Q: Several years ago you wrote about celiac disease. Well, I was surprised to read about the same symptoms I have. I have since been diagnosed with colagenous colitis with bloating, diarrhea, etc, following a colonoscopy.
I was never told to avoid gluten products, despite the fact that I find ice cream and cheeses aren’t tolerated very well by me.
Could my avoiding gluten be a way of avoiding the bloating and other symptoms? I would appreciate any advice you may have.
A: Celiac disease is an immune reaction from eating gluten which is found in rye, wheat and barley products. For those individuals diagnosed with celiac, ingesting products that contain gluten triggers an immune response in the small intestine that, over a period of time, produces inflammation. This inflammation damages the lining of the small intestine and can prevent absorption of some nutrients. Malabsorption may lead to damage of other areas of the body, including the brain, liver and bone that actually depend on specific nutrients in order to function normally. As you have discovered, the condition may cause bloating, diarrhea, changes in bowel habits, fatigue, joint pain, paresthesias (tingling and numbness) of the extremities, osteoporosis from less than optimal absorption of calcium and vitamin D, skin rash, and weight loss.
While the exact cause of celiac remains unknown, it is thought to be an autoimmune disorder with familial or genetic components. Despite this statement, not all individuals with a family history will develop the condition. Those with type 1 diabetes, microscopic colitis, Sjogren’s syndrome and autoimmune thyroid disease seem to be at an increase for development.
The colagenous colitis you have been diagnosed with is a rare but treatable inflammatory disorder of the digestive system characterized by inflammation and thickening of the lining of the large intestine. Those individuals at an increased risk for developing the disorder are males over the age of 40; however, cases have been reported in children as young as 7.
Symptoms may include fatigue, dehydration, chronic watery diarrhea, and weight loss. The diarrhea may occur as often as 30 times in a day, a situation that understandably may lead to dehydration. Specific foods – particularly those high in fat and fiber, a variety of spices, dairy products, and uncooked fruits and vegetables might be triggers for an episode to occur in some individuals. Interestingly and having mentioned foods, some research indicates little evidence of the link between food and colagenous colitis. Therefore, if you feel your bloating and other symptoms might be kept at bay by discontinuing products that contain gluten, I recommend you make dietary modifications. If you find your symptoms lessen or dissipate altogether, you will certainly have your answer.
For others, specific medications including budesonide, prednisone, metronidazole, cholestyramine, aminosalicylates and bismuth subsalicylate have been effective in treating the disorder. Symptoms may also be treated with anti-diarrheal drugs such as loperamide. When loperamide fails to control symptoms, bismuth subsalicylate may be added. It is estimated that about 25% of all patients diagnosed with collagenous colitis will require long-term therapy, simply because the symptoms may appear once the treatment is discontinued.
