Celiac disease often diagnosed as irritable bowel syndrome

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DEAR DR. DONOHUE: For the past five years, I have suffered from diarrhea and stomach pain. At times, the diarrhea was so bad that I couldn’t leave my house. I was told I had irritable bowel syndrome and would have to learn how to live with it. In the past year, my weight dropped by 25 pounds, but I was not trying to lose any weight. My husband insisted I see another doctor. The doctor discovered I had celiac disease and has me on a diet for it. My life has changed. I have not felt this well in a long time, and the diarrhea has stopped. Tell people about this illness. — S.A.

ANSWER: I’m happy you’re feeling so well, but unhappy that it took so long to find the right diagnosis. Celiac (SEE-lee-ak) disease is anything but unusual; however, it often is mistaken for irritable bowel syndrome. It affects about one in every 133 people. It’s an intolerance to gluten, a protein found in wheat, barley and rye. It’s more than an intolerance. Gluten, in susceptible people, stimulates the immune system to make antibodies that interfere with the absorption of foods from the small intestine.

Diarrhea, weight loss, bloating and stomach pain are the major signs of this illness. Sometimes, those signs are not prominent, but things like anemia, osteoporosis at an early age or nerve disturbances (neuropathy) are. Those illnesses are the result of the malabsorption of nutrients, vitamins and minerals.

Doctors put the diagnosis on firm ground by finding the abovementioned antibodies in the blood and by microscopic examination of a tiny piece of the small intestine.

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Treatment is the elimination of wheat, barley and rye from the diet. When a celiac patient does so, the loss of symptoms takes place quite rapidly — usually. It sounds like this is no big deal. Following a gluten-free diet is a big deal. Those grains are a major portion of everyone’s diet, and their products turn up in foods you would not think were related to the grains. A dietitian should teach every patient the ins and outs of the celiac diet. And every celiac patient ought to contact the Celiac Disease Foundation at www.celiac.org or at 818-990-2354. The foundation provides people with hard-to-find information and tells where to find gluten-free foods.

DEAR DR. DONOHUE: All my life I had beautiful fingernails. I don’t anymore. They split and break all the time. What can I do? — M.N.

ANSWER: Keep your nails short, but before you trim them, soak your hand in warm, soapy water. Nail hardeners strengthen your nails. Make sure they do not contain toluene sulfonamide or formaldehyde. Or apply a thin coat of nail polish to your nails. Use polish remover infrequently, no more than once a week. Do not use a nail-polish remover that has acetone in it.

Use a moisturizer on your nails if they are not covered with nail polish. Petroleum jelly keeps them hydrated.

Some feel that biotin, a B vitamin, restores nail health.

DEAR DR. DONOHUE: My heart misses a beat every now and then. The doctor tells me this isn’t dangerous. He has said nothing about food or drink as being a cause of this. I drink two cups of coffee a day. I can’t tell any difference on the days I drink it or on the days I don’t. What’s the thinking on this? — P.M.

ANSWER: Moderate amounts of caffeine have little effect on the heart. Two to four cups of coffee a day shouldn’t affect your heartbeat. However, if a person is quite sensitive to caffeine, then that person should abstain from coffee.

There appears not to be any relationship between coffee drinking and artery hardening, artery obstruction or heart pumping. Heart attacks and strokes are no more frequent in coffee drinkers than in those who never touch it.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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