Celiac disease leads to deficiencies

Dr. Paul Donohue
Syndicated Columnist
Published Sunday, January 04, 2009

DEAR DR. DONOHUE: My 38-year-old daughter has celiac disease. She is married and has three children. She suffered from daily diarrhea and lost 40 pounds. It took a year before doctors diagnosed her condition. How unusual is this? Will her children get it? -- M.S.

ANSWER: Celiac disease is anything but unusual. One in every 300 people has it. With a population of more than 305 million, that means there are a whole lot of celiac sufferers in the United States. The digestive tract of celiac patients can't cope with a protein called gluten. It inflames their tracts and impairs the absorption of nutrients.

Gluten is found in wheat, barley and rye. To a lesser extent, it's in oats, but many celiac patients can tolerate oats without developing symptoms.

Your daughter's symptoms are typical. Diarrhea and weight loss are prominent signs. However, people can have celiac disease without either. Their illness is discovered when they come down with vitamin or mineral deficiencies from celiac's interference with nutrient absorption. Osteoporosis might develop at a young age because calcium cannot be absorbed by the digestive tract, or anemia occurs because iron isn't assimilated.

The diagnosis of celiac disease has become easier to make by finding peculiar antibodies in the blood. The immune system makes antibodies, and in this case they are antibodies against gluten. Sometimes a biopsy of the small intestine is needed to confirm the diagnosis. Treatment is the avoidance of gluten. Once that protein is eliminated from the diet, symptoms generally clear quickly. Your daughter should make a full recovery. Her children ought to be checked, since genetics has a role in the illness.

Gluten avoidance isn't all that easy. People are greatly helped in coping with the illness by contacting the Celiac Disease Foundation, whose Web site is www.celiac.org and whose phone number (not toll-free) is (818) 990-2354.

TO READERS: The asthma booklet provides information on the diagnosis and treatment of this common ailment. To obtain a copy, write: Dr. Donohue -- No. 602, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Allow four weeks for delivery.

DEAR DR. DONOHUE: I just visited a longtime friend who turned 65. He stated that you can't take enough vitamin C. I disagree. I'm sure I have read that too much vitamin C can be harmful. I couldn't convince my friend. Please clarify. -- G.C.

ANSWER: Vitamin C and the B vitamins are water-soluble. That means they don't accumulate in the body. Excess is gotten rid of in the urine. That's a safeguard against overdosing with it. In addition, when people increase their vitamin C intake above what is needed, the absorption of the vitamin decreases, another safeguard against taking too much. Large amounts, however, can irritate the stomach and provoke diarrhea.

The recommended daily intake of vitamin C for adult men is 90 mg and for women, 75 mg. The upper limit is set at 2,000 mg. There's no good reason to take large doses of this vitamin.

DEAR DR. DONOHUE: My husband, who has two artificial heart valves and a pacemaker, had a hernia operation. Two days later, his abdomen and bladder became enlarged and painful. He was admitted to the intensive care unit. He developed a hematoma, then pneumonia and then a Staph infection of his blood with the MRSA Staph germ. He is on vancomycin now. I found that MRSA is treatable but not curable. It becomes dormant and can resurface. Not only is my husband highly contagious, but I worry about his quality of life. -- W.W.

ANSWER: MRSA Staph is a Staph germ that's resistant to many antibiotics, but there are some to which it responds. Vancomycin is one of those drugs. It kills MRSA Staph. The germ doesn't remain dormant. It has been eradicated.

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