Celiac disease chest pain

Contents

Gluten May Be Making You Sick

According to a Mayo Clinic study, 1.6 million Americans who have never tested positive for celiac disease are on gluten-free diets. The NPD Group, which tracks eating habits, recently reported that one out of every three adults in the U.S. claims to have reduced or eliminated gluten from their diet. Why are so many Americans avoiding gluten, and is it doing them any good even if they don’t have celiac disease?

Celebrity endorsements have no doubt fueled public interest in gluten-free diets, but there’s reason to believe that gluten can make you sick even if you don’t have celiac disease.

In 2001, celiac experts coined the term non-celiac gluten sensitivity to describe people who suffer gluten-related health issues without having the disease. Symptoms are similar to celiac disease, but less severe: headache and joint pain, for example, but not serious intestinal damage. According to the Center for Celiac Research & Treatment, gluten sensitivity may affect 18 million people.

“Gluten sensitivity is the new kid on the block when it comes to gluten-related diseases,” said Alessio Fasano, MD, director of the Center for Celiac Research at MassGeneral Hospital for Children. “The only way to determine if someone has it is if you rule out celiac disease and a wheat allergy.”

Talk to your doctor if you’re worried that gluten may be making you sick. Once celiac disease and other possible conditions are ruled out, you can work with your doctor or a dietitian to identify your level of gluten sensitivity.

“With celiac disease even eating a crumb of bread could have long term effects,” Fasano said. “But for someone with gluten sensitivity, depending on how sensitive they are to gluten, they could eat a piece of pizza and may not feel anything or recover quickly.”

Gluten sensitivity is best measured by going on a gluten-free diet for a couple of weeks and then gradually reintroducing healthy, gluten-containing foods like whole grains.

High-fiber, low-sugar eating that’s gluten free isn’t difficult if you focus on filling up with the kind of fresh whole foods known to help manage weight and reduce risk for chronic disease.

Remember that avoiding gluten is not an excuse to load up on gluten-free breads, cookies and cakes. Gluten-free or not, unhealthy high-glycemic foods can lead to weight gain and increase your risk for metabolic complications, such as heart disease and type 2 diabetes.

Here’s how Agatston describes a typical day on a whole-food, gluten-free diet:

  • Breakfast: A veggie omelet
  • Mid-morning snack: A low-fat mozzarella cheese stick with cherry tomatoes
  • Lunch: A tuna salad with romaine
  • Afternoon snack: Whole almonds
  • Dinner: Grilled salmon with roasted cauliflower and grilled asparagus

Chest Pain from Bread: Doctor Explains Why and Solutions

That heavy, uncomfortable feeling in your chest when you eat bread—a unique chest pain that no other food causes.

What truly is going on here?

How can bread cause chest pain
in the first place?

“Bread itself is not the cause of chest pain,” says Stacy Mitchell Doyle, MD, resident physician of FoodTherapyMD and long-time advocate of plant-based nutritional protocols.

So right off the bat, you’ll want to eliminate any ingredients as a culprit.

Dr. Doyle explains, “It is that mechanically, it is being poorly digested and stuck at the junction of your stomach and esophagus.”

The esophagus (“food pipe”) is behind your sternum, so any irritation to it will cause pain in the chest area.

/Magic Mine

“Any food bolus can cause these symptoms,” says Dr. Doyle. “However, some foods may also be more likely to cause acid reflux, which results in irritation and spasming of the esophagus.

“These are spicy foods, alcohol, tomatoes and peppermint. This spasming causes chest pain, which can be indistinguishable from the chest pain caused by the heart.

“The solution is to eat small bites, eat slowly and chew your food well.”

And insert sips of water to help smooth out the process.

The esophagus is a muscle, actually, so it’s capable of going into spasms, just like skeletal muscle is.

And you may already know just how painful a skeletal muscle spasm is.

Ever get a calf cramp in the middle of the night? How about a toe cramp? The pain is horrendous though very transient.

If you still continue to suffer chest pain from eating bread, you may want to cut back on bread and replace it with something that’s more health-giving to the body, such as brown, wild or basmati rice; barley; or lentils.

FoodTherapyMD™ is the brainchild of Dr. Mitchell Doyle and recognizes that phytonutrients, the substances that make plant food so amazing, can be tailored to fight specific disease states. To learn more please visit her LinkedIn page: linkedin.com/in/stacy-mitchell-doyle-m-d-ab6745146/
Top image: /fizkes

Is My Chest Pain Heartburn, or Is It Something More Serious?

Chest pain that doesn’t subside is frightening — but it doesn’t necessarily mean you’re having a heart attack. Here’s what else it could indicate.

Unexplained chest pain is common, and it’s sometimes hard to discern between heartburn, high blood pressure and a heart attack. Here are a few questions that can help you decide whether your symptoms mean you should see a doctor.

Do your symptoms appear after eating?

If you have overindulged or eaten greasy or spicy foods, you may experience a scorching feeling in your chest. This could be heartburn, which is a symptom of acid reflux and is caused by GERD, or gastroesophageal reflux disease.

“30%-40% of patients presenting to ER with chest pain have chest pain due to acid reflux, or GERD,” says Caitlin Houghton, MD, a general surgeon at Keck Medicine of USC and assistant professor of clinical surgery at the Keck School of Medicine of USC. Although, “heartburn can be due to heart problems and should be checked by an ER or local doctor,” she adds.

Call for an Appointment
(800) USC-CARE (800-872-2273)

Is your pain accompanied by a runny nose, coughing, sore throat and fever?

Acute bronchitis can make your chest ache, a pain that worsens if you have a hacking cough. The condition occurs when your bronchial tubes become inflamed. Mucus builds up, leading to shortness of breath and feeling like you have a cold.

Your doctor may prescribe anti-inflammatory drugs and ask you to rest and drink plenty of liquids to thin the mucus and keep your bronchial tubes lubricated. If symptoms continue longer than 10 days, consider getting a chest X-ray to determine whether your condition has turned into pneumonia or if there is another culprit causing your pain.

Do you have a rapid heart rate, fever, fatigue or trouble breathing?

Myocarditis is an inflammation of the heart muscle that produces symptoms resembling a heart attack. If you have these symptoms, seek medical help immediately.

Do you feel pressure in your chest and discomfort in your shoulders, arms, neck, jaw or back? Do you feel like you have indigestion?

Angina signals an underlying heart condition that can lead to a heart attack. Stable angina is triggered by emotional stress, smoking, heavy meals and extreme variances in temperature, all of which cause your heart to work harder.

This type of angina is episodic but controllable. Your doctor will prescribe rest and nitroglycerin to manage the condition.

Unstable angina is characterized by sudden chest pain or worsening or persistent chest discomfort that occurs during sleep or reduced physical activity. It is caused by a reduction in blood flow to the heart. This is a serious health issue that requires immediate medical attention.

Are you experiencing shortness of breath, nausea, arm pain, fatigue, profuse sweating or pale and clammy skin?

If you experience these symptoms for longer than five minutes and have no explanation for them, call 911. You could be having a heart attack.

The best way to thwart this “silent killer?” Tune in to your body and learn how to determine whether your chest pain is the result of overuse, poor diet and other habits — or whether it’s something more serious.

“Sometimes people are concerned about unexplained symptoms but may delay seeking attention, and that can be a big mistake,” says Luanda Grazette, MD, associate professor of clinical medicine at the Keck School of Medicine of USC and a cardiologist at Keck Medicine of USC. “It is never too early to be evaluated for heart disease, but, unfortunately, you can wait too late.”

by Heidi Tyline King

Concerned that you have a heart condition? Schedule an appointment with a cardiologist at Keck Medicine of USC to assess your risk for heart attack or stroke. If you are in the Los Angeles area and are looking for a cardiologist, make an appointment by calling (800) USC-CARE (800-872-2273) or by visiting https://cvti.keckmedicine.org/request-an-appointment/.

Gluten Free UAE

Celiac Disease / Gluten intolerance / Wheat allergy

Despite how widespread the gluten free diet has become nowadays, there is still a great deal of confusion about why people avoid gluten.

There are those who avoid it as a lifestyle choice, because they hope it may help them lose weight or maintain a healthier diet. But then there are those who suffer from celiac disease, gluten intolerance or a wheat allergy. For some, there may appear to be no difference between the three, however if you look closely, the fact one is a disease, one an intolerance and one an allergy is a significant clue the three are vastly different from each other.
Going back to basics, it is probably best to briefly explain the question that many people who have to avoid gluten frequently get asked – “What is Gluten?”

Put simply, gluten is a protein composite which is found in food that has been processed from grains such as wheat, barley and rye. The word ‘gluten’ gives a clue as to its function in that it acts like glue and helps stick food together. For example, in bread, gluten helps the dough rise, helps to keep its shape and impacts on the texture of food. This means people who are avoiding gluten in their diets must avoid wheat, barley and rye. There is also a great deal of debate about whether those on a gluten free diet should be avoiding oats. Oats are naturally gluten free however due to cross contamination with gluten-containing grains when the oats are growing or during harvest, those on a gluten free diet are often recommended to avoid oats.

So, what is the difference between celiac disease, gluten intolerance and wheat allergy?

Celiac disease is an autoimmune disorder which damages the small intestine and interrupts the absorption of nutrients from food. When those who suffer from celiac disease consume gluten, their immune system responds by attacking the small intestine, damaging the villi in their intestines and causing malabsorption. Celiac disease is now known as a common genetic disorder and therefore parents with celiac disease should be wary when feeding their children gluten-containing products.Those with celiac disease should avoid subspecies of wheat such as spelt, semolina and durum as well as barley, rye, triticale and kamut. Diagnosing celiac disease can be quite difficult. Generally it is diagnosed via a blood test, however this is not particularly accurate, and many celiac come up as ‘negative’. The only way to accurately diagnose celiac disease is through a biopsy, and even then numerous biopsies can be required before a correct diagnosis is made.

Gluten intolerance is also known as gluten sensitivity. Those with gluten intolerance suffer similar symptoms to people with Celiac Disease.
There are over 250 documented symptoms of celiac disease and gluten intolerance. The symptoms are extremely varied and affect people differently.
These include but are not limited to, abdominal pain and bloating, weight loss, anemia, vomiting, diarrhoea, constipation and fatigue, abdominal distension, , hair loss, bone density loss, dermatitis herpetiformis (skin rash), joint pain and nausea to name a few.
Gluten intolerance has a slower onset than celiac disease making it difficult to diagnose due to its vast range of symptoms. While celiac disease is typically diagnosed via a blood test and biopsy, a gluten intolerance will come up negative, therefore the only way of diagnosing a gluten intolerance is through a successful gluten free diet.

While celiac disease and gluten intolerance share more similarities, wheat allergy stands out on its own. An allergy to wheat is an allergic reaction to food containing wheat productions such as breads, cakes, cereals, biscuits, beer and soy sauce. Wheat allergies are more common in children and many will grow out of their symptoms as they reach adulthood. There are, however, still a number of adults struggling with a wheat allergy.
The allergic reaction to wheat is generally limited to the seed storage proteins of wheat. Some with wheat allergies may react to wheat proteins and others may react to certain varieties of seeds and plant tissues.

Many of the symptoms of a wheat allergy are similar to the symptoms of celiac disease and gluten intolerance, however they can also include chest pains, depression, dizziness, palpitations, runny nose, cough and swollen throat or tongue. A wheat allergy can also affect the respiratory tract system causing asthma-like symptoms. This means for a few unlucky wheat allergy sufferers, the consumption of, or inhalation of wheaten products can cause life threatening anaphylaxis.

The primary treatment for wheat allergy is to avoid wheat products yet some will require medication to manage allergic reactions for those times when they accidentally consume wheat. Those with a wheat allergy typically don’t need to avoid other gluten-containing grains such as rye and barley.
This does not mean, however, that those with celiac disease or gluten intolerance should be taken any less seriously when dealing with possible gluten-containing food products. All too often, those who suffer from celiac disease or gluten intolerance feel as though they’re forced to claim they have a gluten or wheat allergy in order to ensure their meal is gluten free. It seems in many cases, unless a restaurant believe someone’s life may be at risk, they will not take the request for a gluten free meal seriously. I must say though, this is not true of all restaurants. There are some that will take special care in ensuring a gluten free meal is completely gluten free.

Regardless of whether you have a wheat allergy, gluten intolerance or celiac disease, following a wheat or gluten free diet is never easy. It’s more time consuming (researching restaurants that are safe to eat at), more expensive (the price of a gluten free loaf of bread is enough to break the bank) and makes life that much more difficult. Yet we don’t necessarily have a choice. Unless we want to suffer the symptoms it is just one of those things that have to be done. On the upside, we’re a lot more aware of what we put in our mouths and eat much less processed foods, simply because we have to. If you’re just discovering you have to embark on a life without gluten, don’t stress. It’s not the end of the world and once you know what to avoid and what is ‘safe’, it gets much easier. To those who run a food outlet, whether it be a supermarket, a cafe or a restaurant – be careful with your claims of what is and isn’t gluten free. If someone wants a gluten free meal, they genuinely may require it, and not just be following the latest Hollywood fad. Don’t just take a guess as to whether a food item is gluten free or not – know your menu and be confident in providing safe gluten free foods for those who need it.

Now, all we need is a decent gluten free raspberry bun and i’ll be set!

-by Samantha

A big thank you to Samantha for writing this article for us. You can find more from Samantha on her blog here: http://foodshake.wordpress.com/

What are the first signs of gluten intolerance?

Many of these symptoms occur shortly after consuming gluten. However, the exact combination of symptoms can vary.

People who report gluten intolerance note the following symptoms as some of the most commonly occurring ones when they include glutenous foods in their usual diet.

1. Diarrhea and constipation

Share on PinterestSymptoms of gluten intolerance may include constipation, fatigue, headaches, and nausea.

Those who report gluten intolerance say regular instances of diarrhea and constipation are a common symptom.

Occasionally having such digestive issues is normal, but experiencing them on most days can indicate an underlying condition.

People with celiac disease may also experience diarrhea and constipation. They may also have poop that smells particularly unpleasant, as the condition causes poor nutrient absorption.

2. Bloating

Another very common symptom that people report in cases of gluten intolerance is bloating. This refers to the feeling of a full stomach that is uncomfortable and lasting. It is common also to feel a buildup of gas.

Over-eating is the most common reason for bloating, but it can happen for a number of different reasons. In people with gluten intolerance, the feeling of bloating may occur very regularly and is not necessarily related to the amount of food they eat.

3. Abdominal pain

Similarly, several different causes can lead to abdominal pain. But, again, those reporting gluten intolerance often note experiencing abdominal pain frequently and without another obvious reason.

4. Fatigue

Fatigue is another symptom that people may find hard to identify, as it can have a lot of different causes, many of which are not related to any medical condition.

People with gluten intolerance may have persistent feelings of tiredness that impair daily functioning.

5. Nausea

People with gluten intolerance may also experience nausea, particularly after consuming a meal containing gluten. Nausea can have many causes, but if it often occurs after eating gluten it can be a sign of gluten intolerance.

6. Headaches

Experiencing regular headaches is another symptom that can occur in people with gluten intolerance.

7. Other symptoms

People with gluten intolerance may experience several of these symptoms on a regular basis.

It is also possible for other symptoms to occur with gluten intolerance, although they are less common.

These may include:

  • joint and muscle pain
  • depression or anxiety
  • confusion
  • severe abdominal pain
  • anemia

Low-gluten diet linked to heart attack risk

“Gluten-free diet can do more harm than good for people without coeliac disease,” The Independent reports, as a new study found that the “trendy gluten-free diets loved by Gwyneth Paltrow and Russell Crowe may increase the risk of heart disease”.

Gluten is a protein found in grains such as wheat, barley and rye. In people with coeliac disease, it damages the intestines and triggers digestive symptoms such as diarrhoea, meaning they need to follow a gluten-free diet.

Recently there has been increasing interest in the possible health benefits of avoiding gluten among people who do not have coeliac disease, though the long term evidence about its effects in this group is currently limited. Despite this, the gluten-free food market is reported to have made $3.5bn worth of global sales in 2016.

The current study followed more than 100,000 people from 1986 to 2012, assessing their diets and whether they had heart attacks during that time. These people did not have heart disease at the start of the study, and importantly did not have coeliac disease.

Overall, it found that once other risk factors were taken into account, people’s consumption of gluten was not related to their risk of heart attack. However, further analyses suggested that lower consumption of gluten specifically from whole grains (wheat, barley and rye) was associated with increased heart attack risk compared to higher consumption from these sources.

Ideally these findings would be confirmed by other studies, but this research will take time. In the meantime, if you don’t need to avoid gluten for medical reasons, this study suggests it may be beneficial to continue including whole grains in your diet for their cardiovascular benefits.

Where did the story come from?

The study was carried out by researchers from Columbia University in New York, and Massachusetts General Hospital, Harvard Medical School, Brigham and Women’s Hospital, and the Harvard T. H. Chan School of Public Health in Boston. The authors were funded by grants from the American Gastroenterological Association, Massachusetts General Hospital and the National Institutes of Health.

The study was published in the peer-reviewed British Medical Journal on an open access basis so it is free to read online.

The UK media provided reasonable coverage of the study. As you would expect, most of the otherwise academic reporting was given a touch of glamour by listing celebrities associated with gluten-free dieting.

What kind of research was this?

This was a prospective cohort study looking at whether how much gluten a person eats is linked to their risk of developing heart disease over a long period of time.

Gluten is a protein found in wheat, rye, and barley. It causes inflammation and damage to the intestines in people with coeliac disease. People with coeliac disease have an increased risk of heart disease, but eating a gluten-free diet helps to reduce this risk, as well as symptoms.

Eating a gluten free diet has become increasingly popular among people who do not have coeliac disease as a result of concerns that gluten may cause various digestive and other health problems. However, the impact a low gluten diet may have on risk of heart disease in people who do not have coeliac disease has not been studied in long term prospective studies. This is what the current study wanted to assess.

While a randomised controlled trial is generally the best way to test whether a particular factor causes a specific outcome, it would not be feasible to randomly allocate thousands of people to eat gluten or not for a long period of time. Therefore, a large cohort study such as this is the best way to look at this question.

The main challenge with this study type is to try and single out the effect of gluten as opposed to any other factor. Researchers do this by using statistical techniques to try and “remove” the impact of these other factors (known as confounders).

What did the research involve?

The researchers analysed data from two very large cohort studies in the US called the Nurses’ Health Study and the Health Professionals Follow-up Study.

The 110,017 participants without coeliac disease who did not have heart disease in 1986 filled out detailed questionnaires about their diet at the start of the study and every four years after that, up to 2010. The researchers followed them up to see who developed heart disease over this period, and whether different levels of gluten consumption affected the likelihood of developing the condition.

The standard diet questionnaire included more than 130 questions about how often a person consumed specified portions of certain foods and drinks. The researchers used the participants’ responses to estimate how much gluten they were consuming on average over the study period using a database of nutritional contents of the foods and drinks.

They included gluten from wheat, rye and barley, but did not include the small amounts of gluten which are present in oats or condiments such as soy sauce as they felt these would be negligible. People were then split into five groups with increasing levels of gluten consumption for comparison.

Because people might change their diet as a result of illness, for people who developed diabetes, cancer, or certain heart disease events such as stroke or had surgery to treat heart disease, the researchers only considered their diet before they developed these conditions.

Participants filled out questionnaires about their health every two years, and if they reported having a heart attack their medical records were checked.

Deaths from heart attack were identified from state and national records, or reports from next of kin. Medical and post-mortem records and death certificates were also checked for these individuals. If these record checks confirmed the reported diagnosis, these people were considered as having developed heart disease.

The researchers analysed whether participants who consumed more gluten were any more or less likely to develop heart disease. They took into account many potential confounders that could be related to heart disease risk, including:

  • age
  • race
  • body mass index
  • history of diabetes, high blood pressure or high cholesterol
  • regular use of aspirin and non-steroidal anti-inflammatory drugs
  • current use of statins
  • current use of a multivitamin
  • smoking history
  • physical activity
  • parental history of heart attack
  • menopausal status and menopausal hormone use
  • other dietary factors such as alcohol, red and processed meats, polyunsaturated and trans fats, and fruit and vegetables

In addition, the researchers also looked at what happened if they took into account consumption of whole and refined grains, as these contain gluten, and have been linked to level of heart disease risk.

What were the basic results?

The mean daily intake of gluten at the start of the study was:

  • 7.5g among women and 10.0g among men in the highest consumption group
  • 2.6g among women and 3.3g among men in the lowest consumption group

People with higher gluten intake tended to have:

  • lower alcohol intake
  • smoke less
  • consume less fat overall
  • eat less unprocessed red meat
  • consume more whole grains and refined grains

During the study 6,529 participants (5.9%) experienced a heart attack.

Before taking into account potential confounders, heart attacks were more common in the group with the lowest gluten consumption than in those with the highest consumption.

However, after taking into account known risk factors for heart disease, the difference between the groups was not statistically significant.

When the researchers looked at the impact of consumption of gluten from just refined grains they also found the difference between groups was not statistically significant.

But when they considered the impact of consumption of gluten in whole grains – they found those with highest gluten consumption were 15% less likely to develop heart attacks over follow up (hazard ratio 0.85, 95% confidence interval 0.77 to 0.93).

How did the researchers interpret the results?

The researchers concluded that differences in long term dietary intake of gluten were not associated with risk of heart disease. However, their results suggested that avoiding gluten may reduce consumption of whole grains, and this may lead to increased risk of heart disease.

They recommended that “promotion of gluten-free diets among people without disease should not be encouraged”.

Conclusion

This study has found that while overall gluten consumption in people without coeliac disease may not be related to heart disease risk, avoiding whole grains (wheat, barley and rye) in order to avoid gluten may be associated with increased heart disease risk.

This study has several strengths, including its large size, the fact that data was collected prospectively and diet assessed at several time-points, the long period of follow up, and that it took into account a wide range of potential confounders.

As with all studies of this type, it is possible that other factors may affect the results. However, the researchers took into account as many potential confounding factors as they could in their analyses. This increases confidence in the results, but it is still possible that these or other unmeasured confounding factors are having an effect.

The researchers noted that they did not specifically ask participants whether they were intentionally following a “gluten free” diet or consumption of gluten-free substitute foods.

It is important to emphasise that this study was only in people who did not have coeliac disease. People with coeliac disease need to eat a gluten free diet to control their symptoms, and it is thought that this diet may actually contribute to the reduction in risk of heart disease seen after diagnosis in this group. So people eating a gluten free diet for this purpose should not be concerned by the findings in this study.

The study collected data from 1986 to 2012. Diets over this period have changed, and avoidance of gluten is likely to be more common nowadays. It would be interesting to repeat the study now to see if the same results are found. While it would be good to have these findings confirmed by other studies, carrying out similarly large scale and long term research will take time.

Ideally, if you don’t need to avoid gluten for medical reasons, then this study suggests it may be beneficial to continue including whole grains in your diet for their cardiovascular benefits.

Find out more about common digestive problems, such as bloating and heartburn, and how to treat them.

Analysis by Bazian
Edited by NHS Website

Links to the headlines

Gluten-free diet can do more harm than good for people without coeliac disease, scientists say

The Independent, 3 May 2017

Eating a gluten free diet when you’re not coeliac could damage your health

Daily Mirror, 3 May 2017

Sorry, Gwynnie, gluten-free is not so great: People who avoid grains increase the risk of developing heart disease

Daily Mail, 3 May 2017

Gluten-free diet should not be eaten by people who are not coeliac, say scientists

The Daily Telegraph, 2 May 2017

Links to the science

Lebwohl B, Cao Y, Zong G, et al.

Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study

BMJ. Published online May 2 2017

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