This week, Bobbi Conner talks with Dr. Gregory Habig about symptoms, diagnosis and management of celiac disease. Dr. Habig is a Clinical Assistant Professor of Medicine and a gastroenterologist at MUSC.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. It's estimated that one in every 100 people worldwide has celiac disease. Doctor Gregory Habig is here to talk about the symptoms, diagnosis, and treatment of this condition. Doctor Habig is a Clinical Assistant Professor of Medicine and a gastroenterologist at MUSC. Doctor Habig, tell us about celiac disease.
Dr. Habig: Celiac disease is a condition where the immune system is activated in response to gluten exposure. Gluten is a specific protein found in grains like wheat, rye, or barley. When activated, the immune system actually attacks the lining of the small intestine, causing damage, GI symptoms, and issues with absorbing the things that we eat and drink.
Conner: What are the typical symptoms and when might these symptoms typically occur, if someone does have celiac disease?
Dr. Habig: Celiac disease is a little tricky because symptoms can onset typically early in childhood between age one and four. But if it's not diagnosed at that point, the diagnosis cannot be made sometimes until patients are in their 30s to 50s. Symptoms include things like gas, bloating, flatulence, loose stools or abdominal pain. But celiac disease can also present very subtly and just have symptoms of maybe a little bit of abdominal distension. It can also have weight loss. Sometimes patients don't have any symptoms at all, and they're only noticed to have abnormal labs.
Conner: And how is this condition diagnosed?
Dr. Habig: Celiac diagnosis comes in two stages: an initial blood test that looks at antibodies that patients with celiac generate when they're exposed to gluten, and then a confirmatory biopsy on an upper endoscopy. Importantly, patients need to be eating gluten for either of these tests to be positive, though, so if they've already gone gluten free, these tests will be normal.
Conner: And how is celiac disease treated or managed?
Dr. Habig: So currently the only treatment for celiac disease is strict gluten free diet. That means no exposure to gluten at all. Even a small amount of crumbs from someone else's bread can be enough to trigger symptoms and damage to the GI tract from celiac disease.
Conner: What's the first step for anyone who thinks they may have celiac disease?
Dr. Habig: First step would really be to talk to your primary care doctor, or schedule an appointment with a gastroenterologist to talk about your symptoms and determine if you'd benefit from testing for celiac disease.
Conner: Does gluten sensitivity always mean that a person actually has celiac disease?
Dr. Habig: No. So importantly, not everyone who eats gluten and has symptoms has celiac disease, and not everyone who has celiac disease has symptoms. There are other components in gluten containing foods that can trigger symptoms, and people with non-celiac, gluten sensitivity don't have the negative long term outcomes of celiac disease from the damage to the bowel wall.
Conner: I'm wondering, is gluten free a healthy routine even for someone without celiac disease or gluten sensitivity?
Dr. Habig: So, that's a really great question, because a gluten free diet for patients who do not have celiac disease is actually not a healthier diet. There's usually less fiber and essential nutrients in a gluten free diet. Commercial gluten free foods usually have higher sugar content and fat content to add flavor, and there's no real weight loss benefit or heart health benefit from being gluten free.
Conner: Doctor Habig, thanks for talking with us about celiac disease.
Dr. Habig: You're welcome.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
