The Varied Symptoms of Celiac Disease
By THE NEW YORK TIMES
Dr. Sheila Crowe, a professor in the division of gastroenterology and hepatology in the department of medicine at the University of Virginia, recently joined the Consults blog to answer reader questions about celiac disease. Here, Dr. Crowe responds to reader questions about the many signs and symptoms of celiac disease.
Digestive Complaints, Anemia and Celiac Disease?
Q.
As a college student I experienced what seemed to be symptoms of celiac disease bloating, irritation and frequent loose stools. I also experienced vomiting, although this may have been from the pain associated with the abdominal cramps I would sometimes experience after eating. These symptoms persisted throughout my college years, but ever since I graduated (three years now) I have been symptom free. I have also had mild anemia since my early teens. Is it possible for symptoms of celiac to manifest in this way and then disappear (I have not changed my diet at all since this time)?
Anna
A.
Dr. Crowe responds:
Celiac disease can present in many different ways, including the symptoms you describe during your college years, although vomiting is not common in adults with celiac disease. Anemia is a common problem in celiac disease, usually due to poor absorption of iron by the damaged intestine.
However, medical conditions other than celiac disease are more likely to have been responsible for your problems during college. Lots of students, particularly women, suffer from a very common form of a group of digestive disorders known as functional gastrointestinal disorders, particularly one type known as irritable bowel syndrome, or I.B.S. These digestive disorders can be made worse by stress and often get worse during the college years.
Anemia can also be caused by many different medical problems. It would be interesting to know if your anemia also improved in addition to the digestive symptoms. Sometimes problems of celiac disease first show up when kids go to college, since the diet on campuses tends to be higher in gluten than a traditional meat and potatoes diet. However, you have not changed your diet, making it less likely your celiac disease became less active due to a changed, lower-gluten diet.
If you want to be certain that you do not have celiac disease even though you feel better at present, my suggestion would be to get tested with a special blood test called the tissue transglutaminase antibody, or T.T.G. IgA, test. If that test result is normal, then theres a very high chance you dont have celiac disease and you can keep eating a normal diet. And thats good news as we enter the holiday season! If the antibody is abnormal, then your doctor will want you to go on for further testing for celiac disease.
(Please note: Ill be discussing diagnostic tests for celiac disease in more depth in a subsequent Consults post; check back for updates.)
Low White Blood Cell Counts, Lactose Intolerance and Celiac Disease?
Q.
Can celiac disease cause you to have a low white blood cell count? I have had stomach problems for about eight years and was just diagnosed with celiac disease two months ago and was advised to stay off of casein too. I have been strictly sticking to the gluten-free, dairy-free diet. One year ago they sent me to a hematologist because my white blood cell count was 3.5. It has now dropped to 3.0. It is my NYs that are low. I was just wondering if the celiac was causing my white blood cell count to be low. The hematologist did not know much about celiac. Thank you!
Lesley Puhr
A.
Dr. Crowe responds:
Celiac disease does not commonly cause a low white blood count. However, there are some other immune diseases that can be associated with celiac disease, such as lupus, that can result in a low white blood cell level. Other autoimmune disorders can also lead to low blood cell counts, including low platelets, red blood cells or white blood cells. I would imagine the hematologist has checked you for these conditions.
As an aside, Im curious how your celiac disease was diagnosed. It is not typical for someone with celiac disease to also be placed on a casein-free diet, as milk proteins do not cause problems in celiac disease. Dairy products are an excellent source of calcium, so you may want to make sure you arent placing yourself at risk of nutritional problems by being dairy-free without good reason. Lactose intolerance is one reason to avoid lactose-containing dairy foods, but even then, most lactose intolerant patients with celiac disease can consume yogurt and other fermented dairy products as well as most hard cheeses. In addition, lactase treated milk can be consumed. It may be you dont have celiac disease, and perhaps another condition is related to the low white blood cell level.
Ovarian Cysts, Urinary Tract Infections and Celiac Disease?
Q.
Is there any relationship between ovarian cysts, recurrent urinary tract infections and celiac disease? I was diagnosed several months ago and am no longer plagued by U.T.I.s as I once was. I am hoping that the ovarian cysts I have will shrink from a gluten-free diet.
Liz
A.
Dr. Crowe responds:
Celiac disease is associated with many different conditions, but ovarian cysts and urinary tract infections have not been specifically reported to be linked to the disease. All three of these disorders are common, so of course there is a good chance they can all occur in a given individual.
Regarding the urinary tract infections getting better on a gluten-free diet, this may be due to improved nutrition and associated better health as your intestine heals. I have never heard of a gluten-free diet helping ovarian cysts, but I would love to hear how it goes for you!
To learn more, visit The Times Health Guide: Celiac Disease and see Dr. Crowes other responses in:
* Gluten Free for the Holidays, and Beyond
Dr. Crowe will be responding to additional reader questions in subsequent Consults posts in the coming weeks. Check back for updates at nytimes.com/consults.
