May is National Celiac Awareness Month: Is gluten causing problems for you?
By Sharon L. Mason, CHAU
Celiac disease, or celiac sprue, is a
chronic disorder of the small intestine
caused by sensitivity to gluten, a protein
found in wheat and rye and, to a lesser
extent, in oats and barley. It causes poor
absorption by the intestine of fat, protein,
carbohydrates, iron, water and vitamins
A, D, E and K.
The word sprue comes from the Dutch
spruw, which means mouth blisters. These
were described as an important sign of
the illness by Dutch physician Vincent
Ketelaer in 1669, almost three centuries
before gluten’s role was suspected.
The diagnosis for celiac disease came
about when Holland’s supply of cereal
grains gave out during a famine at the end
of World War II. Some Dutch children
who were ill before the shortage started
became a lot less ill when all they had to
eat were potatoes and vegetables.
After the famine was over, these same
children started eating as before, immedi
ately became ill again and started deterio
rating. Careful experiments conducted in
Holland identified gluten, a protein insol
uble in water, as the cause of this illness.
If fat were the only nutrient not being
absorbed by the sprue (celiac) victim’s
digestive tract, the consequences of the
disease would be less serious. Unfortu
nately, inflammation and destruction of the
small intestine’s lining prevents the normal
absorption of many types of nourishment.
Patients with celiac disease can
become anemic because of the faulty
uptake of iron, folic acid or both. Because
calcium and/or vitamin D are not being
absorbed, the bones can become porous
(not solid throughout the bone) and brittle.
Legs can swell, gums can bleed and
easy bruising will be noticed with the
reduced amount of vitamin K in the body.
Deficiency of other vitamins can cause
neurological damage, dry skin and sore
ness of the lips or tongue.
Symptoms of celiac disease some
times become apparent as soon as cereal
is introduced into an infant’s diet. Occa
sionally, though, there are no signs of the
disorder until middle or late adulthood.
Persistent diarrhea, usually accom
panied in children by failure to grow
properly and in adults by unexplained
weight loss, is a clue. Stools are typically
bulky, light tan or gray, frothy and rancid
smelling; they tend to stick to the bowl
when the toilet is flushed. This is because
of the high content of fat in the stool.
An adult untreated for celiac disease
often excretes 30 to 40 grams of unab
sorbed fat daily. This is 10 times the
normal output. Their stools also can be
watery and patients might have frequent
bowl movements. They may experience
lots of gas and weakness. Itchy bumps
occur over the legs, trunk, scalp and neck
in less than 10 percent of patients.
In diagnosing celiac disease, a patient
will give a history and undergo a physical
exam and lab work to confirm mal-absoiption
of iron folate and vitamin B12, and to con
firm anti-gliadin (anti-gluten) antibodies.
Stool studies and mucosal biopsies of the
small intestine also might be performed.
The primary treatment of celiac
disease is to remove all gluten from the
diet, which is easier said than done. Food
labels should be examined carefully for
the addition of gluten or grain products.
Hot dogs, ice cream, commercial soups
and sauces, candy bars and all kinds of
baked goods can be sources of gluten (even
small amounts of gluten must be avoided).
Rice, soybean, potato and com flours
are safe.
Many doctors refer the patient to a
dietician to help them to get foods high
in calories and low in fat. Vitamins and
minerals will be prescribed as needed.
Lactose intolerance can develop tem
porarily or permanently.
Please call the clinic if you have any
concerns or questions, 541-444-1030 or
800-648-0449.
Head Start gets ready for end of school year; federal review is this month
By Lori Jay-Linstrom, Parent Involve
ment Coordinator
It’s May already and that means the
end of the school year is fast approaching.
Our teachers, along with Bonnie
Crawford and I, have been following up
with families on the health care needs of
their children. All families have done a
wonderful job of taking care of dental,
vision, lead and hemoglobin issues.
The Head Start federal review begins
the week of May 9. A team of reviewers
will be in the area for a week looking at all
aspects of our Head Start program. They
will be in classrooms, at the administra
tion building and out in the community.
We look forward to their arrival and
to assisting them as they discover what a
wonderful Head Start program we have.
Our new Head Start applications have
been mailed. If you received one, please
return it as soon as possible. If you did not
receive one and would like to have one
mailed to you, please call 800-922-1399,
ext. 1376, or 541-444-8376.
Finally, we are almost ready to con
clude our annual Head Start raffle. We
have more than 100 items to give away,
some of which are on display at the Tribal
administration building in Siletz.
An updated list is available and tickets
can be purchased from Lisa Paul or any Head
Start parent or staff. Tickets will be drawn
by the Head Start Policy Council in May.
Our Community, Our Future
Depoe Bay Firefighter and Kenny's IGA employee
. . Georqe Blacketer
Courtesy photo from Siletz Tribal Head Start staff
Tribal member George Blacketer and children from the Siletz Tribal Head Start program in Lincoln City
May 2011
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