09/23/05

CELIAC DISEASE A COMMON CAUSE OF STOMACH PAIN AND DIARRHEA

DEAR DR. DONOHUE: My specialist has diagnosed me with celiac disease, via an intestinal biopsy. I am 71. It seems strange that I should get it at this late date. Does old age make you more sensitive to it? Now, if I eat even so much as a tiny morsel of wheat, I feel awful for 24 hours. Will I ever get off the gluten-free diet? -- A.S.

ANSWER: Not so long ago, celiac was believed to be a rare bird. Today it is diagnosed with 100 times the frequency it was diagnosed 50 years ago.

The problem is a sensitivity of a person's digestive tract to gluten, a protein found in wheat, barley and rye. The protein causes inflammation of the small intestine, the part of the digestive tract where food absorption takes place.

Symptoms include crampy stomach pain, fatigue, weight loss and diarrhea. Sometimes the symptoms are so mild that the only manifestations of the illness show up in deficiencies of such things as iron, which leads to anemia, or calcium, which leads to osteoporosis.

Celiac disease usually appears at younger ages, but 15 percent of patients don't get it until after age 65, and a few develop it in their 90s. Age doesn't make you more sensitive to it.

Treatment is strict avoidance of gluten, something difficult to do, and something all but impossible to do without precise instructions. Gluten is in many foods that you would least suspect. The diet is for life.

Do two things. Contact a dietitian for diet instructions. Then contact the Celiac Disease Foundation. Its Web site is www.celiac.org. If you don't have a computer, a friend might have one, or the local library can help you out. The foundation's phone number is 1-818-990-2354 -- not a toll-free number. You'll find the foundation a best friend on whom you can rely for information on how to cope with the ailment and with the diet that brings relief from it.