Wednesday Dec 3, 2008
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CELIAC DISEASE

If it was up to two year old Noah Winkler, he’d spend every waking hour on the playground. But it was the complete opposite just months ago.
“We would go to the playground and he would refuse to get out of his stroller and he would sit in the stroller and say, I want to go home, I want to go sleep, crib, crib,” says Sara Winkler, Noah’s mother.

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye and barley.

Two year old Noah Winkler was debilitated by the disease and wasn’t his normal self. “We would go to the playground and he would refuse to get out of his stroller and he would sit in the stroller and say, I want to go home, I want to go sleep, crib, crib,” says Sara Winkler, Noah’s mother. Noah was rapidly losing weight and growing slowly. He suffered from constant fatigue and was on the brink of malnutrition. After a battery of blood tests, Noah was diagnosed with celiac disease.

“When the disease is expressed early on in life, for example between 6 months and 18 months of age, these children are generally quite symptomatic. Problems with growth, weight gain, irritability, diarrhea,” explains Dr. Steven Schwarz of Long Island College Hospital, New York.

According to research presented at the 2004 Digestive Disease Week Meeting, the disease, although a common disorder, frequently goes undiagnosed in the United States because of the variability of symptoms and lack of awareness about the disease.
“Many go with minimal or even no symptoms early in childhood and those are the subjects that have a delayed diagnosis and sometimes never get diagnosed,” says Dr. Schwarz.

When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine. Specifically, tiny fingerlike protrusions, called villi, on the lining of the small intestine are lost. Nutrients from food are absorbed into the bloodstream through these villi. Without villi, a person becomes malnourished, regardless of the quantity of food eaten.

Celiac disease, which is genetic, could also be a marker for other diseases.
According to Dr. Schwarz, “Early onset of osteoporosis is a relatively common finding in adults who are diagnosed with celiac disease. Infertility may be a common problem associated with celiac disease.”

The only treatment for celiac disease is to follow a gluten-free diet. For most people, following this diet will stop celiac disease symptoms, heal existing intestinal damage and prevent further damage. Improvements begin within days of starting the diet and the small intestine is usually completely healed…meaning the villi are intact and working.

Once Sara changed Noah’s diet, instantly there was dramatic change. “The first time we took him to the playground after the first day we took him off wheat, this little boy who had sat in his stroller crying and asking to go home and go to sleep, got out of his stroller, ran across the playground to the tallest ladder on the playground and jumped up. My husband and I just sat there crying, it was amazing and that was one day later. The change is profound, immediate and profound,” exclaims Sara.

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Dr. Daniel G. Davis

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