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Celiac - help please


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Hi guys

 

My sister was in the hospital a few days ago: From what I could understand, she suddenly and quite violently began throwing up continuously on Friday afternoon. The emergency service doctor that came to our house checked her for 5 minutes with accute pains in the abdomen, and decided she has to run to the emergency room emmediately, as he suspected appendicitis.

 

She got there while still not stoping to throw up, and was quite dehydrated as a result. The doctors ruled out appendecitis and gave her something to calm her stomach a bit, and ran some tests.

 

She ended up staying for observation for almost four days in a row; The doctors couldn't quite find what was wrong with her, and her blood tests seemed to be coming back "messy" (hey..their choice of words)..

 

She finally was released back home, and now the doctors suspect that perhaps she has Celiac, and her accute stomach pains are a symptom of it.

 

I was trying to find information about this condition (from what I understood it's not really a 'desease'), and I can't make heads or tails of it..

 

I did understand there is a problem with digesting (or 'breaking down') gluten. Therefore, she should probably have some sort of no-wheat/rie/whatever-else diet, I would imagine.

 

Two thing I must understand since it seems a bit odd to me, and I couldn't find answers online:

 

  1. Isn't this desease genetic? it's supposed to be 'from birth', no? She's twenty years old.. how could this desease not manifest itself earlier? She's been eating a LOT of wheat-containing foods, I can promise you that - my mother is a very good pastry cook, and we have lots of it at home.. is it logical for her to show symptoms (and quite violent ones) only now???
     
  2. My sister is in her mandatory-stage of the military. She's a non combat soldier, but still is in the military.. can this condition be 'environmental'? Is it possible the army food/facilities/hygene contributed to the manifestation of this desease?

 

I would seriously appreciate any and all help on the matter, this is very confusing.

 

Thanks

 

~moo

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I know someone with Ciliac and it apairs to have genetic linkage. And as you mentioned the an allergic reaction to Gluten. Appearently its something that manifestes its self later in life; she had symptoms as a child but it grew worse as she got older. Finanlly at age 27 she was diagnosised with Ciliac.

 

I think its got something to do with immune response/foreign antigenicity/reduced immune tolerance, but check it out.

 

The Army food would not have precipitated the disease, but now she has to be careful with what she eats. Basically everything has to be GLUTEN free.

 

She may have to go as far is having her own silverware/dishware and if she eats any bread or wheatbased carbs, she as to know that it is Gluten free.

 

However, she's free to eat salads, meats etc.

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We're argentinians at home, she'd KILL someone if she wasn't able to eat meat :P so at least that.

 

I've read somewhere that Celiac outburst in a person that is inclined to have the desease can occur due to stress related situations, or environmental variables such as sleep / food and such....

 

Anyone knows if this is true?

 

 

This is very important, since if this violent occurance happened due to poor military conditions, we might want to get her shifted to a different base.. or.. kill their cleaners. :P

 

~moo

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hello

 

http://www.celiac.com/index.html

 

http://familydoctor.org/236.xml

 

http://www.mayoclinic.com/health/celiac-disease/DS00319

 

http://www.cdc.gov

 

try these if not already.

as above your sister should immediately modify her diet to avoid gluten a protein found in wheat products. be careful to read the labels on food packages as wheat can be found in other than simply bread products, provides a binding agent in some other foods.

also she should start diary of what she eats, as a person with food allergies i can tell you that she may develope other allergies though unlikely. but a diary will help show if other items make her ill as well, and you may see a common thread amougst them.

if celiac, they do think it is genetically based, so once it starts usually no going back.

if you read one of those sites i believe it is mentioned they think it may be a throwback gene where for most of human developement the human diet consisted of meat and fruit and berries, wheat is a recent developement and has only been cultivated for some 4,000 years. and that in some people a gene gets triggered that considers wheat\gluten to be a poisonous substance, as for around 50,000 years humans ate no wheat.

but only a theory, they have no proof.

fortunately it appears to be controllable by modified diet. unfortunated that includes loosing a lot of fine pasta dishes.

perhaps you might see if there are wheat substitue versions.

celiac seems rather common so would suspect such to be the case.

 

mr d

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I was trying to find information about this condition (from what I understood it's not really a 'desease'), and I can't make heads or tails of it..

 

I did understand there is a problem with digesting (or 'breaking down') gluten. Therefore, she should probably have some sort of no-wheat/rie/whatever-else diet, I would imagine.

It's an auto-immune disease. Her body has formed antibodies against a gluten-transaminase. Thus, when the protein is high concentration (as it is after she eats gluten), she'll have symptoms. They can do a serological test for this, but a negative test does not mean she does not have the disease. If she stops eating glutin and the symptoms subside, then that's probably the disease. This is cheaper and easier than a duodenal biopsy (which is diagnostic).
1. Isn't this desease genetic? it's supposed to be 'from birth', no?
It has a genetic component--but environment also plays a role in activating" the disease. Trauma and stress are known to contribute to the onset of the disease.

 

She's twenty years old.. how could this desease not manifest itself earlier?
It's likely she hadn't encountered the conditions that triggered it.

 

She's been eating a LOT of wheat-containing foods, I can promise you that - my mother is a very good pastry cook, and we have lots of it at home.. is it logical for her to show symptoms (and quite violent ones) only now???
Yes, see above.

 

*I am only a first year medical student. Don't take my comments as gospel. I saw a patient two weeks ago in a clinic who had the disease, and I did some research and talked with my attending physician about it.

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Blike, I apreciate your help greatly, thanks a LOT!!

 

btw, just an "extra" comment: In israel, unlike America, we have a Socialist-type thinking (faaaaaaaaar from perfect, but quite different than the USA) - one of its VERY good manifestations, is that we have practically free medical insurance, that includes almost everything. I remember paying about 40 NIS (equivalent to about 10USD) per month, for the "EXTRA EXTRA FEATURES" like dental bi-yearly free-preventative-measures and stuff like that...

So thanks for the "it will be cheaper" but luckily, since Celiac is a known condition, the israeli insurance has it in its list of covered conditions and we won't pay a dime.

 

Well.. maybe "a dime" is all we will pay.. ;)

 

In any case, thanks! :)

 

~moo

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My Fiancee actually is Coeliac (UK spelling), and came down with it since I met her. Basically, she was fine for a long while (though she always had unexplained bouts of listlessness and stomach trouble), but then the Xmas before last we both came down with a horrible stomach bug that had us both bed-ridden for days (and not in the fun way). After that, the coeliac really showed up. She's always had it, but the disease triggered it to really show up.

 

The good news is that there are several communities for this, including several on Livejournal, which I recommend she join. It'll help, and they trade helpful hints (what has gluten in and what doesn't) and good recipes. Honestly, a lot of them are really good.

 

The bad news: No cheating! The nature of the disease means that repeated ingestion of gluten will cause permanent damage to the intestines.

 

Mokele

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The bad news: No cheating! The nature of the disease means that repeated ingestion of gluten will cause permanent damage to the intestines.

 

Yeah. I read about that... well, we don't yet have definitive answer if this really was what she was having.. but if she does, she will be closely monitored by my mother to not even come close to any of the things she should'nt be ;)

 

Btw... could she have eaten gluten all her life with no affect and only now suddenly encountering it!?!? i saw what you guys said about suddenly having a break of the situation due to stress but.. but seriously, if this is a stomach condition that it cant break down gluten, i just cant see how she could have been a normal eating person up until now..:(

 

sorry if this is a repeat-question, I just.. can't understand it..

 

~moo

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OK, Basically its an aquired autoimmune disease that is associated with an abnormal response to dietary antigens. Ciliac in particular has been linked to T cells, the major histocompatability complex locus (HLA-DQ) and tissue transglutamase. Defects in any one of those genes can lead to aberrant presention of gluten antigens to not only innate system componants, but also T cells, (adaptive system) thus initiating an uncontrolled response to the antigen upon exposure.

 

There is a good review by MacDonald and Monteleone in Science, vol 307, 2005 that discusses the molecular/cellular development of Gut autoimmunity and contains a whole section of ciliac.

 

Good luck.

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