Blood Disorders and Celiac Disease EP070
05/04/18 • 21 min
If you are being treated for a blood disorder, it is time to look deeper and explore the underlying cause. Rather than simply addressing iron- or B12-deficiency anemia in isolation, ask WHY you have a deficiency in the first place. It is possible that damage to your intestines caused by gluten is preventing your body from absorbing the nutrients necessary to grow your red blood cells and keep your immune system healthy. And anemia is not the only blood disorder associated with celiac disease and non-celiac gluten sensitivity!
The Gluten Free RN is taking a closer look at the hematologic manifestations of celiac disease from anemia to hyposplenism. She explains the connection between disorders of the blood and bones, offering insight around why men with both anemia and osteoporosis are also likely to have celiac disease.
Nadine discusses the danger in taking H2 blockers or proton pump inhibitors for GERD long-term, describing how those medications decrease the gastric acid necessary for breaking down food. She also addresses what you can do to identify any nutritional deficiencies in your blood and reminds us why celiac patients have difficulty absorbing the nutrients necessary to form red blood cells. Listen in to understand how the skin reflects what’s happening internally and learn how to prevent a number of blood disorders with a gluten-free diet!
What’s Discussed:The hematologic manifestations of celiac disease
- Anemia secondary to malabsorption of iron, folate and vitamin B12
- Thrombocytosis, thrombocytopenia, leukopenia, venous thromboembolism
- Hyposplenism, IgA deficiency and increased risk of lymphoma
Why iron supplements didn’t solve Nadine’s anemia
- Couldn’t absorb supplements due to undiagnosed celiac disease
The connection between anemia, osteoporosis and celiac disease
- B12 forms red blood cells made in long bones
The danger of taking H2 blockers and PPIs long-term
- Decreases levels of gastric acid necessary to liquify food
- Leads to bacterial overgrowth, gastritis
How to uncover potential nutrient deficiencies in your blood
- CBC with differential (breakdown of red blood cells)
The conclusions of the 2007 study in Blood
- Anemia and hyposplenism are most common complications of celiac disease
- Obtain small-bowel biopsy in all patients with iron-deficiency anemia
The fat-soluble vitamins
- A, D, E and K
- Deficiency in one indicates malabsorption, potential celiac disease
The connection between DH and celiac disease
- Skin disorders begin in intestines
‘Hematologic Manifestations of Celiac Disease’ in Blood
Celiac Disease and Your Spleen
Dr. Ben Lynch: Folic Acid vs. Folate
‘The Thrombophilic Network of Autoantibodies in Celiac Disease’ in BMC Medicine
‘Hematologic Manifestations of Celiac Disease’ in Celiac Disease— From Pathophysiology to Advanced Therapies
‘Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: A Rare Association’ in Balkan Medical Journal
‘Celiac Disease Manifesting with Deep Venous Thrombosis: A Case Report’ in Govaresh
‘How Often Do Hematologists Consider Celiac Disease in Iron-Deficiency Anemia?’ in Clinical Advances in Hematology & Oncology
If you are being treated for a blood disorder, it is time to look deeper and explore the underlying cause. Rather than simply addressing iron- or B12-deficiency anemia in isolation, ask WHY you have a deficiency in the first place. It is possible that damage to your intestines caused by gluten is preventing your body from absorbing the nutrients necessary to grow your red blood cells and keep your immune system healthy. And anemia is not the only blood disorder associated with celiac disease and non-celiac gluten sensitivity!
The Gluten Free RN is taking a closer look at the hematologic manifestations of celiac disease from anemia to hyposplenism. She explains the connection between disorders of the blood and bones, offering insight around why men with both anemia and osteoporosis are also likely to have celiac disease.
Nadine discusses the danger in taking H2 blockers or proton pump inhibitors for GERD long-term, describing how those medications decrease the gastric acid necessary for breaking down food. She also addresses what you can do to identify any nutritional deficiencies in your blood and reminds us why celiac patients have difficulty absorbing the nutrients necessary to form red blood cells. Listen in to understand how the skin reflects what’s happening internally and learn how to prevent a number of blood disorders with a gluten-free diet!
What’s Discussed:The hematologic manifestations of celiac disease
- Anemia secondary to malabsorption of iron, folate and vitamin B12
- Thrombocytosis, thrombocytopenia, leukopenia, venous thromboembolism
- Hyposplenism, IgA deficiency and increased risk of lymphoma
Why iron supplements didn’t solve Nadine’s anemia
- Couldn’t absorb supplements due to undiagnosed celiac disease
The connection between anemia, osteoporosis and celiac disease
- B12 forms red blood cells made in long bones
The danger of taking H2 blockers and PPIs long-term
- Decreases levels of gastric acid necessary to liquify food
- Leads to bacterial overgrowth, gastritis
How to uncover potential nutrient deficiencies in your blood
- CBC with differential (breakdown of red blood cells)
The conclusions of the 2007 study in Blood
- Anemia and hyposplenism are most common complications of celiac disease
- Obtain small-bowel biopsy in all patients with iron-deficiency anemia
The fat-soluble vitamins
- A, D, E and K
- Deficiency in one indicates malabsorption, potential celiac disease
The connection between DH and celiac disease
- Skin disorders begin in intestines
‘Hematologic Manifestations of Celiac Disease’ in Blood
Celiac Disease and Your Spleen
Dr. Ben Lynch: Folic Acid vs. Folate
‘The Thrombophilic Network of Autoantibodies in Celiac Disease’ in BMC Medicine
‘Hematologic Manifestations of Celiac Disease’ in Celiac Disease— From Pathophysiology to Advanced Therapies
‘Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: A Rare Association’ in Balkan Medical Journal
‘Celiac Disease Manifesting with Deep Venous Thrombosis: A Case Report’ in Govaresh
‘How Often Do Hematologists Consider Celiac Disease in Iron-Deficiency Anemia?’ in Clinical Advances in Hematology & Oncology
Previous Episode
Eosinophilic Esophagitis and Celiac Disease EP069
Your gastrointestinal tract is approximately 30 feet long, and it runs from your mouth all the way to the anus! We know that celiac disease can impact any part of the digestive tract. But there is another disease that wreaks havoc on the GI tract as well, a condition called eosinophilic esophagitis or EoE.
The Gluten Free RN is explaining the fundamentals of eosinophilic esophagitis, from its characteristic inflammation of the esophagus and elevated eosinophils in the blood to the common symptoms of vomiting and upper abdominal pain. She walks us through the treatment for EoE, an elimination diet or steroid therapy.
Nadine speaks to the research exploring a possible connection between eosinophilic esophagitis and celiac disease, citing a paper that found a higher prevalence of EoE in children with celiac disease than the general population as well as the case study of a woman with both celiac disease and elevated eosinophils in her blood. Listen in for the Gluten Free RN’s insight on the best EoE clinics and physicians in the country and learn why further study is needed around EoE and celiac disease!
What’s Discussed:The fundamentals of eosinophilic esophagitis
- Allergic response to dietary antigens
- Causes inflammation of esophagus, increased eosinophils in blood
The benefits of unsedated transnasal endoscopy for children with EoE
- Monitors esophageal mucosa without sedation
- Safer, faster and less costly
Some common symptoms of eosinophilic esophagitis
- Vomiting, difficulty swallowing, food stuck in throat
- Chest pain, heartburn, upper abdominal pain
The condition of achalasia
- Muscles of esophagus don’t work appropriately
- Causes spasms or constriction
The treatment for EoE
- Elimination diet (remove wheat, eggs, milk, soy, shellfish and seafood, peanuts and tree nuts)
- Topical or systemic steroids
The potential increased prevalence of EoE in children with celiac disease
- 2015 paper found prevalence of 10.7% (much higher than general population)
- Other research articles argue no increased prevalence of EoE in CD
The case study of a 30-year-old woman with celiac disease and elevated eosinophils
- Presented with abdominal pain and distension, vomiting and frequent bowel movement
- Treated with IV hydrocortisone, but developed steroid induced psychosis
Nadine’s insight on the best specialty clinics for EoE in the US
- University of Colorado (Denver School of Medicine)
- Pennsylvania
Dr. Glenn Furuta’s insight on the difficulty of diagnosing EoE
- Relatively new disease, tendency to diagnose based on pathology report alone
- Elevated eosinophils also found in GERD, inflammatory bowel disease and celiac disease
Special considerations for pediatric patients with EoE
- Consultation with dietician
- Limited exposure to corticosteroids
- Attention to development of feeding skills
- Potential psychosocial, behavioral problems
‘Unsedated Transnasal Esophagoscopy for Monitoring Therapy in Pediatric Eosinophilic Esophagitis’ in Gastrointestinal Endoscopy
‘Eosinophilic Esophagitis Associated with Celiac Disease in Children’ in BMC Research Notes
‘Eosinophilic Gastrointestinal Disorder in Coeliac Disease: A Case Report and Review’ in Case Reports in Gastrointestinal Medicine
‘Eosinophilic Esophagitis in Children and Adults’ in Gastroenterology and Hepatology
‘The Association Between Celiac Disease and Eosinophilic Esophagitis in Children and Adults’ in BMC Gastroenterology
‘Eosinophils in Gastrointestinal Disorders’ in Immunology and Allergy Clinics of North America
‘2013 Update on Celiac Disease and Eosinophilic Esophagitis’<...
Next Episode
Celiac Disease & Why No One Should Have Belly Pain EP071
Approximately 50% of ER visits are associated with abdominal pain, and the vast majority of those patients are given a diagnosis of ‘abdominal pain of an unknown origin’ and directed to come back if the condition gets worse. This is little comfort to people suffering from severe discomfort who need answers around the cause of their belly pain, not just medication to mask it temporarily. Could undiagnosed celiac disease be the source of their suffering?
Today, the Gluten Free RN is diving into the issue of belly pain and undiagnosed celiac disease, discussing the expensive testing often conducted to determine the cause of abdominal discomfort—testing that rarely includes a celiac panel. She covers several of the common misdiagnoses of celiac patients as well as the incredibly high prevalence of abdominal pain in children.
Nadine shares the case study of a child-patient who was misdiagnosed with appendicitis and the research published in Digestive and Liver Disease outlining the unnecessary surgical interventions endured by undiagnosed celiac patients. Listen in for the Gluten Free RN’s advice to patients with idiopathic abdominal discomfort and learn why no one should suffer from belly pain!
What’s Discussed:The statistics around ER visits and abdominal pain
- 50% of visits associated with belly pain
The most common abdominal pain diagnoses
- Abdominal pain of unknown ideology, idiopathic abdominal pain
How patients are treated for idiopathic abdominal pain
- Medication, directive to return if condition gets worse
The testing to find the cause of chronic abdominal pain
- Expensive blood workups, rarely include celiac panel
How many children suffer from belly pain
- 30% report abdominal discomfort
Nadine’s patient who received a misdiagnosis of appendicitis
- Mother of child-patient sought second opinion prior to surgery
- Child didn’t have appendicitis, cause of pain still unknown
A research study around abdominal surgery and celiac disease
- Patients with celiac disease at increased risk of abdominal surgery
- Misdiagnosis leads to inappropriate interventions (i.e.: appendectomy)
Nadine’s advice for patients diagnosed with idiopathic abdominal pain
- Initiate clinical trail of gluten-free or Paleo diet
‘Increased Rate of Abdominal Surgery Both Before and After Diagnosis of Celiac Disease’ in Digestive and Liver Disease
‘Screening for Celiac Disease in Children with Recurrent Abdominal Pain’ in the Journal of Pediatric Gastroenterology and Nutrition
‘Effect of a Gluten-Free Diet on Gastrointestinal Symptoms in Celiac Disease’ in the American Journal of Clinical Nutrition
‘Clinical Features and Symptom Recovery on a Gluten-Free Diet in Canadian Adults with Celiac Disease’ in the Canadian Journal of Gastroenterology
‘Association of Adult Celiac Disease with Surgical Abdominal Pain’ in Annals of Surgery
‘A New Insight into Non-Specific Abdominal Pain’ in The Annals of The Royal College of Surgeons of England
Connect with Nadine:‘Your Skin on Gluten’ on YouTube
Melodies of the Danube Gluten-Free Cruise with Nadine
Books by Nadine:Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Heal
If you like this episode you’ll love
Episode Comments
Generate a badge
Get a badge for your website that links back to this episode
<a href="https://goodpods.com/podcasts/gluten-free-rn-70324/blood-disorders-and-celiac-disease-ep070-3716131"> <img src="https://storage.googleapis.com/goodpods-images-bucket/badges/generic-badge-1.svg" alt="listen to blood disorders and celiac disease ep070 on goodpods" style="width: 225px" /> </a>
Copy