Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

How Can I Gain Weight With Celiac Disease?

Monday, 14 June 2010 04:49 PM

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.

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