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Dr. Fred Williams, St. Luke's Hospital

Women need to be aware of signs of celiac disease

Celiac disease affects about one percent of Americans and is more common in women than in men. No longer considered just a gastrointestinal disorder in which the major symptoms are diarrhea, bloating, gas and weight loss, celiac disease is now recognized as a condition that causes many non-GI problems throughout the body. Some symptoms are unique to women.

Celiac disease is an autoimmune disease, meaning one's immune system attacks healthy cells. In people with celiac disease, ingesting gluten, a protein found in wheat, rye and barley, causes inflammation of the small intestine. This impairs the body's ability to absorb nutrients.

It can result in multiple vitamin and mineral deficiencies including vitamin D and calcium deficiencies which lead to osteoporosis, the thinning of bone tissue and loss of bone density over time. Osteoporosis prior to menopause could be a sign of celiac disease.

Likewise, poor absorption of iron can lead to anemia, a condition involving insufficient red blood cells. Though menstruation is often a cause of mild anemia in younger women, anemia that doesn't respond to iron supplementation could be due to celiac disease.

There are multiple reproductive problems associated with celiac disease in women such as delayed onset of menstruation in adolescents, irregular or no menstruation, infertility, miscarriages, low birth weight infants and possibly preterm births. Women with reproductive issues should talk with their doctors about being tested for celiac disease.

In addition, irritable bowel syndrome often has symptoms identical to celiac disease and is a clear indication for celiac disease testing.

Fatigue, muscle and joint aches, unexplained weight loss/gain and headaches are also common non-specific symptoms of celiac disease that should prompt evaluation.

Celiac disease is a genetically-based disorder, so there is an increased risk of having the disease if one has a family history of it. And it is often associated with other autoimmune disorders, especially Type 1 diabetes and Hashimoto's thyroiditis.

If celiac disease is suspected, a simple diagnostic blood test can be performed. The treatment is a lifelong gluten-free diet. Because there are many hidden forms of gluten in processed food, it is best to seek nutritional counseling when implementing a gluten-free diet.

Dr. Fred Williams specializes in gastroenterology at St. Luke's Hospital. Call 314-205-6060.

This article was published in the St. Louis Post-Dispatch on August 7, 2014.