"Endoscopy for gastrointestinal procedures only came into use about 10 years ago," Mukul Arya, M.D., explains. "Where in the past a major surgery would have been required, we can now use a small fiber-optic viewer for early cancer detection or the removal of benign tumors."

Meet Mukul Arya, M.D., Gastroenterologist, Director of Advanced Endoscopy at NYM.


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Celiac Disease

Celiac disease, also called sprue, is an autoimmune condition characterized by gluten intolerance. Gluten is found in many foods and drinks. Foods that contain wheat, rye, barley and even oat have gluten. Some examples include pizza, pasta, pastries, cereal and bread. Many people are surprised to find out that products such as beer, soy sauce, salad dressing and certain meats and cheeses contain gluten. Celiac disease damages the lining of the small intestine, and can cause many problems if left untreated.

Celiac disease is generally found in the Caucasian population and in people of European descent. Women are affected more than men. People who have family members with celiac disease are also more likely to develop it themselves . It can develop at any age. 

Celiac disease is also seen in tandem with other auto-immune diseases. People with thyroid conditions,  type-1 diabetes, lupus, rheumatoid arthritis are also more likely than those without these conditions to get celiac disease.

Symptoms

People with celiac disease can have a variety of symptoms, such as gas, bloating, abdominal pain, constipation or diarrhea, early satiety (feeling full quickly after meals), foul smelling or floating stools, nausea, vomiting, or weight loss. Symptoms are different for each person, and people do not necessarily have all the symptoms. These symptoms often become more severe after consuming food or drinks with gluten. 

The inability to absorb certain vitamins and nutrients may also cause symptoms. Examples include anemia because of low iron levels, numbness and tingling because of low levels of vitamin B12, and osteoporosis due to low calcium and vitamin D levels. Recent studies link celiac disease to infertility. Children with celiac disease may be small for their age, have delayed puberty, and/or poor weight gain.

Diagnosis

Diagnosis begins with a through medical history, including symptoms related to eating certain foods and family history. If there is a suspicion of celiac disease, a series of blood tests will be important for the diagnosis. If needed, genetic testing may also be offered.
Celiac disease often causes changes in the small intestine that can only be seen by endoscopy and biopsy.


Other diseases that affect the small intestine include irritable bowel syndrome, Crohns disease, lactose intolerance, bacterial overgrowth, and small intestine cancers. Because the symptoms of many bowel disorders are similar, careful diagnosis is especially important. In addition to physical examination and evaluation, doctors may use CT scans, barium studies, endoscopy/colonoscopy, or capsule endoscopy. Once the bowel disorder has been diagnosed, the physician can plan the most effective dietary and medical treatment for the patient's condition.

Treatment

The best treatment for celiac disease is the elimination of gluten from the diet, which not only helps eliminate the symptoms, but also heals the lining of the small intestine. It is very important that people who believe they may have celiac disease do not change their diets prior to undergoing blood tests, since diet changes may lead to inaccurate results.



Find a physician who specializes in Gastroenterology here or call 866 DIGEST-1 866-344-3781.

To contact NYM's Division of Gastroenterology, call 718.780.3851.



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