Author Archives: Michael Covalciuc

Michael Covalciuc

About Michael Covalciuc

Michael A. Covalciuc, M.D., M.P.H., is director of the Mayo Executive Health Program at Mayo Clinic in Scottsdale.

Gluten-rich bread

Watch For Signs That Gluten-Rich Foods Are Affecting Your Health

Digestive symptoms are common. Most are transitory or respond to simple changes in diet or lifestyle. However, for some people digestive symptoms can be chronic, severe and cause significant impairment to their quality of life.

One such condition is Celiac disease; also known as Celiac Sprue, Nontropical Sprue or Gluten-sensitive Enteropathy.  Celiac disease is an immune reaction to the protein gluten, which is found in foods containing grains such as wheat, barley and rye (e.g. bread, pasta, and pizza crust). When gluten is ingested, the immune reaction causes damage to the lining of the small intestine.

The cause(s) are unknown. There is a hereditary risk of 5 percent to 15 percent if an immediate family member is affected. In studies of identical twins, 70 percent-85 percent of the time, the second twin is affected if one twin has Celiac disease.  Sometimes the disease develops after some form of trauma — infection, surgery or pregnancy.  Persons with Type 1 diabetes (insulin dependent) or certain thyroid diseases are more commonly impacted.

Typical symptoms include bloating, abdominal pain and diarrhea. However, these symptoms can mimic other gastrointestinal diseases, and infrequently some people may not have any gastrointestinal symptoms.  Other features/complications include anemia (from malabsorption of nutrients and vitamins, leading to malnutrition), joint pains, muscle cramps, skin rash, mouth sores, osteoporosis (loss of calcium and vitamin D), nerve damage, general weakness and fatigue and weight loss. Due to damage to the small intestines, some people will develop lactose intolerance. Untreated persons have a long-term increased risk of some cancers, such as intestinal lymphoma.

Diagnosis, in addition to a medical history and physical exam, involves testing the blood for specific antibodies present at high levels. These antibodies can identify people more likely to have the disease. In addition, a biopsy of the small intestine (done by a scope inserted through the mouth) is used to confirm the diagnosis.

Treatment involves a gluten free diet.

If you have persistent digestive symptoms, discuss with your doctor.  Keeping a diary of foods eaten and symptoms can be very helpful. Only your doctor can make the proper diagnosis.

Routine screening tests can be one of the most important personal health strategies

A Personal Health Plan Includes Screening Tests

Everyone should develop a lifetime plan to stay healthy. A healthy lifestyle, an understanding of personal health risks and the appropriate use of screening tests are all important parts of a plan.

Routine screening tests can be one of the most important personal health strategies.  Screening tests are designed to detect disease or risk factors for disease before symptoms appear. Detecting disease early can lead to more effective treatment. Identifying risk factors for disease may reduce the chance of developing certain diseases or prevent them completely.

Much research on the development and effectiveness of various screening tests has been done in recent years. Although effective screening tests are widely available, many people do not take advantage of them. A screening test is not necessarily complicated or expensive. For example, a simple blood pressure check can detect elevated blood pressure or hypertension, which is a risk factor for heart disease and stroke. Discovery can lead to early treatment and prevention of these adverse outcomes.

Common screening tests in addition to blood pressure measurement include checking your cholesterol value and blood sugar (diabetes). Cancer screening tests are available for colon cancer (starting at age 50), breast cancer (mammograms, annually starting at 40), cervical cancer (Pap test) and prostate cancer (blood PSA test starting at 50). Personal risk factors can change the age at which testing begins and the frequency with which the tests are performed.

There are also other important strategies to stay healthy and prevent disease. In addition to specific screening tests, reviewing your family history and lifestyle can help identify risk factors that may increase or decrease your chances of developing specific conditions. The best approach is to discuss a lifetime preventive strategy with your personal physician. Completing one of the many available health risk appraisal tools on the Internet can help make you more informed about your personal risks and increase the focus and productivity of your discussions with your physician.