Chapter 13

Choosing the right parents

  • (Age: 43 years, female)

    I was a girl about 4 years old (1962) when I started having problems.

    I remember in Grade 1 being sent home from school because I had vomited. I missed a lot of school time. My mother tells me that she brought me to the doctor just about every week. He suggested several options but continued to think that the problem was mental, my mother must have liked my older sister better and I was suffering emotionally.

    I continued to have classic symptoms; anemia, weakness, vitamin deficiency, diarrhoea, steatorrhoea, abdominal pain, bloating, vomiting and weight loss.

    Finally, these symptoms reached a point where the doctor had to agree something was wrong. I was hospitalized when I was 9 but no cause could be found. I had vitamin injections every week and my mother fed me the best food in the house.

    A couple of months later, I was hospitalized in Halifax. Many doctors and tests later, nothing helped. I had lost so much weight and was dying of malnutrition.

    I was about to be sent home to die when a young doctor was consulted. He made enquiries to the Netherlands for more information.

    I was put on the gluten-free diet and sent home. My mother followed the diet very strictly.

    I improved dramatically. I gained weight and grew. The doctors had predicted that I would always be short but I grew by leaps and bounds. At periodic checkups, the doctors were astounded at my progress.

    As a teenager, I tried to find out as much as possible about celiac disease. After high school, I worked as a lab technologist and came to know a gastroenterologist there. With his recommendation, I took the gluten challenge (1979). The biopsy proved inconclusive but, in retrospect, the biopsy was performed too early. The pain was caused by the addition of yeast to my diet, not the gluten.

    I continued on the celiac diet.

    My first child was born and I watched constantly for signs. There were none. My second child started to have problems around three years of age. The biopsy was very difficult to do and proved to be inconclusive. He is now 16 and remains on the celiac diet because he has pain when he deviates. (He will have my consent should he decide to do the gluten challenge to get his diagnosis). My third child has no symptoms.

    In 1999, I took another gluten challenge. I had been to a Celiac Association conference and came home very sick. The only thing different was the yeast in the bread products so I wondered if my entire problem was with yeast. This biopsy was positive for celiac disease.

    I am now 43 and have been on the gluten-free diet for thirty-four years.

    All five of my siblings are symptom free. My parents are from the Netherlands and sometime after I was on the diet, my uncle in the Netherlands was diagnosed with celiac disease. He had always been a sickly child and young adult.

  • Clinical Pearls

    Whether you develop celiac disease or not depends on how carefully you chose your parents”!

    Celiac disease is a hereditary disorder. Both first and second-degree relatives are at high risk for having celiac disease and should be screened.

  • Highly sensitive serological tests (tissue-transglutaminase antibody and endomysial antibody) are currently available to screen for celiac disease. The definitive test to diagnose celiac disease is a small intestinal biopsy.

The treatment of celiac disease is a strict gluten-free diet for life. The diet should not be started before the confirming the diagnosis with a small intestinal biopsy.


Copyright © 2007 by Mohsin Rashid
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