We jumped in the car at 9am on Thursday morning and
travelled by way of Calgary, Banff, Golden, Sicamouse, Vernon and then Kelowna.
It was a beautiful drive despite the snow (!!!!) and we arrived safe and sound
at about 7pm BC time (an 11 hour jaunt). Our house was perfect for us – a beautiful
2 bedroom house in West Kelowna that overlooked vineyards and Lake Okanogan.
On Saturday morning I arrived bright and early (7:30am!) at
the conference. I only knew a couple of people there so right away this was something
that was way outside of my comfort zone. We were welcomed by the CCA and by
Kelowna’s MP, Ron Cannan (who I should add showed up late, so the first speaker had started
to speak, then they interrupted her so that the MP could welcome us – and he
didn’t even apologize!!!! Good thing I can’t vote there!).
The first speaker was Dr. Sheila Crowe. Dr. Crowe has an
extensive expertise in Celiac Disease and works at the University of California
in San Diego. She was an extremely good speaker and I learned a lot. Here’s a
summary of some of the key things I learned.
·
The main test for Celiac Disease (CD) is still
tTg IgA, though in young children they will sometimes use the AGA version
because it’s more accurate.
·
The biopsy is still the gold standard. This may
become more important as time goes on – there are a number of drug trials
currently underway and these drugs will be extremely expensive. If there is any
hope of having them covered, a proven biopsy will likely be needed.
·
At least 4 biopsies should be taken and at least
one of them should be from the duodenal bulb. This seems to be the most
accurate way of testing and if CD is present, the duodenal bulb almost always
shows it.
·
There are 2 genes known to be part of CD – HLA DQ2
and HLA DQ8. One of these needs to be present in order for someone to have CD.
These genes are neither dominant nor recessive – they are just passed down by
chance.
·
Having the gene does NOT guarantee active CD.
Someone with the gene should be tested every few years even if symptoms are not
present because of “silent Celiac” or asymptomatic Celiac.
Dr. Crowe spoke about how far we’ve come in research in the
last ten years and I can certainly attest to that! I was diagnosed 3.5 years
ago and I can see even how far the research and availability of products has
come in the few short years. See her whole talk in pdf here.
Our second speaker was Dr. Mohsin Rashid. Dr. Rashid is a
pediatric gastroenterologist out of Halifax. He was really interesting in terms
of how he got involved in Celiac Disease research. First, he learned about it
(albeit not very much) in med school. Then his daughter (who also had Type 1
Diabetes) got diagnosed with CD. Then his niece in Pakistan was diagnosed. He
was then invited to be a member of the Professional Advisory Board of the CCA
and it’s been Celiac ever since!
Dr. Rashid’s talk was all about “Celiac Without Borders” –
it was a fascinating talk about Celiac Disease primarily in Pakistan. He spoke
about the Gluten Free Diet being the prescribed therapy around the world, but
that there is a serious lack of availability in many places. Pakistan for
instance, has a predominantly wheat based diet. They have so many other health
concerns (Hepatitis B and C being one), that Celiac Disease isn’t even on their
radar and yet millions of people suffer from it.
CD is very social restrictive, especially for children, and
in Pakistan this is even more so the case. The Gluten Free Diet (GFD) is also
very costly – to put it into perspective, one dollar will buy 40 pitas in
Pakistan, but will only buy 2 plates of rice. When you are faced with feeding
your family, this is extremely expensive!
Ultimately, we are one community – it is the same disease,
we all have the same problems, and it doesn’t matter where in the world you
are.
Visit the Celiac Support Group in Pakistan for some great
information as well as GF recipes! www.celiac.com.pk. The website is available in both English and Urdu.
See Dr. Rashid's talk here.
Our third speaker was Dr. Hardy Lineback. I had the great
privilege of sitting with Dr. Lineback throughout the day. We spoke extensively
at lunch time about CD in general. Dr. Lineback doesn’t have any celiacs in his
family, and he is very new to the disease, but his curiosity was peaked! I could
literally feel him vibrating with excitement over learning about CD from both
personal and professional perspectives.
Dr. Lineback is a dentist out of Toronto. He was asked by
Dr. Rashid to work on a research piece about Dentistry and CD. Although his
talk was more technical than the others, it was extremely interesting.
·
Many patients with CD exhibit white spots or
striations on the teeth that looks exactly like fluorosis (fluoride
overconsumption)
·
Teeth enamel is 96% mineral and dentin is 70%
mineral
·
Bowel problems can erode the enamel of teeth
from gastric acid –whether by vomiting or by reflux up into the mouth.
·
Symmetrical lesions on the teeth indicate that
something is happening in the body, and isn’t local to the teeth.
·
There are more defective teeth in celiac groups.
·
Mouth ulcers/canker sores are symptoms of Celiac
Disease
·
Patients on the GFD have fewer cavities – there are
several hypothesis about this – one is that CD sufferers tend to be more
diligent about their diets, another is that CD patients associate high sugar
diets with feeling gross (given that many high sugar foods are also wheat
based) so they tend to stay away from them.
Overall, this means be in good contact with your dentist!
Watch for striations on your child’s teeth – front teeth are formed before
birth but molars are formed after. Adult teeth are formed between 1 and 3 years
of age so teeth can tell you a lot about what happened at certain times of
children’s lives.
Also, Sensodyne may have traces of Gluten. Use Crest or
Colgate instead.
See Dr. Hardy's talk here.
Our last speaker was Dr. Ian Blumer. He has authored 9 books, including Co-authoring Celiac for Dummies with Dr. Sheila Crowe. His talk was about
Autoimmune Associations with CD. Dr. Blumer was quite humorous which I think
was needed after a long day of talks. Dr. Blumer made it quite clear that these
Autoimmune Diseases don’t guarantee CD, and that if you have CD, you aren’t
guaranteed to have another disorder. However, you are more likely to have
another disease if you have CD. Diseases associated with CD are:
·
Dermatitis Herpetiformis affects up to 25% of people with
CD. It looks like small blisters on a rash but most of the time it presents
differently because it is so itchy that many people scratch until they bleed. A
biopsy should be taken if DH is suspected. The Gluten Free Diet will make
significant improvements and many people on the GFD report no symptoms of DH.
·
Vitiligo is likely autoimmune (think Michael
Jackson)
·
Psoriasis
·
Eczema – tends to affect creased areas more
·
Ataxia – being off balance – B12 can be the
culprit
·
Infertility – is associated with active CD
·
Miscarriage – also associate with active CD
·
Peripheral Neuropathy – damage to small nerves
in the feet and hands
·
Type 1 Diabetes
·
Thyroid Disease – both Grave’s Disease and
Hashimotos Thyroiditis
·
Elevated liver enzyme levels
One thing that was noted about Thyroid medication is that
this is one instance where the brand DOES matter. Do not use the generic brands
if you have been prescribed another type. Also, how you take it is important –
it needs to be taken first thing in the morning on an empty stomach.
Lastly, it was announced that Health Canada has pledged
$245,000 for Celiac Certification programs. A step in the right direction for
sure. The first Certified Gluten Free product by the CCA was also announced –
Lays Potato Chips by Pepsico.
While these are both amazing advances, I think they’re also
kind of sad. Celiac research money is hard to come by given that there are no
pharmaceuticals involved. The drug research that is being done is mostly for
those one-offs – when you’re going to a restaurant and want to avoid cross
contamination for instance, a drug may be coming that will stop the reaction,
but it’s not for every day use. The only prescribed therapy is the GFD and
unfortunately, that means not a lot of grant money.
Also, while I love that we are getting more Certified GF
foods and that the CCA and other organizations are working diligently to make
sure our food is safe, it saddens me that the first one certified by the CCA is
potato chips – complete junk. I feel that there is so much GF crap out there!
There are more companies trying to make healthier GF options, but walk down any
GF aisle and you will see copious amounts of junk food – just what our bodies
do NOT need!
Remember – many whole foods are inherently gluten free –
vegetables, fruits, meat. Put into your body what it NEEDS.