Prilosec, Nexium, Rolaids, Tums, Gas-X, Mylanta, Di-Gel, Pepto-Bismol - these are just a few of the medications people take for gas, reflux, heartburn and stomach aches. Ads for these drugs are plastered all over magazines and TV, making these common problems seem normal. “Burning stomach again? Take one of these!” One website I found claims that it is normal to pass gas up to 20 times a day!

In my opinion, people should not be led to believe that digestive problems are normal. I believe that they can be resolved with a change in diet and that the above medications may not be necessary at all for many people. I feel quite confident in saying this because of my and my family’s experiences, which I am about to share with you… (thanks mom and dad!)

I used to have gas. As embarrassing as that is for me to say, it is not as embarrassing as sitting in a shared office at work every day hoping my bloated belly wouldn’t give way. I can talk about this now because I used to have gas. Once on a gluten-free diet, no more bloating, no more stomach aches, no more gas. Seriously - almost none, unless I accidentally ingest gluten.

My dad the pediatrician used to have gas. Throughout his life he was the not-so-proud recipient of numerous gag gifts related to flatulence - we thought that he was just a gassy person (like it was part of his personality or something!) Then he went gluten-free. No more gas. Think of all the gifts he could have received instead…

My mom used to have heartburn and gas. She had a big container of Di-Gel and munched on it after dinner like it was candy. Same story… no more gluten, no more gas.

My sister-in-law’s baby had gas. She stopped eating gluten while breastfeeding. Her baby stopped having gas.

Enough examples? I could go on and on with just people I know, but I will spare you any more details. My point in sharing this personal information is to raise the question: why are we popping pills to treat the symptoms, instead of identifying the cause of the symptoms?

Here are a few reasons that I can see why people take medication instead of change their diet:

1. It is easier to take a pill than to change a diet.
2. Pharmaceutical companies make money from selling drugs. These companies educate (and wine and dine) doctors and give them samples. No one is calling on the doctor’s office to teach them about the effects of gluten on the body - there’s no money in that.
3. Doctors are generally not trained in diet management and don’t have the time to spend on it. Their job is to make their patients feel better, which these medications can do.
4. There is a lack of awareness, and often a disbelief by everyone, doctors included, that a change in diet can have such a drastic effect.
5. People don’t know how to identify the offending food. Confusing advice doesn’t help - differing sources will say it’s certain vegetables, beans, sugar, or fiber. Maybe these can cause gas, but if it’s frequent, painful, or odorous, look at gluten and dairy first.

If you suspect something in your diet is causing you distress, see your doctor and make it clear that you want to identify the cause, not just take medication. If you suspect gluten, ask about getting tested for celiac disease. It should be noted that of the people mentioned above, I am the only one who tested positive for celiac disease. Either their tests were inaccurate or they have some form of gluten intolerance. If you suspect other foods, ask about food allergy testing, or see a nutritionist to help you try an elimination diet. Good luck!

Filed under: Gluten Intolerance, Symptoms | 2 Comments »

Q. How accurate are the blood tests for celiac disease?

A. The commonly used antibody tests (IgA anti-gliadin and anti-tissue trans glutaminase) can diagnose aobut 85-90% of those with celiac disease. A total IgA (immunoglobulin A) level must be done, because 10% of celiacs are deficient in this immunoglobulin, and these antibodies may be falsely low in this setting. On occasion, even those with biopsy-proven disease may test negative, so it is recommended that genetic testing for HLA-DQ2 and HLA-DQ8 genes be done. Either one or both are positive in 95-98% of celiacs, but are also present in about 25-30% of the population at large, so an intestinal biopsy remains the gold standard for diagnosis.
Health and happiness,
Dr. Aron

Have a question?

Filed under: Ask the Doc, Celiac Disease | No Comments »

Would you believe a bread with a delicious taste and wheat-like texture could be made without gluten, corn, dairy, soy, rice or eggs? Believe it, because I made some yesterday!

I have been a fan of Breads from Anna bread mixes since I first tried them in 2004. They make a great loaf that rivals a wheat bread. I had been using the “Gluten, Soy and Rice Free Bread Mix”, but stopped making it when I stopped eating corn, and when my daughter was diagnosed with egg and dairy allergies.

Anna makes another bread mix called “Gluten, Corn, Dairy, Soy and Rice Free Bread Mix”, which solves most of our problems, except the eggs. Yesterday I decided to try an experiment. I used Ener-G Egg Replacer for the eggs called for in the bread mix. The mix calls for 2 eggs + 1 egg white to equal 2/3 to 3/4 cup liquid. I mixed the equivalent of 4 eggs with the egg replacer to equal 2/3 cup liquid. And voilá! A perfect egg-free (and everything-else-free) loaf!

On the lunch menu today: turkey sandwiches - almost makes me forget about all the stuff we can’t eat.

If you are not feeling confident in your bread-making abilities, read How to Make Gluten-Free Bread. A gluten-free loaf is better than none!

Filed under: Food Ideas, Products, Corn Allergy, Dairy Allergy, Recipes and Cooking Tips, Gluten Intolerance, Egg Allergy | No Comments »

Ron Hoggan, Ed. D., is the author of a wonderful book, Dangerous Grains, about celiac disease and gluten-associated medical conditions. I consider this book a must-read for anyone with celiac disease or gluten intolerance.

Dr. Hoggan has recently written an article entitled “How Gluten Grains Can Impede Scholastic Achievement” which appeared in the Price Pottinger Nutrition Foundation Journal in April (Hoggan, R. “How Gluten Grains Can Impede Scholastic Achievement” Health & Healing Wisdom, Spring 2007, Vol. 31; #1). He has given me permission to share his article on this site.

I encourage everyone to read it in its entirety, however the article requires full focus because it is chock-full of information, some of it quite technical with regards to brain functionality. For those of you who may not read the article, I hope you will at least read what I interpret as Dr. Hoggan’s main points (leaving out the technical stuff). For those of you who want to get to the head of the class, go ahead and read the whole article - it is really good.

“How Gluten Grains Can Impede Scholastic Achievement” - the main points:

1. Learning disabilities and behavior problems are increasing.
2. Our grain consumption is on the rise.
3. Certain people are not adapted genetically (based on their heritage) to gluten grains because of the relatively short time (compared to human existence) that grains have been around.
4. People in general may not be adapted to gluten grains because of all the changes that humans have made to the grains themselves.
5. Grains make up much more of our diet today than in the past.
6. Gluten grains have been shown to cause neurological damage.
7. Celiac disease patients have reported more frequently than the rest of the population: abnormal blood flow patterns in the brain, attention deficit hyperactivity disorder (ADHD), learning disabilities and dyslexia.
8. Gluten sensitivity patients have problems with learning and behavior which are very similar to those found in newly diagnosed celiac patients.
9. Gluten sensitivity is found in 11% to 12% of random groups in the U.S. and U.K. (celiac disease accounts for 1% of the population).
10. Patients with gluten sensitivity showed improvements in learning readiness after at least three months on a gluten-free diet.

Wow - did you follow the logic here? Quite fascinating, even moreso when you read the full arguments. He concludes by stating that the food guide recommendations (the pyramid), which advocate gluten grains and dairy products, are misleading and dangerous.

For other reading by Dr. Hoggan, see this list of articles on a variety of topics related to gluten intolerance. Thank you, Dr. Hoggan, for the article and for the work that you do!

Filed under: News & Research, Celiac Disease, Gluten Intolerance | No Comments »

For people who have food allergies or celiac disease, walking up to an ice cream counter and asking about the ingredients in each flavor can be a discouraging experience. Either the person behind the counter will have no idea what the ingredients are, or everyone working there will be too busy to give any information, or there won’t be any flavors that are safe to eat.

Last night I had no such experience. When my friend and I walked into a bustling gelato shop called Gelateria Naia in North Beach in San Francisco, I was prepared for the usual back and forth with the employee behind the counter. But then I noticed something — color-coded tags on the gelato flavors. Brown for soy gelato (dairy-free), green for whole fresh fruit gelato (dairy-free) and red for the regular (dairy) flavors. This tipped me off that there might be an allergy awareness here.

I then asked the scooper if she had a list of ingredients. She retrieved a folder, and while she didn’t hand it to me, she was able to tell me if the flavors I was interested in were gluten-free (most were). I ordered 4 flavors (I could have ordered 6 since I got the biggest size bowl!) What a pleasant and easy experience that was! I wasn’t made to feel like an annoying customer and the employee even seemed proud that she could help me.

I called the company today and spoke with one of the creators of Naia, Chris, who told me that they label their flavors (if someone were to ask) with the following: gluten, dairy, soy, nuts (includes peanuts), eggs, seeds, alcohol. I suggested that they make an allergy chart that they can hand out and/or put on their website.

They have other stores in Berkeley, Castro St. in SF, and Walnut Creek, and a “Lounge” on the UC Berkeley campus.

Delicious gelato, unique flavors and allergy awareness - what more could we ask for? (gluten-free cones?)

Filed under: Restaurants/Bakeries/Stores | 2 Comments »

Q. I have been gluten-free since Sept., 2004, although a biopsy came back negative at that time. I have experienced a night and day difference on the diet, and as a result, my partner and I work very hard to keep my diet extremely clean. However, I have noted that there are some things that I consider GF based on the listed ingredients and what the manufacturer tells me, that I get gastrointestinal symptoms from. Can you tell me if there is a way to narrow down what the culprit might be by how long it takes for me to have symptoms? In other words, if I go to a restaurant, and I eat something that has cross contamination from say a grill or utensils that are used in the kitchen, I know that within the hour. But there are times when I don’t exhibit any symptoms for 4 or 5 hours. I am wondering if this is because the ingredient I am responding to is such a trace ingredient, that I don’t feel it till the food is broken down to a certain level, way beyond the superficial. Is that a possibility, or am I way off base here?

A. We know that small fragments or peptides of glutens are directly injurious to the gut. These are independent from the celiac mechanism. It probably depends on the dose and variety of peptides that arrive in your gut. You’ll drive yourself crazy trying to figure it out, but it is likely that you will not undergo serious damage from this occasional exposure.
Health and happiness,
Dr. Aron

Have a question?

Filed under: Ask the Doc, Celiac Disease | No Comments »

We just got back from a family vacation where we took the kids to dinner with us every night. The baby was easy - she slept in her stroller, and my almost-3 year old daughter was great for the most part, but when the dinner lingered on, she became restless as little kids normally do.

That’s when I pulled out the never before seen or tasted lollipops. My daughter had never really had lollipops before, partly because she was too young to handle them, partly because I didn’t want her to know that candy existed (lost that battle!), and mainly because I hadn’t found a lollipop with ingredients that I felt comfortable giving her. Until now!

I am so excited to have found Yummy Earth Organic Lollipops for the following reasons (in no particular order):

1. They are delicious.
2. They are: Certified Organic, 100% Natural Colors, 100% Natural Flavors, Real Fruit Extracts, Allergen-free, Gluten-free, Casein-free, 100% Vegan, GMO free, Egg-free, Soy-free, Nut-free, Wheat-free, Dairy-free.
3. They are a great size for kids.
4. They were created by 2 dads.
5. They have tapioca syrup instead of high fructose corn syrup.
6. They are colored with things like cabbage and Japanese purple carrots instead of red dye #whatever.
7. I like candy.

There are also candy drops available if you think that sucking on a lollipop doesn’t look very grown up!

I bought mine at Whole Foods, but they are also available on my Amazon store.

Filed under: Babies & Kids, Products, Food Allergies | 2 Comments »

My family and I are off to Mexico for a vacation. We are staying at the same hotel we usually do, but this time I am bringing something new - an EpiPen.

It was at this hotel where we had the “cashew incident.” Months before, my daughter had tested positive to cashews (and other things) on a food allergy skin-prick test, but she had never eaten one, and to this day never has. At the hotel bar they routinely put out chips and salsa and a big bowl of mixed nuts. My daughter knew to stay away from the nut bowl, and I kept it out of her reach, but beyond that I didn’t think much about it.

A little while later, she started scratching her face around her lips. It was a bit dark so I didn’t think anything was serious, until she said to me “Mommy, my lips hurt.” I focused my eyes on her lips and saw that they were swollen. In an instant I scooped her up and went running to our hotel room where I had a bottle of Benadryl. I called my dad, who is a pediatrician, in a panic. I gave her the Benadryl and waited for her symptoms of food allergy to subside. It worked. Within a half an hour she was as good as new (and a little high off the Benadryl).

I was relieved and confused - what set off this allergic reaction? When did she eat a cashew, or maybe there was something else she was reacting to, but she had not eaten anything that she hadn’t had before. I voiced my confusion to my in-laws who had joined us on the vacation. It was my father-in-law who volunteered that he had been playing a game with my daughter where she would bring him a tortilla chip and he would give her a little kiss. In addition to the chips, he had been eating from the nut bowl - and picking out the cashews in particular. Wow… wow. I was a little stunned - she had a reaction to cashews via a kiss.

I had heard of the peanut-kissing story back in November of 2005, where a Canadian girl died after kissing her boyfriend who had eaten peanut butter 9 hours before. Months later, the coroner said that she did not die from an allergic reaction to peanuts, but by then the case had already received so much media attention that nobody knew this conclusion to the story. What did come out of this news was that a study was done on peanut allergens in saliva. It concluded that peanut is detectable in saliva right after eating a meal with peanuts, but that it leaves the saliva after several hours. In other words, don’t kiss someone who has just eaten the thing you are allergic to!

When I told the pediatric allergist of the incident, he asked “Did she have any trouble breathing?” “No.” “Did she have any drop in blood pressure” “No.” He concluded that she did not have an anaphylactic reaction and therefore probably does not need an EpiPen. That made me feel better, but then I thought - if she had that reaction just from a little contact, what would happen if she actually ate a cashew?? My daughter’s pediatrician and my dad agreed with me and felt it was better to be safe than… well, you know.

So off we go to Mexico with an EpiPen. It makes me nervous to have it, but nervous not to.

Related topics:

• Learn how to use an EpiPen.
• Read the Tree-Nut Free Guide.

Filed under: Peanuts/Nuts Allergy, Food Allergies | 5 Comments »

Q. What is the link between celiac disease and cancer?

A. There is an increased risk of developing lymphoma of the digestive tract and the bloodstream in those who have celiac disease and go undiagnosed and do not eat a gluten-free diet, or in those who have celiac disease, and who do not stay on the diet. If the initial biopsy used to make the diagnosis was a Marsh III or worse (Marsh I means no architectural change to the villi; Marsh IV means complete destruction of the villi), then the risk is greater than the rest of the population that does not have celiac disease. There is a very slightly increased risk in developing other solid tumors of the gut, such as colon cancer or esophageal cancer, if one does not adhere to the gluten-free diet. If, at the time of diagnosis, the biopsy is Marsh III or worse, you should also get imaging of the rest of the small intestine. The best way for this is still the barium swallow small bowel follow-through test.
Health and happiness,
Dr. Aron

Have a question?

Filed under: Ask the Doc, Celiac Disease | No Comments »