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Monday, January 24, 2011

Update: My New Book, “Gluten Toxicity” Is Available At Amazon.ca (Canada), Amazon.com (USA), Amazon.co.uk (United Kingdom), Amazon.de (Germany), And Amazon.co.jp (Japan).

Great news! “Gluten Toxicity” is now available in Canada, the United States, the United Kingdom, Germany, and Japan through the Amazon online bookstores. I’m thrilled to use my book as a resource to increase awareness in all of these geographical areas.

If you are interested in purchasing a paperback copy of “Gluten Toxicity: The Mysterious Symptoms Of Celiac Disease, Dermatitis Herpetiformis, And Non-Celiac Gluten Intolerance”, then please see the links below.

Amazon For Canada 
Amazon For The USA
Amazon For The United Kingdom
Amazon For Germany
Amazon For Japan

If you would prefer an e-book version of “Gluten Toxicity”, please see the E-Book from my blog.

Thank you very much for your support,
Shelly Stuart, R.N., B.Sc.N.

Saturday, January 22, 2011

Lactose Intolerance Can Be A Symptom Of Gluten Intolerance

Many people are told that they have a lactose intolerance and are never investigated further to find the cause. Usually, only a lactose-free diet is recommended. I think we (doctors, nurses) need to dig a little deeper. Gluten could be the trigger and a a gluten-free diet could be the real solution. For many, a lactose intolerance may actually disappear once an individual is consuming a gluten-free diet.

Let me explain further………


Lactose is natural sugar found in dairy products. It requires lactase, an enzyme produced within the intestines, to digest it. Usually, this enzyme is produced by the small intestinal villi. In Celiac disease (CD) (and in some with Dermatitis Herpetiformis), the intestinal villi becomes damaged (flattened) and this can impair the production of lactase. Immune reactions to ingested gluten can cause this damage. Loss of this brush border (another name for microvilli) enzyme results in a condition called lactose intolerance.

With lactose intolerance, the lactose passes undigested into the colon and then it is broken down by commensal bacteria. This process produces CO2 and hydrogen which can cause abdominal discomfort, bloating, flatulence, and possibly diarrhea. With a gluten intolerance, this may be temporary, since lactase production may resume once a gluten-free diet has commenced and the bowel has healed.

Other factors can cause villi damage and this could affect the production of lactase as well. Food allergies can also affect the villi and sometimes the reactions can lead to flattened intestinal villi. For example, flattened villi have been found in people with soy and milk allergies. Theoretically, this could lead to lactose intolerance.

As well, there is some evidence that a lectin intolerance can affect the intestinal villi. This could potentially lead to a lactose intolerance if the villi were no longer able to produce lactase to digest the lactose in diary. For people suffering with a lectin intolerance, a paleolithic diet may be helpful.

In some, the lactose intolerance may be persistent. In fact, it may appear to be a permanent condition. This could be due to ongoing accidental ingestion of the offending food that is causing villi damage, the presence of bowel infections, or perhaps a state of dysbiosis in the bowel could hinder the production of lactase as well. In this situation, further testing for infections, further diet modification to remove the offending foods or probiotics might help. Unfortunately, even with all of these interventions, the damage could be permanent. An ongoing lactose free diet may be needed along with lactase supplements when necessary. Perhaps, the persistent damage has occurred for too long in some who were undiagnosed for years.

With this in mind, I think everyone with a lactose intolerance should be tested for a gluten intolerance since it can be an underlying trigger. It is important to diagnose the cause, not just the symptoms.

Future Studies

 

In a study, I would like to see a large group of people with lactose intolerance investigated for gluten intolerance (celiac disease, dermatitis herpetiformis, and non-celiac gluten intolerance), a lectin intolerance, and food allergies (IgA, IgG, and IgE antibody mediated). The results may help to shed some light onto the true underlying cause of lactase deficiency.
This reminds me of how I was told that I had anemia, but further investigations were not suggested to find the cause, only iron pills were offered as a solution. 

References

 

1. Ojetti V, Nucera G, Migneco A, Gabrielli M, Lauritano C, Danese S, Zocco MA, Nista EC, Cammarota G, De Lorenzo A, Gasbarrini G, Gasbarrini A. High prevalence of celiac disease in patients with lactose intolerance. Digestion. 2005;71(2):106-10. Epub 2005 Mar 16.
2. Radlovi? N, Mladenovi? M, Lekovi? Z, Risti? D, Pavlovi? M, Stojsi? Z, Vuleti? B, Radlovi? V, Nikoli? D, Djurdjevid J, Gaji M. Lactose intolerance in infants with gluten-sensitive enteropathy: frequency and clinical characteristics. Srp Arh Celok Lek. 2009 Jan-Feb;137(1-2):33-7.
3. Jarocka-Cyrta E, Baniukiewicz A, Wasilewska J, Pawlak J, Kaczmarski M. Focal villous atrophy of the duodenum in children who have outgrown cow’s milk allergy. Chromoendoscopy and magnification endoscopy evaluation. Med Wieku Rozwoj. 2007 Apr-Jun;11(2 Pt 1):123-7.
4. Martelossi S, Ventura A, Perticarari S, Not T, Anibal J. Antibodies against milk and soy proteins in specific intolerances and celiac disease. Pediatr Med Chir. 1993 Jan-Feb;15(1):45-51.
5. K. Fälth-Magnusson, K.-E. Magnusson . Elevated levels of serum antibodies to the lectin wheat germ agglutinin in celiac children lend support to the gluten-lectin theory of celiac disease. Pediatric Allergy and Immunology. Volume 6, Issue 2, pages 98–102, May 1995.
6. Ceri H, Falkenberg-Anderson K, Fang R, Costerton JW, howard R and Barnwell JG. Bacteria-lectin interactions in phytohemagglutinin-induced bacterial overgrowth of the small intestine. Canadian Journal Of Microbiology 34, 1003-8, 1988.
7. JH Ovelgonne, JFJG Koninkxa, A Pusztaib, S bardoczb, W Koka, SWB Ewenc, HGCJM Hendriksa, JE van Dijka. Decreased levels of heat shock proteins in gut epithelial cells after exposure to plant lectins. Gut. 2000 May;46(5):679-87.

My Book, “Gluten Toxicity”, Is Available At “Lifetime Organics” In South Surrey, BC, Canada

I just dropped off some books at a store called “Lifetime Organics” in South Surrey, BC, Canada. This store can be found at 102-2099 152nd St., South Surrey and their phone number is 604-541-0933. They are selling “Gluten Toxicity” for $21.99.

Best Regards,
Shelly Stuart, R.N., B.Sc.N.

Thank You, “Celtic Celiac”, For Posting Information About My Book, “Gluten Toxicity”, On Your Blog

Thank you, Georgianna Reilly, also known as “Celtic Celiac”, for posting information about my book on your blog. I appreciate your support. I am excited to finally be finished and am hoping that this book will be a helpful resource for others who are affected by this little, but significant protein called gluten.

Georgianna has a blog called, “Celtic Celiac: A Modern Guide to Staying Sane Without Grain”. On her blog, she states, “This blog will share my story and insight on living a gluten free life in a busy gluten loving world as well as sharing of news stories and reviews of products, restaurants, books, articles, research papers and giveaways. I believe we can all make a difference by sharing our story and this is mine. I am living, loving and eating Gluten Free and I hope you’ll follow along on the journey”. Georgianna can also be found on Twitter and Facebook.

Thank You, Erin Smith, For Posting An Update: “Gluten Toxicity” Is Available At Amazon.com

Erin Smith, from New York City (USA), increases awareness and provides support to people with celiac disease at her informative blog,  “Gluten-Free Fun”.  On her blog, she discusses gluten-free food, restaurants, gluten-free recipes and many other celiac disease and gluten-free topics.  Yesterday, Erin posted an update about my new book, “Gluten Toxicity: The Mysterious Symptoms Of Celiac Disease, Dermatitis Herpetiformis And Non-Celiac Gluten Intolerance". The update mentions that my book is now available at Amazon.com in the USA. In a previous post, Erin did a book review and includes her opinion about “Gluten Toxicity”. Thank you very much Erin for your interest in my book and for posting a review plus an update on your blog. I appreciate your support!

The review can be found at http://glutenfreefun.blogspot.com/2011/01/new-e-book-gluten-toxicity.html

Erin also runs the “NYC Celiac Meet-Up Group”.

Wednesday, January 19, 2011

Thank you, “Gluten Free RN”, For Reviewing My Book, “Gluten Toxicity”

Last night, I arrived home after a 14 hour day at work, to find a very kind and lovely review of my book, “Gluten Toxicity”, at Amazon.com. Thank you so much “Gluten Free RN”, Nadine Grzeskowiak, for doing this review. I appreciate your time and your support. In Nadine’s review, she said, “Gluten Toxicity is a terrific resource! Shelly has managed to very accurately address all of the current issues and misconceptions regarding celiac disease and gluten intolerance with well researched information. Shelly has much sought information on the paleolithic diet and why this should be considered. I look forward to referencing Gluten Toxicity with clients and offering Shelly’s new book an excellent first resource.” To see the review on Amazon.com, you will need to go to the page for “Gluten Toxicity” and then scroll down to view Nadine’s comments.

I highly respect Nadine and all of her accomplishments. Nadine Grzeskowiak, tirelessly promotes awareness about gluten intolerance through her business, “The Gluten Free RN Resource Center”, in Corvallis, Oregon, USA. She can also be found at her blog, at Twitter, and on Facebook. Although, I haven’t formally met Nadine, I feel a comradeship, we both recognize that undiagnosed gluten intolerance is a significant public health problem, we have the same mission to increase awareness, and we both are working long hours to help end the suffering. Someday, it will be an honour to meet Nadine Grzeskowiak, “The Gluten Free RN”.

Have You Been Diagnosed With Gastroesophageal Reflux Disease (GERD), Heartburn, Or Indigestion? You Could Be Having Immune Mediated Reactions To Foods!

Gastroesophageal reflux disease (GERD), heartburn, and indigestion can be a symptom of gluten intolerance and other food allergies. Many doctors are not aware of this connection, unless they are specialists in the field of gluten intolerance and allergies. The lack of awareness around this issue is the reason why most patients are put on medication for their symptoms and they are never informed that their symptoms could be related to immune reactions to food.


Why are many doctors (and nurses) unaware of this association? The answer is a sad reality, many doctors are unaware of the wide variety of symptoms associated with gluten intolerance and food allergies. In fact, many people with a gluten intolerance, including celiac disease (CD), dermatitis herpetiformis (DH) and non-celiac gluten intolerance remain undiagnosed. For example, with CD, over 90% of individuals remain undiagnosed. Likely, it is even higher in non-celiac gluten intolerance since it is more under-recognized by doctors than celiac disease. Unfortunately, many doctors are not very aware of the many elusive symptoms associated with gluten intolerance and as a result, only the symptoms (ie. possibly GERD, heartburn, indigestion) are diagnosed, not the underlying problem. Typically, it isn’t on the doctor’s radar so it often isn’t investigated as a cause.

Within the medical profession, gastric reflux is generally called gastroesophageal reflux disease (GERD), but many people just call it heartburn or indigestion. Gastric reflux (reflux of stomach contents) usually presents with burning pain that can radiate from the upper abdomen to the neck (sometimes it can be sharp and feel like pressure), nausea can be a problem and sometimes regurgitation of foods and vomiting can occur. If a gluten intolerance and allergies are the underlying cause and left undiagnosed, many complications can occur, such as inflammation in the esophagus (esophagitis), ulceration of the esophagus, blood loss, adenoiditis, build up of fluid in the sinus and middle ears of children (from irritated adenoids), aspiration pneumonia and pulmonary fibrosis (from aspiration of gastric contents). As well, sore throat, hoarseness, coughing, asthma like symptoms (irritated esophageal nerves can affect lung nerves), scarring and strictures of the esophagus, and cancer in the inflamed areas can occur (ie. Barrett’s esophagus). As you can see, for some, chronic heartburn can lead to many problems, some of which can be life threatening. 

I had indigestion and heartburn for many years prior to my diagnosis. For me, the symptoms would flare up for a month or two and then disappear for a few months or more. During the flare ups, I would live fully stocked with an antacid. Once I was diagnosed with celiac disease and eating gluten-free, the gastric reflux went away and has never returned. I experienced permanent relief with a natural treatment which was wonderful since gastric reflux is usually treated with medication. A medication-free approach was very appealing!

I have met many patients who had heartburn while they were undiagnosed with a gluten intolerance and/or food allergies. Studies have also identified an association as well. Others had the same symptoms that were due to a food allergy (IgA, IgG, or IgE mediated) and experienced symptom relief once the offending foods were removed from their diet. Some patients may also have an infection (ie. H. Pylori) that requires treatment as well. With this in mind, I believe it is worthwhile to rule out a gluten intolerance by testing for celiac disease, dermatitis herpetiformis and non-celiac gluten intolerance. Other types of tests can investigate possible infections. Further testing for food allergies (IgE, IgA, and IgG mediated) can help to identify other food reactions. An allergist often only tests for IgE mediated allergies and offers an elimination diet. Naturopathic doctors will generally do blood tests for the other types of allergic reactions. Your physician, allergist or naturopathic doctor may recommend a food log along with an elimination diet if needed.

Some people on a paleolithic diet also experience relief from gastric reflux once they are eating a lectin-free. These people may have an underlying lectin intolerance, gluten intolerance or be allergic to a food that is naturally removed from the diet with eating paleolithic. Others, like myself, eat a paleolithic diet, but have additional allergies as well. My entire story with gluten-free and paleolithic living can be found in my book, “Gluten Toxicity”.

For a future study, I would like to see a large group of patients with gastric reflux, heartburn and indigestion tested for infections, gluten intolerance (celiac disease, dermatitis herpetiformis, and non-celiac gluten intolerance), a lectin intolerance, food allergies (IgA, IgG, and IgE antibody mediated) and investigated for other diseases. The results may help to shed some light onto the true underlying cause of gastric reflux.

References

1. Karpova EP, Tulupov DA, V. ina EE, Zakharova IN, Soldatski? IuL. Chronic adenoiditis prevention in children with acid-depended stomach pathology. Vestn Otorinolaringol. 2009;(5):55-8.
2. Bernztein R, Grenoville M. Chronic cough in pediatrics. Medicina (B Aires). 1995;55(4):324-8.
3. Al-Saab F, Manoukian JJ, Al-Sabah B, Almot S, Nguyen LH, Tewfik TL, Daniel SJ, Schloss MD, Hamid QA. Linking laryngopharyngeal reflux to otitis media with effusion: pepsinogen study of adenoid tissue and middle ear fluid. J Otolaryngol Head Neck Surg. 2008 Aug;37(4):565-71.
4. Williams JL. Gastroesophageal reflux disease: clinical manifestations. Gastroenterol Nurs. 2003 Sep-Oct;26(5):195-200.
5. Nachman F, Vázquez H, González A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, Sánchez IP, Mauriño E, Bai JC. Gastroesophageal Reflux Symptoms in Patients With Celiac Disease and the Effects of a Gluten-Free Diet. Clin Gastroenterol Hepatol. 2010 Jun 30.
6. Usai P, Manca R, Cuomo R, Lai MA, Russo L, Boi MF. Effect of gluten-free diet on preventing recurrence of gastroesophageal reflux disease-related symptoms in adult celiac patients with nonerosive reflux disease. J Gastroenterol Hepatol. 2008 Sep;23(9):1368-72.
7. Odman M, Bart PA. Rev Med Suisse. Eosinophilic esophagitis. 2010 Oct 6;6(265):1854-6, 1858.