Question: Can you address the problem of being underweight? I'm 75 years old and have celiac disease, so I can't eat wheat, barley or rye. I eat extremely well — lots of fresh fruits and veggies, some protein, and only organic canned items. I weight 95 pounds soaking wet, and nothing I do seems to put on an ounce.
Dr. Hibberd's Answer:
Celiac disease, otherwise known as celiac sprue, non-tropical sprue, or gluten enteropathy, is a hereditary disorder where the bowel is inflamed causing malabsorption, abdominal cramps and diarrhea. Celiac is caused by sensitivity to the gliadin protein in gluten (a component of wheat; similar proteins are found in rye and barley), and it creates intolerance to gluten. Inflammation of the mucosal lining of the bowel is the result of the body’s immune reaction to gluten.
Celiac improves with a strict gluten-free diet. Symptoms usually abate in one to two weeks. Continuing symptoms suggest an incorrect diagnosis or persistent disease which often responds to corticosteroid treatment. Residual symptoms demand further investigation that includes surveillance for intestinal lymphoma (a malignant condition of lymphoid tissue) which develops in as many as 6-8 percent of patients with celiac sprue.
There is also an increased incidence of other gastrointestinal malignancies such as small bowel adenocarcinoma, esophageal and pharyngeal carcinoma etc, which makes periodic surveillance of the disease of great importance.
Remember, being "organic" does not assure product purity, and gluten is so widely used in processing commercial soups, sauces, hot dogs, fillers and even ice cream, that you really need a detailed list of foods to avoid. See your dietician for this, and join your local celiac disease support group. Be sure to see your private physician and your gastroenterologist for further evaluation, endoscopy, biopsy and surveillance since your disease is obviously not in remission. You need re-evaluation.