Part III – Gluten Free
"Jane, your test results have come back and it does appear that you have been suffering from Celiac Disease," Dr. Michaels, Jane's new gastroenterologist, explained.
Jane pulled out a pad of paper with some notes. "Since Dr. Klein mentioned Celiac Disease, I've been reading about it online. All the websites say I will have to give up gluten. I've looked at samples of gluten free diets and they seem really strict."
Dr. Michaels smiled sympathetically. "Unfortunately, Jane, the only treatment for Celiac Disease is to eliminate gluten in your diet completely."
Jane frowned. "I really like bread and pasta, so is it okay if I cheat once in a while and have some spaghetti?"
Dr. Michaels shook her head. "Jane, the autoantibodies made by your immune system will always be there and respond to very small amounts of gluten. There are more and more gluten-free products that can be found, so it's not as hard to follow the diet as it used to be. We will put you in contact with a nutritionist who can help you plan some easy meals and give you ideas about substitutions to make in your diet."
"Dr. Michaels, if I follow the gluten-free diet, will my fertility problems go away? Dr. Klein said we needed to figure out all of this stuff before thinking about my fertility issues, but I'm not getting any younger, and Brian and I would really like to have children," Jane asked hopefully.
"Jane, I can't give you any guarantees that your fertility issues will go away. Unfortunately Celiac Disease cannot be cured, it can only be controlled. Infertility can be a severe complication of untreated Celiac Disease. Hopefully Dr. Klein can give you a more definitive answer when you see him again."
Question
1. What would be a possible diet for a person with Celiac Disease? Provide a menu for breakfast, lunch, dinner, and snacks. Ensure that proper amounts of nutrients are obtained. Compare the prices of gluten free foods to normal foods.
2. What problems could a child with undiagnosed Celiac Disease encounter as he/she grows? Why?
3. Why might Jane still have intestinal flares despite removing major sources of gluten from her diet? Why could this be dangerous?
4. What other diseases are people with Celiac Disease susceptible to? Hypothesize why a person with Celiac Disease would also be susceptible to these other diseases.
5. Do a literature search and describe why autoantibodies may be linked to infertility. (This is an emerging topic, so you probably won't find anything in your textbook!)