What part of the GI tract do they affect?
Celiac disease is a digestive disease that damages the small intestine andinterferes with absorption of nutrients from food. People who have celiacdisease cannot tolerate a protein called gluten, found in wheat, rye, andbarley. Gluten is found mainly in foods, but is also found in products weuse every day and even some medicines.
Gastroesophageal reflux disease, or GERD, occurs when the lower esophagealsphincter (LES) does not close properly and stomach contents leak back, orreflux, into the esophagus. Lactose intolerance is the inability to digest significant amounts oflactose, the predominant sugar of milk. This inability results from ashortage of the enzyme lactase, which is normally produced by the cellsthat line the small intestine.
How does the disorder affect nutritional status/nutrient absorption?
When people with celiac disease eat foods or use products containinggluten, their immune system responds by damaging the small intestine. Thetiny, fingerlike protrusions lining the small intestine are damaged ordestroyed. Called villi, they normally allow nutrients from food to beabsorbed into the bloodstream. Without healthy villi, a person becomesmalnourished, regardless of the quantity of food eaten. When refluxed stomach acid touches the lining of the esophagus, it causes aburning sensation in the chest or throat called heartburn. The fluid mayeven be tasted in the back of the mouth, and this is called acidindigestion.
Lactase breaks down milk sugar into simpler forms that can then be absorbedinto the bloodstream. When there is not enough lactase to digest the amountof lactose consumed, the results, although not usually dangerous, may bevery distressing.
What are some common misconceptions about these disorders?
Sometimes celiac disease is confused with irritable bowel syndrome, iron-deficiency anemia caused by menstrual blood loss, Crohn’s disease,diverticulitis, intestinal infections, and chronic fatigue syndrome. As aresult, celiac disease is commonly under diagnosed or misdiagnosed. Occasional heartburn is common but does not necessarily mean one has GERD.
What kinds of medications/treatments are recommended?
Recently, researchers discovered that people with celiac disease havehigher than normal levels of certain auto antibodies in their blood. Antibodies are protective proteins produced by the immune system inresponse to substances that the body perceives to be threatening. Autoantibodies are proteins that react against the body’s own molecules ortissues. To diagnose celiac disease, physicians will usually test blood tomeasure levels of Immunoglobulin A (IgA) anti-tissue transglutaminase(tTGA) or IgA anti-endomysium antibodies (AEA).
If you have had heartburn or any of the other symptoms for a while, youshould see your doctor. You may want to visit an internist, a doctor whospecializes in internal medicine, or a gastroenterologist, a doctor whotreats diseases of the stomach and intestines. Depending on how severe yourGERD is, treatment may involve one or more of the following lifestylechanges and medications or surgery. Dietary control of lactose intolerance depends on people learning throughtrial and error how much lactose they can handle.
