Ann Kwong, Health Writer

Celiac Disease – It’s Not a Fad

 

If you’ve strolled through your supermarket bakery aisle recently, you may have noticed the many gluten-free products for sale. Some supermarkets have even devoted special sections entirely to gluten-free foods. A recent Mayo Clinic study noted that almost two million Americans are currently on a gluten-free diet, which seems to account for the popularity of grain-free products. Is this a new fad? Not for those with celiac disease. For this population, eating gluten-free food is more than a diet or a trend; it’s a way of life.

What is celiac disease?
Celiac disease is an autoimmune disorder affecting the small intestine. Individuals with celiac disease experience a reaction to proteins found in common grains such as wheat, barley or rye, which causes inflammation in the lining of the small bowel. Over time, the small intestine begins to lose the ability to properly absorb nutrients in food, leading to minor symptoms such as weight loss, bloating, and abdominal discomfort as well as major complications such as malnutrition, loss of bone density and even lymphoma. The only known cure for celiac disease is a life-long gluten-free diet.

How common is celiac disease?
According to a 2012 study by the National Institutes of Health (in partnership with the Mayo Clinic), approximately 1.8 million Americans (or 1-3% of the US population) suffer from celiac disease. Of those, over 75% of them do not know they have it. Part of the problem is that symptoms can vary from person to person, and some people don’t exhibit symptoms at all. Children can react differently than adults, and men can react differently than women. Celiac symptoms can also mirror those of other conditions, making self-diagnosis more difficult.

Cases of celiac disease seem to be rising in prevalence. In a NIH-sponsored study published in Gastroenterology, researchers concluded that the incidence of celiac disease has risen fourfold in the United States over the previous half-century. Reasons for the increase are unknown. Some experts point to changes in grain processing over the years, while others suggest that intestinal microbes are to blame. Still others note that changing patterns of childhood infection can affect general immunities over time. Yet another camp believes a major “trigger” such as a traumatic event or severe health issue could be the straw that pushes an otherwise healthy but genetically susceptible person over the edge.

What are the symptoms of celiac disease?
In addition to digestive maladies such as bloating, constipation and diarrhea, the following are common side-effects of celiac disease:

  • Fatigue
  • Headache
  • Anemia
  • Joint pain
  • Damage to dental enamel
  • Itchy, blistery skin
  • Numbness in extremities

In general, physicians advise seeking medical help if diarrhea symptoms persist for longer than two weeks.

How is celiac diagnosed?
The first step in diagnosing celiac disease is a simple blood test. If the results are indicative of the disease, an intestinal biopsy may be recommended to further confirm the diagnosis. In some cases, patients with gluten sensitivities turn out not to have celiac disease. This condition is known as non-celiac gluten sensitivity or NCGS, and the treatment remains the same as for those with celiac disease. The NCGS designation is relatively new and more research is needed, but early indicators show that cases of NCGS are 6-7 times more common than those of celiac disease.

What should you do if you think you may have sensitivity to gluten?
If you think that you may have a gluten sensitivity, make an appointment to see your provider. If a blood test is recommended, you’ll want to be sure that you have not already begun eating a gluten-free diet, as this may skew your results.

Need a provider? Visit valleymed.org/docs or call our free find-a-physician line: 425.277.DOCS (3627).

The South Seattle Gluten-Free Support Group meets at Valley Medical Center on the third Tuesday of each month from 7:00 – 9:00 pm in the Medical Arts Center (MAC) building, Conference Room B (northwest end of campus). Valley Medical Center is located at 400 S. 43rd Street in Renton, WA. 

 

 

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GLOW

The Lowdown on High Blood Pressure

 

High blood pressure is called “the silent killer” for a good reason: You can have it and not even know it.

According to the American Heart Association,  nearly 78 million (1 in 3) U.S. adults have been diagnosed with high blood pressure (also known as hypertension), and only about 80% know they have it. If you have high blood pressure and don’t control it, you increase your risk for serious illness.

High blood pressure has no symptoms. So, if you don’t have your blood pressure checked regularly, the first sign could come in the form of a heart attack, a stroke, heart failure, or kidney failure.

High blood pressure is easily detected, and it can be controlled. But it is up to you to take action. Here is how to control high blood pressure.

Be aware: Get checked
The easiest way to detect high blood pressure is to have your blood pressure checked. Blood pressure is made up of two measurements. The first is the force of your blood pushing against artery walls when your heart beats and pumps blood. This is called systolic pressure and it’s the top number. The second – the lower number – is the pressure between heartbeats. This is called diastolic pressure.

A normal blood pressure reading is less than 120 over 80, written 120/80. If your blood pressure is higher than 120/80, it means your heart is working harder than it should. A systolic blood pressure of 120 to 139, or a diastolic blood pressure of 80 to 89, is called pre-hypertension – you are at risk for developing high blood pressure which is a reading of 140/90 or higher.

No one knows what causes most cases of high blood pressure. It can be related to a medical condition, such as obesity or kidney disease. We do know, however, that your gender, race, and family history play a role in whether you develop high blood pressure. Age is also a factor. In people older than 35, blood pressure can increase. Older people often have other medical problems, and high blood pressure can put them at risk for cardiovascular complications.

Since you can’t control your age, heredity, or race it’s important to manage the risk factors you can control such as diet, activity level, stress, weight, and smoking. Studies show that lifestyle changes can lower your blood pressure – the more positive lifestyle changes you make will have an even greater effect on lowering your blood pressure.

DASH to the vegetable section of your grocery
If you have high blood pressure, but are otherwise healthy, your doctor may suggest that you try to manage it through lifestyle changes. One place to start is by eating healthy.

Consider following the DASH eating plan: “Dietary Approaches to Stop Hypertension.” The diet includes a certain number of servings from a variety of food groups: vegetables, fruits, fat-free or low-fat milk, whole grains, fish, poultry, beans, seeds, and nuts. It also provides a combination of foods rich in minerals, such as calcium, magnesium, potassium, and vitamins, limiting intake of saturated fats and cholesterol.

The American Heart Association recommends that everyone — no matter what age, ethnic background, or medical condition — consume less than 1,500 mg of sodium a day. Following the DASH eating plan and keeping salt intake to 1,500 mg a day has shown the biggest benefit for blood pressure reduction in people with high blood pressure. Talk with your health care provider to learn more about DASH and what is best for you.

When shopping, check food labels for the words “sodium-free,” “low-sodium” or “reduced-sodium.” Sodium or salt is used as a flavor enhancer and preservative in many canned and packaged foods. You can easily decrease the amount of salt you eat by avoiding these foods and by cooking meals without adding salt. Take your salt shaker off the table so you don’t add salt to food before you eat it. Try using herbs and spices for more flavor.

Move it, move it
Even a moderate amount of exercise can help you lose weight and lower your blood pressure. Walking is a good choice. It is easy to do and is easy on your body.

Before you begin exercising, talk with your doctor and keep these guidelines in mind:

  • Begin slowly, and slowly increase the amount you exercise.
  • Drink a lot of water, even if you do not feel thirsty.
  • Always warm up before exercising and cool down after.
  • Try to exercise moderately for 30 to 60 minutes most days of the week.

In addition, try to increase your activity level. When possible, use your feet instead of your car to go places. Add variety with activities such as swimming, golfing, or gardening.

But wait, there’s more!
Lowering your stress level can also help lower your blood pressure. Exercise can help you reduce your stress. So will relaxation techniques, meditation, yoga, tai chi and breathing exercises.

Smoking is another risk factor that you can control. It isn’t easy, but kicking the habit is one of the best things you can do to lower your blood pressure — and improve your overall health. Older adults tend to stay off cigarettes once they do quit. Ask your doctor for advice on how to stop smoking.

Sometimes you need a little extra help
If lifestyle changes are not enough, or if you have other health problems, such as cardiovascular disease, it may be necessary to manage your high blood pressure with medication.

Health care providers use more than 50 medicines to treat high blood pressure. Most medicines fall into one of these categories: diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and angiotensin II receptor blockers (ARBs).

There are several things to remember when taking medicine for high blood pressure:

  • Always follow your doctor’s instructions. Ask questions if you’re not sure what to do.
  • Make sure your pills are properly labeled and stored.
  • Make sure your health care providers know about any prescription and over-the-counter drugs that you take.
  • Try to be patient. It may take a few tries to find the best medicine and dosage for you. Some people need more than one medicine to control their blood pressure.
  • Never stop taking a medicine without your doctor’s approval. If you have side effects, talk with your doctor.
  • Never skip a dose. Keep taking your medicine even when you feel well.
  • Keep in shape. Eating healthy foods and getting regular exercise will also help your medicines do their job.

High blood pressure will not go away on its own, and if you return to your old habits or stop taking medication, it can go back up. Controlling your high blood pressure is a lifelong task that can make your life longer.

Need a primary care physician? Visit valleymed.org/docs or call our free find-a-physician line: 425.777.DOCS (3627).

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