Medical Ask Your Doctor

The Changing Face of Celiac Disease

Stefano Guandalini, MD, is an internationally recognized expert on celiac disease who has greatly influenced the way the condition is diagnosed and treated. He founded the University of Chicago Celiac Disease Center in 2001, where he’s served as medical director, as well as section chief of Pediatric Gastroenterology, Hepatology and Nutrition at the University of Chicago Medicine. He recently transitioned from these positions to the role of professor emeritus.

Ask the Doctor: April/May 2018

Allergist Scott Commins, MD, PhD, is one of the nation’s leading experts on the alpha-gal allergy, an allergy to mammal meat induced by a tick bite. A member of the University of Virginia’s research team that discovered alpha-gal allergy about ten years ago, Commins now heads the laboratory that studies the allergy at the University of North Carolina. He also serves as Associate Professor of Medicine in the Division of Rheumatology, Allergy and Immunology and has a clinical practice that specializes in diagnosing and treating patients with the alpha-gal allergy.

Celiac and Pregnant

There’s ample scientific evidence that untreated celiac disease, characterized by inflammation and nutrient deficiencies, can lead to infertility. There can be issues during pregnancy, too. If a woman with untreated celiac does conceive, the fetus potentially could be at risk: An Italian study published in 2010 demonstrated that anti-transglutaminase (anti-tTG) antibodies in the blood—a hallmark of untreated celiac disease—can interfere with the function of the placenta, possibly leading to early loss of the pregnancy.

Research Roundup: February/March 2018

A case recently published in the Journal of Medical Case Reports described a dramatic and surprising presentation of celiac disease. A 3-year-old Albanian girl came to a clinic with carpal spasms (involuntary muscle contractions) and paresthesia (numbness and tingling) in her hands. A physical exam revealed no other symptoms but a blood test showed the child had severe calcium depletion. A screening for celiac disease was conducted (among other tests) with positive results; the diagnosis was confirmed with a duodenal biopsy.

Gut Feeling

In proper balance, bacteria in the colon prevent illness, regulate food absorption and digestion and play a role in many body functions. But when bacteria invade and take over the small intestine, they can cause digestive problems (like gas, abdominal bloating, stomach pain), nutrient malabsorption, food sensitivities and more.

Ask the Doctor: February/March 2018

Last November, Dr. Alessio Fasano, director of the Center for Celiac Research and Treatment and director of the Mucosal Immunology and Biology Research Center at Massachusetts General Hospital, gave the keynote address at the Institute for Integrative Health’s In Good Health Wellness Expo in Baltimore. Associate editor Jules Shepard was there. In her interview with Dr. Fasano, he expands upon his presentation and discusses factors related to the development of celiac disease and other autoimmune conditions.

Always Tired? Adrenal Insufficiency Can Zap Your Energy

Miller and his mother didn’t know what was wrong, nor did his primary care doctor. A year earlier, Miller had been diagnosed with celiac disease, so at first he assumed his symptoms were related to that. But even on a gluten-free diet, his fatigue continued to worsen. Eventually, he ended up in the emergency room of a university hospital center where he was promptly admitted.

Ask the Doctor

Australian-born gastroenterologist Peter H.R. Green, MD, is one of the world’s leading experts on celiac disease. He’s the Phyllis & Ivan Seidenberg Professor of Medicine, director of the Celiac Disease Center at Columbia University and author of Celiac Disease: A Hidden Epidemic. Dr. Green sat down with GF&M’s associate editor Eve Becker at Digestive Disease Week earlier this year to talk about celiac disease and wheat sensitivity. This edited version of that interview contains additional information from Dr. Green in response to our follow-up questions.

What To Do When Your Doctor Won’t Listen

You know yourself better than any doctor. Learn to pay careful attention to your body and to your symptoms. Take daily notes, keeping close track of what you eat, how you sleep, your energy levels during the day, your fluctuating moods, your toilet habits, your pain and other symptoms. An organized, detailed log of symptoms can help you and your doctor spot any overarching patterns that may provide clues and point to triggers.

What is Resistant Starch?

Resistant starch resists digestion in the stomach and small intestine—hence, the name. This resistance is important. Since resistant starch isn’t broken down into sugar in the small intestine, it doesn’t spike blood sugar levels. Instead, it’s broken down in the large intestine where it feeds the good bacteria in the colon, creating beneficial molecules that promote a healthy gut.

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