Celiac leads to bone loss
Scientists have long known that people with celiac disease have a higher than average risk for developing osteoporosis, but until recently the link between the two conditions was poorly understood.
Celiac disease is caused by an immune system reaction to gluten, a natural protein found in wheat, barley and rye.
When individuals with the disorder eat gluten-containing foods, their immune systems rebel, launching an attack against tiny intestinal structures called villi. These fingerlike projections facilitate the absorption of nutrients from food.
After repeated assaults from gluten in the diet, the intestinal villi of affected individuals can become so damaged that they’re incapable of absorbing nutrients properly. As a result, people with untreated celiac disease can become dangerously malnourished.
While scientists once believed that celiac disease led to bone mineral loss and an increased risk of osteoporosis by impairing the absorption of bone-building nutrients, including calcium and vitamin D, the results of a new study published in the New England Journal of Medicine suggest this isn’t the case. Scientists at the University of Edinburgh found that people with celiac disease are more likely to develop osteoporosis because their immune systems attack their bone tissue directly.
Once considered to be rare, celiac disease is now known to affect approximately one in 100 Americans. The condition is becoming increasingly prevalent in the U. S., according to the findings of a Mayo Clinic study published last month in the medical journal Gastroenterology.
For the study, the researchers evaluated recently collected blood samples as well as samples that had been collected between 1948 and 1954. After testing the blood samples for the presence of a protein produced by individuals with celiac disease, the Mayo team determined that young people today are 4 1/2 times more likely to have celiac disease than youngsters in the 1950s. More research is needed to understand why.
Although it is becoming increasingly commonplace, celiac disease poses a considerable diagnostic challenge for physicians. Symptoms of the disorder can be mistaken for other disorders of the gut, including irritable bowel syndrome, ulcerative colitis and intestinal infections.
Common digestive complaints associated with celiac disease include abdominal pain, cramping and bloating, and a perplexing mix of diarrhea, flatulence and constipation. Celiac disease is a known cause of seizure disorders, migraine headaches, infertility and miscarriage.
Symptoms may arise at any stage of life, from infancy to adulthood. Babies and children with the disorder may suffer from chronic abdominal pain and developmental delays, and affected teenagers may experience delayed puberty and remain short in stature.
In some youngsters, symptoms may be so vague or poorly understood that they often go unrecognized until adulthood. Emotional stress, surgery, pregnancy or illness may trigger the first noticeable symptoms of the disease.
Doctors can perform tests that lead to the correct diagnosis. Although new blood tests for celiac disease have been developed in recent years, biopsy of the intestinal tissue may be needed to confirm the diagnosis.
Currently, the best treatment for celiac disease is a gluten-free diet. Obvious sources of gluten include most breads, pastas and cereals. Gluten can be found in a variety of seemingly innocent foods, including canned soup, ice cream and processed meat.
Living a gluten-free life isn’t easy, but it is important in terms of alleviating gastrointestinal discomfort and reducing the risk of bone fractures and osteoporosis. A gluten-free diet promotes a rapid increase in bone mineral density in children that can lead to complete recovery of bone mineralization within six to 12 months.
In adults with celiac, a gluten-free diet typically isn’t sufficient to repair extensive bone damage, but it does help.
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