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Celiac Disease

Celiac disease(CD) is a hereditary (genes HLA DQ2 and DQ8) autoimmune disorder characterized by chronic inflammation and damage of small intestinal villi, mediated by autoantibodies against intestinal tissue which body produces as result of exposure to gluten.

Non-Celiac Gluten Sensitivity (NCGS): Diagnosed in individuals who do not have celiac disease or wheat allergy but who have intestinal symptoms, extra-intestinal symptoms, or both, related to ingestion of gluten-containing grains, with symptomatic improvement on their withdrawal.

Symptoms

  • Gastro/intestinal : abdominal pain, bloating, gas, indigestion, apthous stomatitis, constipation, decreased appetite, diarrhea, GERD, lactose intolerance, nausea and vomiting, foul smelling, oily stool
  • Dental: enamel erosion
  • Mental health: depression, anxiety
  • Musculoskeletal: muscle cramps, joint pain
  • Endocrine: hair loss, missed periods
  • Skin: itchy, dry skin, psoriasis, dermatitis herpetiformis
  • NCGS can present with any of the above symptoms but they typically are less severe and resolve more quickly with gluten elimination than CD.

Long Term consequnces of untreated Celiac disease

  • Early onset osteoporosis or osteopenia
  • Gall bladder malfunction
  • Heart disease
  • Infertility and miscarriage
  • Iron deficiency anemia
  • Lactose intolerance
  • Liver failure
  • Malnutrition
  • Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), headaches, lack of muscle coordination, seizures, ataxia,  dementia, neuropathy, myopathy, and multifocal leucoencephalopathy
  • Pancreatic insufficiency
  • Small intestine cancer and non-Hodgkin lymphoma
  • Vitamin and mineral deficiencies

Treatment

  • Early onset osteoporosis or osteopenia
  • Gall bladder malfunction
  • Heart disease
  • Infertility and miscarriage
  • Iron deficiency anemia
  • Lactose intolerance
  • Liver failure
  • Malnutrition
  • Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), headaches, lack of muscle coordination, seizures, ataxia,  dementia, neuropathy, myopathy, and multifocal leucoencephalopathy
  • Pancreatic insufficiency
  • Small intestine cancer and non-Hodgkin lymphoma
  • Vitamin and mineral deficiencies

1- Permenant elimination of gluten cross reactives:

  • Barley
  • Bulgur
  • Couscous
  • Durum
  • Einkorn
  • Emmer
  • Semolina
  • Spelt
  • Faro
  • Graham flour
  • Kamut
  • Malt, malt extract/flavoring/syrup
  • Rye
  • Semolina
  • Spelt
  • Triticale
  • Wheat wheat bran/germ/starch

2- Permenant elimination of gluten cross reactives:

  • Cow’s milk
  • Yeast
  • Oats, corn, millet, rice
  • Instant coffee

Studies have shown changes in composition and function of intestinal microbiome are associated with celiac diease due to the chronic inflmmation associated with it. Prebiotics and probiotics might be a good option for treating Celiac.

Replace nutritional deficiencies using supplements: Iron, folate, Vtamin B12, Vitamin D, magnesium, and Zinc.

Acupuncture for Celiac disease

Acpucnture plus gluten free diet has shown to be effective in treating Dermatitis herpetiformis associated with Celiac disease. Dermatitis herpetiformis (DH), an intensely pruritic eczematous skin condition that predominantly affects the extensor surfaces of the elbows, knees, buttocks, back, and scalp, is one of the extraintestinal symptoms associated with gluten sensitivity CD.

According to Traditional Chinese Medicine (TCM), the DH presentation combined 2 components: eczema and urticaria. Eczema in Chinese is Shi Zhen or “damp rash,” and urticaria is called Feng Yin Zhen or “Wind hidden rash.” Eczema can be described in TCM terms as dampness under the skin caused by a gastrointestinal disorder, usually a spleen Qi deficiency. “Wind” in the skin manifests primarily as intense itching and dryness in the skin, if the skin around the rash is warm to touch, and the rash would bleed when scratched is called “Blood-Heat.” Using appropriate Acupuncture points to release wind heat, cool blood heat, clear heat in the affected channel (Stomach), clear dampness in spleen and tonify the underying stomach yin deficiency, imrpoved the symptomes of redness and itchying of DH.