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Celiac Disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. The disease can be confused with irritable bowel syndrome, iron deficiency anemia, inflammatory bowel syndrome, diverticulitis, intestinal infections, and chronic fatigue syndrome. While the disease affects one in every 133 Americans, 97% of those who have the disease remain undiagnosed. The risks associated with the disease are malnutrition, anemia, osteoporosis, thyroid disease, type-1 diabetes, infertility and cancer. While there is no cure “per se”, one with celiac disease may avoid these complications by adopting a gluten-free diet. Gluten, found in many different kinds of foods including, but not limited to, breads, cereals, pastas, beers, seasonings, and food additives, attack the villi lining the small intestine. This causes nutrients to not absorb into the body and can cause severe long term problems.

My law clerk was just diagnosed with the disease just two weeks ago. After complaining to her doctors for 5 years about extreme abdominal pain, she was finally tested for the disease. Two weeks after adopting a gluten-free diet, she feels amazingly better. Mimi Winsberg, a triathalete and marathon runner realized she had the disease when her health and her athletic performance spiraled downward. Little did she know, the power bars and pasta she had been ingesting for energy caused her great fatigue. Similarly, Dave Hahn, who had reached the summit of Mount Everest 10 times, realized that he had the disease when he became inexplicably weak during his second hike up to the summit. Diagnosing the disease and changing your diet are key to successfully fighting this disease.

The problem that has lead to many underdiagnoses is that many doctors believe that celiac disease is extremely rare. My law clerk saw four different doctors, two of them being gastroenterologists, before her primary care physician decided to run the necessary blood test and diagnosed her with the disease. Dr. Peter H. R. Green, a professor at the College of Physicians and Surgeons at Columbia and the director of the university’s celiac disease center, believes that it is the “lack of pharmaceutical backing for the disease” that is the root of the problem. Because treatment involves a dietary change and not a traditional medicinal one, the lack of research, medical education and public awareness leads to under and mis-diagnoses. Alba Therapeutics and Alvine Pharmaceuticals, Inc. are working towards finding drugs to inhibit the destructive autoimmune response to gluten. Additionally, dietary supplement manufacturers are working to find enzyme formulations that will assist people in digesting gluten, similar to those used for lactose-intolerance.

Until celiac disease becomes more well-known, patients must pay close attention to their symptoms and push their doctors for appropriate testing. Symptoms to which attention should be paid are: abdominal cramping/bloating, abdominal distension, acidosis, anemia, appetite (to the point of increased craving), back pain, constipation, decreased ability to clot blood, dehydration, reduced fat padding, gas, gluten ataxia, mouth sores or cracks in the corners, muscle cramping, night blindness, very dry skin, change in stools, tooth enamel defects, weakness and weight loss. Also pay attention to depression, disinterest in normal activities, irritability, mood changes and inability to concentrate. If you are suffering from any of these symptoms, seek treatment immediately. The long-term effects and consequences are too risky to ignore.

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