Coeliac (Celiac) disease and gall bladder problems

Posted: August 15, 2012 in diagnostic, diet, Gall Bladder, nutrition, treatments
Tags: , , , , ,

This is an excerpt from my book (see links for editions in print and Kindle, in English and Spanish). Studying the search-terms that bring traffic to the blog, I thought it might be a good idea to post this information to the general public.

The Coeliac Connection

Coeliac Disease (spelled Celiac in the USA) is an autoimmune disorder caused by a reaction to gliadin, a gluten protein found in wheat. The reaction causes inflammation of the small intestine, which leads to atrophy of the vilii (surface cells), which then causes malabsorption of nutrients. Coeliac Disease is not a symptom of gall bladder dysfunction, but it can definitely be a cause. If you are suffering from gall bladder problems you should definitely be screened for Coeliac Disease. It affects about 1% of the population in the USA.

Coeliac Disease gets in the way of proper gall bladder function by dampening or canceling out the Cholecystokinin (CCK) signal sent from the duodenum. If the duodenum can’t sense fat content because its lining is inflamed or atrophied, it doesn’t know to send the CCK and call the gall bladder to action.

The gall bladder, not getting the proper signal, either sits idle waiting or does an inadequate job and doesn’t give 100% effort. Therefore bile doesn’t circulate properly, it has a greater opportunity to settle and crystallize, and the chance of gallstone formation is greatly increased.

Not only does Coeliac Disease cause malabsorption of nutrients in general due to its inflammatory nature, but its problems are further compounded by a double dose of malabsorption caused by reduced bile output from a lazy or unresponsive gall bladder. As the atrophy of the intestinal lining worsens over time, more symptoms and digestive disorders can result (such as lactose intolerance).

Symptoms of Coeliac Disease:

  • Diarrhea: often pale and foul-smelling

  • Abdominal pain and cramping

  • Bloating

  • Often misdiagnosed as IBS (Irritable Bowel Syndrome)

  • Vitamin A, D, E, and K deficiencies

  • Calcium malabsorption/deficiency

  • Bacterial overgrowth in the bowels

  • Dermatitis Herpetiformis (DH), an itchy skin rash

  • Mouth ulcers

  • Hypothyroidism

  • Iron deficiency

  • Chronic fatigue

  • Osteoporosis

  • Intestinal cancer

  • Sterility

Getting tested for Coeliac Disease:

Blood tests are the fastest way to screen for Coeliac Disease. The tests you should get are as follows:

  • IgA or tTG antibodies: Sensitivity 90%, Specificity 99%. IgA means anti-transglutamase antibodies. These antibodies are very specific, occurring 100% in people with Coeliac Disease, and 80% in people with DH (Dermatitis Herpetiformis). IgA is also called tTG (tissue trans-glutamase). If your test comes back IgA positive, there is a 97% chance that you have Coeliac Disease. This test does give occasional false-negatives; if you test negative, there is only a 71% chance that the negative result is accurate.

  • IgG anti-gliadin antibodies: Sensitivity 87%, Specificity 91%. This test shows positive results more readily but does not have as strong a correlation to proving Coeliac Disease. For ecample, IgG-positive results show up in 21% of people suffering from non-Coeliac digestive disorders. This test may not provide as good a test-positive result as the IgA/tTG but it provides less false-negatives, and therefore should be done at the same time.

Other testing methods:

  • Endoscopy with biopsy of duodenum or jejunum. Most Coeliac sufferers have a bowel that appears normal through the endoscope but inspection of a tissue sample viewed through a microscope reveals proof of the disease.

What to do if you have Coeliac Disease:

Presently, the only cure is to go on a gluten-free diet for the rest of your life. There are no miracle medications. Fortunately the solution requires only willpower, and costs nothing extra. In time, the intestinal walls will heal and the symptoms will abate or disappear completely.

Unfortunately, this means that you will have to stop ingesting anything containing gluten. The list of forbidden ingredients containing gluten is as follows:

  • Wheat

  • Spelt

  • Kamut

  • Rye

  • Barley

  • Triticale

  • Oats (if your oats are pure, you may not need to exclude them; normally they do not contain gluten but the machines that process oats are also used to process the other grains and may be cross-contaminated. There are also studies that show oats contain peptide sequences very similar to gluten which can cause problems in 10% of Coeliac patients)

The list does not stop there; all things derived from the above products must be avoided as well:

  • Bread and flour products of all kinds, with exception to pure corn bread.

  • Beer (Rest In Peace!)

  • Most types of Whiskey

  • Malts

A general list of things that are gluten-free:

  • Corn

  • Potatoes

  • Rice

  • Cassava

  • Yams

  • Chickpeas/garbanzo

  • Meats (be careful of sausages, as some use ingredients containing gluten as filler or flavor enhancers)

  • Wine, rum, brandy, sake, vodka, and other spirits derived from fruit, honey, sugar, rice, potatoes, or corn.

The particulars of following a gluten-free diet could easily fill their own book. There are a wealth of gluten-free diet books on the market. It is such a common problem that there is even a “Celiac Disease for Dummies” book in addition to a “Living Gluten-free for Dummies” and a “Gluten-free Cooking for Dummies.” All three are quite informative, and rated 4 stars or higher on that online bookstore everyone knows. Fortunately, many product manufacturers are more aware of dietary gluten problems, and label their ingredient list clearly as either containing gluten or being gluten-free.

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Comments
  1. Erin says:

    I have many malabsorption issues which include surgery that removed my distal ileum and 1/3 of my colon, my gall bladder was surgically removed and celiac disease. B12 deficiency was my biggest issues but through my research and reading your book I have a much better understanding of what is happening (or not happening) in my digestive system. I have read many articles on the internet however it is wonderful to find a wealth of information in your book. I have started taking multiple supplements and will continue them for the rest of my life. Everyone with malabsorption should read The Gall Bladder Survival Guide. Thank you for your wonderful book.

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