Celiac Disease

Discussing the latest advances in celiac disease

September 19th, 2014 · Leave a Comment

Gluten-Free Recipe: Polenta with fresh vegetables

By Margaret Shepard

At a loss of what to prepare for dinner tonight? How about polenta with fresh vegetables! This recipe for creamy polenta has added flavor because of the Parmesan cheese. Try any combination of vegetables, including leafy vegetables such as spinach.

Ingredients
1 cup coarsely ground cornmeal (polenta)
4 cups water
1 teaspoon garlic, chopped
1 cup sliced fresh mushrooms
1 cup sliced onions
1 cup broccoli florets
1 cup sliced zucchini
2 tablespoons grated Parmesan cheese
Chopped fresh oregano, basil or rosemary, to taste
Directions
Preheat the oven to 350 F. Lightly coat a 3-quart ovenproof dish with cooking spray.

Combine the polenta, water and garlic in the prepared dish. Bake uncovered until the polenta pulls away from the sides of the baking dish, about 40 minutes. The polenta should be moist.

While the polenta is cooking, spray a nonstick frying pan with cooking spray. Add the mushrooms and onions. Saute over medium heat until the vegetables are tender, about 5 minutes.

In a pot fitted with a steamer basket, bring 1 inch of water to a boil. Add the broccoli and zucchini. Cover and steam until tender-crisp, 2 to 3 minutes.

When the polenta is done, top with the cooked vegetables. Sprinkle with Parmesan cheese and herbs, to taste. Serve immediately.

Originally posted on mayoclinic.org.

Tags: gluten free recipe, healthy living, recipe

September 12th, 2014 · Leave a Comment

Patient Story: The disease that killed my mother was the same disease that was killing me

By Margaret Shepard

Originally posted on Sharing Mayo Clinic.

I am writing my story of celiac disease. I was diagnosed in March 2008, at the age of 73. I also want to tell my mother’s story. She passed away in 1945 at the age of 30; when I was only 9½ years old.

My mother was sick all her life. I remember her not being able to go anywhere because of diarrhea and being so very sick. At the last part of her sickness she was passing a lot of blood, and her legs were swelled so excessively. She had seen many doctors with no help. The last day they gave her penicillin, but it was too late. Back then, they would only give penicillin to the solider boys. They said she had a new disease!!!!

As we were growing up, my twin brother and I went to live with our grandparents. I was sick off and on my entire life. I married and had a son and daughter.

I suffered with diarrhea, hurting in my stomach, cramps and weight loss. When I gained some weight, I would say (jokingly), “I am going to keep this weight to get sick on.” There was not a clue of what was wrong with me. Tests were done but all they would come up with was irritable bowel syndrome and obstruction of the bile duct.

In the year 2000, I lost 21 pounds in two months. My local physicians couldn’t come up with any answers. I was sent to a specialist in September 2007; all kinds of tests were conducted such as lower and upper endoscopy, C.T. scans, capsule endoscopy and biopsies. Six of these tests were done in 4½ months. I had a lot of polyps the in lower colon removed; one was high grade pre-cancer cells. But, no answers to why I was so sick except an inflammation. They agreed they were missing something! I went back home, made several trips to the emergency room and hospital -- two times my blood pressure was 47/37. There were drastic changes in my eyes, and I went blind in both eyes. My eyes got some better in three weeks, and I could see the Big E. I was losing ground. Two minutes after I would start to eat, I would have diarrhea, and was so sick.

My husband’s health had been failing since 2006, and I was his caregiver. Our daughter and son got two ladies to come in to take care of him. The last trip I made to my local hospital in Missouri on March 14, 2008, my blood pressure was again 47/37. I didn’t think I was going to last very much longer and my doctor AGREED!!!

My symptoms worsened, but no one associated the food with being my problem. My daughter got an appointment for me at Mayo Clinic in Rochester, Minnesota. I left my local hospital on March 23, 2008, and my daughter and I left to go to Mayo Clinic immediately! It took us at least eight hours to get to the Mayo Clinic so my local doctor had suggested I drink Gatorade all the way there. We met with Dr. Glen Alexander at Mayo for the first time at the end of March 2008. After several tests were conducted, Dr. Alexander thought it was likely confirmed that I had collagenous sprue, a disease in which the immune system strikes the body (gluten intolerance). The small intestine is lined with hair-like projections, (called villi). The doctor at Mayo who was treating me said the villi were depleted completely. Then, Dr. Alexander told us that celiac disease was an auto-immune digestive disorder toxic reaction to gluten, which has an increased incidence in family members. When Dr. Alexander said it was more likely to occur in family members, my daughter looked at me, and we both were thinking the same thing -- “Now we know finally what was wrong with my mother when she died.” 63 years ago!!!! Also, the doctor told us what was wrong with my mother and the diseases she had as a child even though he had never met her. We were surprised that he was correct in telling us that she had scarlet fever.

Dr. Alexander gave me medication before I left Mayo Clinic. I have read that celiac disease is not usually treated with drugs, but mine was. When we left the Clinic my feet were swollen. I had worn size 7 women shoes, but we had to get a size 14 wide men’s shoe to come home in.

I was on the medication for one year, and called my doctor at Mayo Clinic every month to report in; he would always call me back and that meant so much to me. In March of 2010, it will be a year after stopping the medicine, (Endocort).

If I eat any gluten-containing substances, I get very sick, but I watch it like a hawk. I have a lot a pain from fibromyalgia and arthritis as well, but no help with that.

I know I won’t get over this celiac disease, but, I am thankful I have come so far from where I was two years ago.

Thanks to God, My Family, Friends, and Mayo Clinic doctors to get me this far!!!!

Sincerely, Betty E. Cornine

P.S. Note!! Please remember the three steps that could save your life:
Step 1 – Blood test;
Step 2 – Endoscopy and tissue biopsy;
Step 3 – Genetic testing

 

Tags: celiac disease, patient story, Sharing Mayo Clinic

September 5th, 2014 · Leave a Comment

Gluten-Free Recipe: Chili

By Margaret Shepard

Get ready for Fall with this gluten-free recipe for chili!

Ingredients

1 pound extra-lean ground beef
1/2 cup chopped onion
2 large tomatoes (or 2 cups canned, unsalted tomatoes)
4 cups canned kidney beans, rinsed and drained
1 cup chopped celery
1 teaspoon sugar
1 1/2 tablespoons chili powder or to taste
Water, as desired
2 tablespoons cornmeal
Jalapeno peppers, seeded and chopped, as desired

Directions

In a soup pot, add the ground beef and onion. Over medium heat saute until the meat is browned and the onion is translucent. Drain well.

Add the tomatoes, kidney beans, celery, sugar and chili powder to the ground beef mixture. Cover and cook for 10 minutes, stirring frequently. Uncover and add water to desired consistency. Stir in cornmeal. Cook for at least 10 minutes more to allow the flavors to blend.

Ladle into warmed bowls and garnish with jalapeno peppers, if desired. Serve immediately.

Originally posted on mayoclinic.org.

Tags: gluten free recipe, healthy living, recipe

August 29th, 2014 · Leave a Comment

Gluten-Free Recipe: Citrus Salad

By Margaret Shepard

Cool down and enjoy the start of the holiday weekend with this citrus salad. Looking for a salad to bring to Labor Day picnic? Speed up the assembly process of the salad by using already-segmented oranges and grapefruit.

Ingredients

2 oranges
1 red grapefruit
2 tablespoons orange juice
2 tablespoons olive oil
1 tablespoon balsamic vinegar
Sweetener, as desired
4 cups spring greens
2 tablespoons pine nuts

Directions

Working with 1 orange at a time, cut a thin slice off the top and bottom, exposing the flesh. Stand the orange upright and, using a sharp knife, thickly cut off the peel, following the contour of the fruit and removing all of the white pith and membrane. Holding the orange over a small bowl, carefully cut along both sides of each section to free it from the membrane. As you work discard any seeds and let the sections and any juice fall into the bowl. Repeat with the other orange and the grapefruit.

In a separate bowl, whisk together the orange juice, olive oil and vinegar. Add sweetener to taste. Pour the mixture over the fruit segments and toss gently to coat evenly.

To serve, divide the spring greens among individual plates. Top each with the fruit and dressing mixture and sprinkle each with 1/2 tablespoon pine nuts. Serve immediately.

Originally posted on mayoclinic.org.

August 22nd, 2014 · Leave a Comment

Bone Density and Celiac Disease

By Margaret Shepard

Raul Ruiz Esponda, M. D., discusses the connection between bone density and celiac disease.

 

Celiac disease and bone health is a very important topic. Bone loss is important because it may lead to osteoporosis and fractures. Fractures can lead to morbidity and in some cases, mortality. It is important to detect boss loss and make sure celiac disease patients are taking care of their bone health.

There are several reason why someone with celiac disease may have bone loss. Malabsorption and inflammation are two of the main reasons for bone loss for celiac disease patients. Malabsorption of calcium leads to secondary hypoparathyriodism. When calcium levels are detected as low in the blood, parathyroid hormone (PTH) is secreted. In situations like celiac disease where malabsorption is occurring, the parathyroid hormone plays an important role in bone reabsorption in order to receive calcium within normal limits leading to decreased bone density or bone wasting.

Some studies have shown that in patients with celiac disease the higher the level PTH, the lower the level of bone density at the hip and the spine. This correlation explains and ties together how patients lose bone density when they have celiac disease.

Another important factor is inflammation. This interferes with bone reabsorption. Other less known factors include lower levels of physical activity, lower body mass indexes, early menopause, and decreased levels of growth hormone. All of these are factors for bone loss.

Bone density is used as a surrogate marker for fractures. Studies that have compared celiac disease patients with healthy controls have shown celiac disease patients at diagnosis have lower bone densities at the hip and spine. Similar studies have also shown bone density correlates with damage at the gastrointestinal level. This means the more malabsorption, the lower the bone density. Pulling the reports together, 50-70% of patients with celiac disease will have some type of low bone density.

Studies examining fractures have shown celiac disease patients are at a 30% higher risk of having a fracture. So what can we do about this? A gluten-free diet has shown to increase bone density by 8% in the first year. After being on a gluten-free diet for one year, physicians may consider putting patients on medication for osteoporosis. The number of vitamin D and calcium supplements a celiac disease patient needs a day varies from patient to patient.

For more information about celiac disease, visit mayoclinic.org/celiacdisease.

Tags: bone density, celiac disease, Raul Ruiz Esponda

August 15th, 2014 · Leave a Comment

New FDA Rules for Gluten-Free Labeling

By Margaret Shepard

Joseph Murray, M.D., discusses the new Food and Drug Administration (FDA) rules for gluten-free labeling.

 

Almost ten years ago congress passed a law legislating food labeling. However, part of that law required the FDA to formulate regulations defining what gluten-free is. Up until now, there was not a set definition of gluten-free in the United States.

The FDA conducted a careful study over several years analyzing all the known literature about gluten and its affect on patients with celiac disease. The goal of the study was to come up an estimation of what is a safe threshold where food is not likely to cause a problem for patients with celiac disease. The FDA came up with a level of 20-parts per million. This is a small amount and also a level possible to detect gluten.

What does this mean for patients? This means that if a food is labeled gluten-free, it has to contain less than 20-parts per million. For a great majority of patients, this means the food should not present a problem. Labeling is voluntary. If a company chooses to put a gluten-free label on its food, it'll have to meet this standard.

This is good news for patients with celiac disease as it sets standards for safety going forward.

For more information about celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: FDA, gluten free, gluten-free labeling, Joseph Murray

August 8th, 2014 · Leave a Comment

Gluten-Free Recipe: Vegetable Salsa

By Margaret Shepard

Is your garden overflowing with fresh vegetables this summer? Here's a gluten-free, fresh recipe for vegetable salsa that makes a great side dish or appetizer.

Ingredients

1 cup diced zucchini
1 cup chopped red onion
2 red bell peppers, seeded and diced (about 2 cups)
2 green bell peppers, seeded and diced (about 2 cups)
4 tomatoes, diced (about 2 cups)
2 garlic cloves, minced
1/2 cup chopped fresh cilantro
1 teaspoon ground black pepper
2 teaspoons sugar
1/4 cup lime juice
1/2 teaspoon salt
Directions

Wash vegetables and prepare as directed. In a large bowl, combine all the ingredients. Toss gently to mix. Cover and refrigerate for at least 30 minutes to allow the flavors to blend.

Originally posted on mayoclinic.org.

For more information about celiac disease, visit mayoclinic.org/celiacdisease.

Tags: gluten free recipe, healthy living, recipe

August 1st, 2014 · Leave a Comment

Motivations for Avoiding Wheat Consumption

By Margaret Shepard

The public has a great interest in avoiding gluten. Joseph Murray, M.D., discusses a recently published article in Public Health and Nutrition about the reasoning behind why people are avoiding gluten.

 

The study took place in Australia, where a lot of people are avoiding gluten. A survey was sent out to adults in Australia and over 1,000 responded. More women than men responded. The survey asked people if they were avoiding gluten and if so, why, and had they experienced symptoms from eating gluten.

The researchers found that a significant proportion of adults in Australia are avoiding gluten because it seemed to make them feel better and most of them didn't have celiac disease.

Recent research, also from Australia, suggests that many people are feeling better because they avoid, not gluten, but perhaps other components of wheat such as fructans or FODMAPs. It may be that going on a gluten-free diets leads to less FODMAPs. Researchers also know that avoiding gluten leads to less consumption of fast food, junk food, and maybe even less food in general.

Read the full article online here.

For more information about celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: celiac disease, gluten, Joseph Murray, Public Health and Nutrition, wheat consumption

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