Elisabeth Hasselback’s Battle with Celiac Disease

After almost a decade of being misdiagnosed and told she had IBS (Irritable Bowel Syndrome) and stress, Elisabeth Hasselback self-diagnosed her condition. She discovered that she was suffering from celiac disease. Dr Green, the then-director of the Celiac Disease Center at Columbia University, confirmed her theory. 

Elisabeth Hasselback was misdiagnosed on multiple occasions because the doctors were never able to relate her problem to her diet. 

In this blog post, we shall learn about celiac disease, its symptoms, diagnosis and its treatment.

Let’s begin. 

What is Celiac Disease?

Celiac disease is an autoimmune disease that is inherited and causes a reaction in the body to the protein gluten. When gluten enters the digestive system, the body alarms the immune system to produce antibodies against it. In turn, these antibodies end up damaging the lining of the small intestine (mucosa). 

This, in turn, causes further difficulties. When the mucosa in the small intestine is damaged, it impairs its ability to absorb nutrients, causing further deficiencies.  

What is gluten?

Gluten is a protein that is found in most of the food that we eat. This includes wheat, barley and rye. In addition, gluten is also an additive in many other food products, like sauces and soups, among packaged foods. 

How does celiac disease affect the body?

Celiac disease affects the small intestine. The mucosa in the small intestine is scrunched up into many folds and fingerlike projections called villi, which help to absorb the maximum amount of nutrients possible.

Celiac disease impairs the ability of these villi to absorb nutrients. Instead, it triggers the immune system, which sends inflammatory cells and antibodies to attack the gluten. This attack, in turn, damages and flattens the villi projections. 

What are the symptoms of celiac disease?

Symptoms of celiac disease vary among people. Some people hardly feel any symptoms at all, while others feel the effects later on when the real damage has already been done. Then again, there are people like Elisabeth who can hardly control the pain in their bowels when they eat gluten. 

Here is the list of symptoms that people suffering from celiac disease might encounter:

• Abdominal pain
• Anaemia
• Bloating
• Bone/joint pain
• Constipation
• Diarrhoea
• Gas
• Heartburn
• Itchy rash (dermatitis herpetiformis)
• Headaches/fatigue
• Mouth ulcers
• Nausea
• Nervous system issues
• Pale/foul-smelling/floating stool
• Weight loss.

Diagnosis and Tests

Now let us come to the most important question: how to diagnose celiac disease in a patient?

Celiac disease can be hard to suspect at first, as exemplified by Elisabeth Hasselback’s case. 

However, as a doctor, you can run some tests and look for evidence of damage because of gluten. 

The problem is that once a patient begins avoiding gluten, the gut starts healing, but this erases any evidence of damage and lowers the chances of detection. Therefore, it is important to test for celiac before recommending a gluten-free diet. 

Here is a list of tests that are carried out to detect celiac disease:

• Serology tests for specific antibodies
• Intestinal fatty acid binding protein tests for assessing intestinal damage
• Complete blood count for anaemia detection
• Vitamin D, B12, and folate tests for vitamin deficiencies
• Genetic testing using human leukocyte antigens to rule out celiac disease
• Imaging tests show signs in the intestine, like wall thickening or changes to blood vessels.

What is the treatment for celiac disease?

The first and most important treatment for celiac is to stop eating gluten, obviously. Once the patient starts avoiding gluten, the gut will begin to heal and begin absorbing nutrients again. However, there is no way to change how the body reacts to gluten. Therefore, the patient will have to maintain a gluten-free diet for life. 

Here is a list of foods that contain gluten:

• Barley
• Wheat
• Bulgur
• Durum
• Farina
• Graham flour
• Malt
• Rye
• Semolina
• Spelt (a form of wheat)
• Triticale

There are additional treatments that include the following:

• Nutritional supplements that will help cover up for any nutritional deficiencies. 
• Specific medications treat dermatitis herpetiformis, which is a severe manifestation of celiac disease on the skin. 
• Corticosteroids treat severe inflammation that does not respond fast enough to the diet. 

In addition to the above, regular testing and following up care is required to make sure the disease is kept under control. 

And that is everything you need to know about celiac disease.

Before we conclude, did you know that the late-night TV show host Jimmy Kimmel suffers from Narcolepsy? This causes him to fall asleep within seconds and get hit with sudden sleep attacks. 

You can read more about Narcolepsy by clicking on the link. 

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