Celiac Disease Diagnosis and Management

Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist, discusses how celiac disease is diagnosed and managed through diet.

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Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist, discusses how celiac disease is diagnosed and managed through diet.
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Featuring Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist

Duration: 3 minutes, 9 seconds

Celiac disease is quite common in our community, and it has two times that the onset is more common. Interestingly, there’s an onset that occurs in the second decade of life, there’s a peak incidence then.

But also there’s another surge in incidence that can occur in the 50s and 60s, for unknown reasons. So as a practitioner we try and be aware of these peaks and incidences, and look for patients that have it.

The underlying problem is an intolerance to gluten. Gluten is a compound that’s derived from wheat and similar grains. It gives the doughy feeling to breads that we so much like. And people with celiac disease cannot tolerate gluten. They have an inflammatory response to it when their intestine comes in contact with the gluten.

The diagnosis is first part clinical: suspecting the disease based on the pattern of what the patient’s been eating and how they’re reacting. Usually, if you have a food intolerance, it’s what you ate one or two days previously. What you ate a week ago generally doesn’t have a big impact on what your intestines feel like today.

So if you think you’re intolerant to gluten or wheat products, and usually that includes wheat, barley and rye – grains predominantly – then you can consider discussing this with your family practitioner or primary care physician.

The diagnosis is made by blood testing. There are serological tests - tests to look for antibodies in your bloodstream - that are directed against gluten, which are reasonably good tests actually.

But today the gold standard – the best test – is still upper gastrointestinal endoscopy, where a gastroenterologist or someone who’s skilled in that procedure looks in through the mouth into the small bowel and biopsies the small bowel. And there’s a characteristic abnormality to the intestine that you can see in celiac disease or gluten sensitivity.

Once the diagnosis is made, it’s important to sit down with a dietitian and review where gluten is in foods, because unfortunately it’s just about everywhere. Gluten gets added to a lot of foods that you might not suspect, such as wieners for example. It’s often used to bulk up and put foods together, so it’s important to know where it is, to go to gluten-free grains and avoid foods where it’s been put in as an additive.

If you think you have symptoms of celiac disease or gluten sensitivity, discuss it with your primary care physician.

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Local Practitioners: Endocrinologist

97-100 People got two or more of these video questions wrong... ( 4 participated.)

Quiz: Do You Understand Celiac Disease?

Questions
 
True
False
1

Celiac disease is related to inflammation of the intestines but Crohn's disease is not.

Explanation:

Celiac disease and Crohn's disease are both diseases related to inflammation of the intestines. Crohn’s disease is more common in people who have celiac disease.

2

Exercise may help reduce inflammation related to celiac disease.

Explanation:

Research has shown that exercise can improve the body's anti-inflammatory response by activating its sympathetic nervous system. During exercise, the body releases hormones such as epinephrine and norepinephrine, which activate immune cells.

3

A gluten-free diet is the only treatment if you’ve been diagnosed with celiac disease.

Explanation:

People with celiac disease need to follow a gluten-free diet for life. Gluten is a protein found in wheat, rye and barley. In people with celiac disease, eating gluten triggers an immune response in the small intestine. Over time, the lining of the small intestine is damaged and is unable to absorb certain nutrients.

4

Celiac disease is not genetic.

Explanation:

Celiac disease is linked to heredity, so if you have a relative with the disease, your risk is higher.

5

There may be a link between depression and celiac disease.

Explanation:

Studies have found that people with celiac disease may have an increased risk of developing depression. This may be related to the stress of managing a chronic disease; and/or the inability to absorb certain nutrients such as the essential amino acid tryptophan, which is converted into serotonin, a chemical that helps regulate mood.

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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