Lower Gastrointestinal disease CELIAC DISEASE LACTOSE INTOLERANCE

What is celiac disease?  Celiac disease is a serious genetic autoimmune disease that damages the villi of the small intestine and interferes with absorption of nutrients from food.  There are NO pharmaceutical cures for celiac disease.  A 100% gluten-free diet is the only existing treatment for celiac today.

What is gluten?  Gluten is a general name for the proteins found in wheat (durum, rye, barley and triticale).  Gluten helps foods maintain their shape, acting as a glue that holds food together.

Treatment The only treatment for celiac disease is a strict, lifelong gluten-free diet. Eating gluten, no matter how small the amount, can damage the intestine.

A gluten-free diet A gluten-free diet will be a big change in your life. You have to rethink your eating habits, including what you buy for lunch, what you eat at parties, or what you snack on. When you go grocery shopping, be sure to read the ingredient label carefully.

Celiac disease and vitamin deficiency  Commonly, people with celiac disease experience iron, calcium and vitamin D deficiencies before adopting a gluten-free diet.  Other common deficiencies include zinc, B6, B12, and folate.  Your physician may prescribe dietary supplements, including a gluten-free multivitamin, to correct this.  The multivitamin is usually prescribed because most gluten- free foods are not fortified.

Hidden gluten Gluten is also "hidden" in many processed foods. Even many non-food items like cosmetics, and household cleansers may contain gluten.

Common Gluten-Free Alternatives:

What is lactose intolerance?  Lactose intolerance is a common digestive problem where the body is unable to digest lactose, a type of sugar mainly found in milk and dairy products.  As a result, they have diarrhea, gas and bloating after eating or drinking dairy products.

Treatments and drugs There's currently no way to boost your body's production of lactase, but you can usually avoid the discomfort of lactose intolerance by:  Avoiding large servings of milk and other dairy products  Including small servings of dairy products in your regular meals  Eating and drinking lactose-reduced ice cream and milk  Drinking regular milk after you add a liquid or powder to it to break down the lactose

Maintain good nutrition  Reducing the dairy products doesn't mean you can't get enough calcium. Calcium is found in many other foods, such as: Broccoli Calcium-fortified products, such as breads and juices Canned salmon Milk substitutes, such as soy milk and rice milk Oranges Spinach  Make sure you get enough vitamin D, eggs, liver and yogurt also contain vitamin D, and your body makes vitamin D when you spend time in the sun.

Ways to change your diet to minimize symptoms of lactose intolerance include: Most people with lactose intolerance can enjoy some milk products without symptoms.  Choosing smaller servings of dairy. The smaller the serving, the less likely it is to cause gastrointestinal problems.  Drink milk with other foods. This slows the digestive process and may lessen symptoms of lactose intolerance.  Not all dairy products have the same amount of lactose. For example, hard cheeses, such as cheddar, have small amounts of lactose.  You may be able to tolerate cultured milk products, such as yogurt, because the bacteria used in the culturing process naturally produce the enzyme that breaks down lactose.  Buying lactose-free products.  Using lactase enzyme tablets or drops. You can take tablets just before a meal or snack. Or the drops can be added to a carton of milk. Not everyone with lactose intolerance is helped by these products.

Alternative medicine Probiotics  Probiotics are living organisms present in your intestines that help maintain a healthy digestive system.  Probiotics are also available as active or "live" cultures in some yogurts and as supplements in capsule form.  They are sometimes used for gastrointestinal conditions, such as diarrhea and irritable bowel syndrome.  They may also help your body digest lactose.

Milk Alternative

Case Study (1) The 21-year-old woman suffered from depressive mood, bloating and diarrhea, and steady weight loss of 20 kg during the past year. Tests also found evidence of anemia and osteopenia. She reported no significant changes in her diet or exercise. Following additional tests, the woman was found to have the genetic marker for celiac disease. Upon biopsy, she was diagnosed with celiac disease. The patient was started on a gluten-free diet since 1 month, which resulted in less abdominal bloating, but she still not very well and concerned about her difficulties gaining weight.  What are common clinical features of celiac disease?  what do you think the reason for the lack of improvement in the symptoms?  What are the advices that you’ll give to her to improve the symptoms?

Case study (2) Jason, a 17 - year-old student, had been experiencing occasional discomfort after meals. The discomfort reached a new peak last Thursday evening about an hour after eating a cheeseburger and a large chocolate milkshake. Jason spent much of that night in pain. He had abdominal cramps and diarrhea and also felt sick to his stomach. He went to the clinic and saw a doctor the next day. Jason is seldom experienced any discomfort after eating at home, and he only experienced discomfort after dining out, especially after eating his favorite fast food meal, a double cheese burger and a chocolate shake.  What do you think Jason is suffer from?  How did you know?  What alternatives would you recommend him to eat instead of his favorite meal?  What are the sources of these alternatives?