HEALTH & FITNESS

Celiac disease: The problem protein in wheat
Dr Rakesh Kochhar

Commonly referred to as wheat allergy, celiac disease is not an allergic disorder; it is actually intolerance to gluten, a protein in wheat. It occurs in people who have a genetic susceptibility. Unfortunately, awareness about this disease is very poor among the population and even among doctors.

EYESIGHT
A silent vision stealer
Dr Mahipal S. Sachdev

Today when retired bank manager G.C. Sharma sits at home reading his newspaper, watching his grandchildren play around him, he still gets shivers as he remembers the day when everything had gone blank. “It was a Sunday. I was reading the newspaper while waiting for my breakfast. But as I tried to make out what was on the paper, all I could see was a white blank,” he recalls.

Cancer not just down to genes, say experts
LONDON: Cancer is not just down to genes, unhealthy diet and poor lifestyle also contribute to the potentially fatal disease, say experts. Dr Rachel Thompson, science programme manager for the World Cancer Research Fund (WCRF), dispelled the myth insisting lack of exercise and being overweight causes three times as many cases of cancer as genetics.

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Celiac disease: The problem protein in wheat
Dr Rakesh Kochhar

Commonly referred to as wheat allergy, celiac disease is not an allergic disorder; it is actually intolerance to gluten, a protein in wheat. It occurs in people who have a genetic susceptibility. Unfortunately, awareness about this disease is very poor among the population and even among doctors.

Signs and symptoms

There are no typical signs and symptoms of celiac disease. In children, it manifests early with diarrhoea which starts when the child is weaned off milk and started on solid diet. Another common manifestation in children is stunting of growth or failure to gain height and weight. School performance may get affected in some children. In India, celiac disease has been recognised in children for the last over 40 years but it has attracted the attention of those caring for adults only in the last decade.

Most adult people with the disease have general complaints, such as intermittent diarrhoea, abdominal pain and bloating. Sometimes people with celiac disease may have no gastrointestinal symptoms at all. In fact, half of the adult celiac disease patients coming to PGI do not have any abdominal symptoms. the most common non-gastrointestinal symptom is iron deficiency followed by weight loss.

Celiac disease symptoms can also minic those of other conditions, such as irritable bowel syndrome, gastric ulcers, parasite infections, skin disorders or bone disease. Celiac disease may also present itself in less obvious ways, including irritability or depression, joint pains, muscle cramps, mouth sores, dental and bone disorders (such as osteoporosis), and tingling in the legs and feet (neuropathy).

When to seek medical advice

It you notice or experience any of the signs or symptoms common to celiac disease, see your doctor. If someone in your family is known to have celiac disease, you may need to be tested. Starting the process will help you avoid complications associated with the disease, such as ossteoporosis, anaemia and certain types of cancer. Seek medical attention for a child who is pale, irritable, fails to grow and who has foul smelling stools. Many other conditions can cause the same signs and symptoms. So, it’s important to talk to your doctor before trying a gluten-free diet.

Left untreated, celiac disease can lead to several complications like the following:

Malnutrition: Untreated celiac disease can lead to malabsorption, which in turn can lead to malnutrition. This occurs in spite of what appears to be an adequate diet. Because vital nutrients are lost in the stool rather than absorbed in the bloodstream, malabsorption can cause deficiency of vitamins A, B-12, D, E and K, folate and iron, resulting in anaemia and weight loss. Malnutrition can cause stunted growth in children and delay their development.

Loss of calcium and bone density: With continued loss of fat in the stool, calcium and vitamin-D may be lost in excessive amounts this may result in a bone disorder called osteomalacia, a softening of the bone also known as rickets in children, and loss of bone density (osteoporosis).

Cancer: People with celiac disease who don’t maintain a gluten-free diet also have a greater chance of getting one of several forms of cancer, especially intestinal lymphoma.

Other complications Celiac disease has been linked to a autoimmune hepatitis and infertility, among others.

Diagnosis

Patients with celiac disease have high titres of certain antibodies, certain proteins related to gluten. A blood test can detect high levels of these antibodies. Commonly used tests are anti-tissue transglutaminase antibodies, anti-gliadin antibodies and endomyseal antibodies. To confirm the diagnosis, a biopsy is taken from the small intestine through an endoscope, which is examined under the microscope.

Treatment

The treatment is simple though not very easy to follow. It involves total avoidance of wheat and wheat products and nutritional supplementation. North Indian diet is very heavily dependent on wheat, so it creates a problem, especially in children. Wheat products are totally prohibited and they include atta, maida, suji, commercially available biscuits, namkeen, noodles, cakes and pastries, ice-creams and other snacks. Rye and barley are also prohibited.

Thus, gluten-free diet consists of maize, rice, rice flour, maize-flour, soya flour besan and a mixture of these flours. All vegetables, fruits, eggs and all meat products are permitted. Certain shops in big cities market gluten-free biscuits and snacks. Indeed, it is difficult for mothers to plan recipes for school-tiffin for their children. However, a consultation with a dietician can easily solve this problem.

Apart from the gluten-free diet, which has to be continued for life, patients with celiac disease need supplements like iron, Vitamin-B and calcium. If adequately treated, these patients can lead a healthy and normal life.

The writer is a Professor of Gastroenterology at the PGI, Chandigarh.
Email: dr_kochhar@hotmail.com


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EYESIGHT
A silent vision stealer
Dr Mahipal S. Sachdev

Today when retired bank manager G.C. Sharma sits at home reading his newspaper, watching his grandchildren play around him, he still gets shivers as he remembers the day when everything had gone blank.

“It was a Sunday. I was reading the newspaper while waiting for my breakfast. But as I tried to make out what was on the paper, all I could see was a white blank,” he recalls.

What happened to Sharma is something that afflicts over 60 million people across the world — glaucoma. And worse, more than half of them do not even realise it until it is too late. Rightly called the silent vision stealer, glaucoma creeps up on unsuspecting victims and by the time it is detected, it is often too late to save the vision. The disease works silently, damaging the outer or peripheral vision first while maintaining the central vision.

Sharma’s glaucoma was detected and he underwent surgery which helped him, but could not reverse the damage already caused. He can at best see vague shadowy impressions with his left eye and relies on his right eye to see. The only good news is that because the glaucoma was detected, doctors were able to save his right eye and his case served as a wake-up call for his family.

Those with a family history of glaucoma are at a higher risk to contracting the disease. When Sharma was diagnosed, his entire family underwent a preventive eye check-up.

There are three tests for the early signs of glaucoma. These are a visual acuity test to see how far you can see, a visual field test to check your peripheral vision and the third test is with a tonometer which checks the pressure of the eyes.

In addition to these, there are advanced tests available like the fibre layer analysis (RNFL) which is done with the help of OCT and can detect glaucoma at a stage before the visual field changes have occurred, hence helping in treatment.

Regular eye check-ups can help catch glaucoma at a very early stage, reducing the chances of vision loss. So, everyone who is in the high risk group should get himself/herself tested.

People with a family history are at the highest risk and should get an annual test done, irrespective of their age. The others who fall in this category are diabetics, hypertension patients, thyroid patients and those with a high plus or minus power.

Remember, the only way to stop glaucoma is early detection. So, add a preventive eye examination to your list of annual check-ups.

Symptoms

Glaucoma in early stages generally does not show any noticeable symptoms. Chronic glaucoma progresses too slowly to get noticed.

Some common symptoms may be:

Inability to adjust the eyes to darkened rooms such as theatres

Frequent changes in eyeglass prescription

Gradual loss of peripheral vision

Blurred vision

Headaches

Poor night vision

In the case of acute glaucoma resulting from a rapid increase in the intraocular pressure, there could be severe symptoms. These include:

Feeling of a blind area in the eye

Seeing rainbow coloured halos around lights

Severe eye pain, facial pain

Red eye

Cloudy vision with halos around light

Nausea and vomiting.

The high risk groups who can get glaucoma:

Family history of glaucoma

History of diabetes

People having high minus or plus numbered glasses

Age above 40 years

People suffering from hypertension

Anybody who has undergone any kind of eye surgery

People with thyroid gland-related ailments

People with over-mature cataracts

People with an injury to the eye

People with a history of prolonged use of steroid eye-drops

Facts to remember:

There is no prevention of the development of glaucoma

Sometimes the symptoms of glaucoma are simply not noticeable

Timely detection of glaucoma is a must

Timely treatment of glaucoma may prevent further loss of vision and blindness

The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: drmahipal@gmail.com


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Cancer not just down to genes, say experts

LONDON: Cancer is not just down to genes, unhealthy diet and poor lifestyle also contribute to the potentially fatal disease, say experts. Dr Rachel Thompson, science programme manager for the World Cancer Research Fund (WCRF), dispelled the myth insisting lack of exercise and being overweight causes three times as many cases of cancer as genetics.

According to her, 39 per cent of the most common cancers, including breast and bowel, could be prevented through a good diet, exercising and keeping weight under control.

"It's important to dispel the myth that cancer is just down to genes," the Telegraph quoted Thompson as saying.

"The evidence shows that an unhealthy diet and low activity levels cause three times more cancer cases than genes”, she added. — ANI

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Health Notes
Vegetable juice may help people lose weight

WASHINGTON: A study conducted at the Baylor College of Medicine has revealed that drinking at least one glass of low sodium vegetable juice daily may help overweight people with metabolic syndrome lose weight.

Researchers found that participants who drank at least 8 ounces of low sodium vegetable juice as part of a calorie-controlled DASH diet lost four pounds over 12 weeks, while those who followed the same diet but drank no juice lost one pound.

Metabolic syndrome is defined by a cluster of risk factors, including excess body fat in the midsection, high blood pressure, high blood sugar and abnormal blood lipids. — ANI

Eating tart cherries may boost antioxidant activity in body

WASHINGTON: Eating tart cherries could significantly boost antioxidant activity in the body, according to a new study. Researchers at the University of Michigan found that healthy adults who ate a cup and a half of frozen cherries had increased levels of antioxidants, specifically five different anthocyanins — the natural antioxidants that give cherries their red colour. They randomly assigned 12 healthy adults, aged 18 to 25 years, to eat either one and a half cup or three cups of frozen tart cherries. The researchers analysed the participants' blood and urine at regular intervals after they ate the cherries and found increased antioxidant activity for up to 12 hours after eating cherries.

"This study documents for the first time that the antioxidants in tart cherries do make it into the human bloodstream and is coupled with increased antioxidant activity that could have a positive impact," said Sara L. Warber, Co-Director of University of Michigan Integrative Medicine and principal investigator of the study. — ANI

Herbal extract inhibits pancreatic cancer development

WASHINGTON: A herb used in traditional medicine by many Middle-Eastern and Asian countries not only kills pancreatic cancer cells but also appears to inhibit the development of pancreatic cancer as a result of its anti-inflammatory properties, researchers from the Kimmel Cancer Center at Jefferson found.

Hwyda Arafat, associate professor of surgery at the Jefferson Medical College of Thomas Jefferson University, said that thymoquinone, the major constituent of the oil extract from a Middle-Eastern herbal seed called Nigella sativa, exhibited anti-inflammatory properties that reduced the release of inflammatory mediators in pancreatic cancer cells. Dr. Arafat said that Nigella sativa seeds and oil, used in traditional medicine by many Middle-Eastern and Asian countries, help treat a broad array of diseases, including some immune and inflammatory disorders. Previous studies have also shown it to have anti-cancer effects on prostate and colon cancers. — ANI


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