac disease, you should seek help from a gastroenterologist immediately. Untreated celiac disease can lead to irreversible and potentially fatal medical conditions, including lymphoma of the stomach and intestines.

RESOURCES

For more information on celiac disease, consult any of the following:

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