Celiac Disease: Gluten-free diet is the treatment

The term allergy means hyper-action of our body's immune system to allergens (mostly proteins or compounds tagged to proteins). Like our skin and respiratory tract, our digestive tract (intestines) can also be hypersensitive to some constituents of food. Celiac disease is a disorder of the digestive system which is caused by intolerance/allergy to a protein called gluten. People with celiac disease can not tolerate gluten. The disease is partially genetic and inherited. Parents, siblings and children of people with celiac disease may also have/be having this disease. Celiac disease damages the inner lining of the small intestine and interferes with the absorption of nutrients from food. The cause of celiac disease is the immunological allergic reaction to gluten present in food that causes inflammation and damages the inner border (microvilli) of small intestine. Figure-1 below shows the ultrastructural changes at the inner lining of small intestine in a patient affected by Celiac disease. A visual comparison with Figure-2 (Normal inner surface of small intestine) would make you understand the pathological change.

Figure-1: Electron micrograph of biopsy from the small intestine of a patient affected by celiac disease showing eroded microvilli.

Figure-2: Electron micrograph showing normal microvilli at the inner surface of small intestine.

Sources of Gluten

Wheat, barley and rye are the main source of gluten. The gliaden component of gluten causes celiac disease. Some adhesives, medicines and vitamin products, which we use daily, may contain gluten.

Diagnostic symptoms of celiac disease

Some of the typical symptoms of celiac disease are failure to gain weight, diarrhoea, irritability, vomiting, abdominal pain and foul stools, early in infant life. The most common period of presentation and detection of celiac disease is between six months and two years of age. Some children may present with excessive appetite, abdominal distension, wasted muscle, finger clubbing and edema.

Preventive treatment of celiac disease

A gluten-free diet is the only treatment of celiac disease. A person aware of having intolerance to gluten should avoid eating foods containing wheat, barley and rye products. Modern drugs may provide symptomatic relief but ultimate treatment is preventive therapy in celiac disease.

Important Tips

1. Parents of the children with celiac disease have great responsibility to make the children comply with the doctor's instructions for gluten-free diet.


2. Recognizing and avoiding new food products containing wheat, barley or rye is a great challenge and people with celiac disease should be very careful since non-compliance of gluten-free diet may cause relapse.


3. People having celiac disease should take food items prepared from rice and corn only along with fruits, juices and milk products.


4. Reading the contents of grocery items is important before eating because many corn and rice products come from the manufacturers of wheat products.


5. Gluten-free but balanced diet is must for normal growth of the children affected by celiac disease.


6. Medicines coated/laced with gluten products should be avoided.

Management of Knee Pain

There are around 150 joints in our body and the Knee joint is most afflicted by disease or injury. The knee joint bears the brunt of our body weight and pain in this joint affects our mobility. Knee injury, immunological disorders, rheumatoid arthritis and gouty arthritis in addition to age related bone disorders may complicate the problem. Early management of pain and care of knee joints could be helpful to prevent any deformity and disability. Knee pain may be at front, back or at inner or outer side of knee joint. Our body weight exerts pressure on our knee joints during we walk, run or climb stairs. Pressure force on knee joint is almost 5 to 6 times more when we climb stairs as compared to when we walk on leveled ground or road. The size of our hips also affects pressure on our knee joints. Individuals with broader hips are at more risk to develop knee pain. Both the young and old people can be inflicted by knee pain but site of pain may vary person to person.

Tips to manage knee pain:

• Consult your family doctor or bone & joint expert for an early diagnosis.
• At home, early treatment involves wrapping with crepe bandage and elevation of knees to prevent swelling.
• Obesity is the major factor for the knee problem, so body weight control should be your first priority.
• Avoid climbing stairs and do non-impact exercise like walking or stationary cycling.
• Use sports shoes as these would help to reduce impact shock while walking.
• Warm oil or pain relieving liniment, spray or gel can be applied to knee joint and injured muscles.
• Try to keep your knees straight while sitting in a chair.
• Join rehabilitation exercise program to strengthen the muscles involved in injury and to regain power & coordination of the knee joint movement.
• Keep in touch with your physician for proper medication to avoid osteoarthritis.

Urinary Bladder Cancer and People at Risk

Blood in urine, termed as hematuria in medical terminology, is the first warning sign of urinary bladder cancer. However, other causes need to be evaluated and one should not panic on seeing blood in urine. Benign tumors, stones in kidney or urinary bladder and infection can also cause hematuria. Generally early stages of the bladder cancer cause bleeding but pain may be absent or there could be mild pain. Enlarged prostate in males may also show such symptoms. Blood in urine may be present one day and absent on the other day or for a week also. Change in bladder habits, such as burning during urination and extra urgency of passing urine can also be symptoms of bladder cancer.

Smokers are at great risk of having urinary bladder cancer. Cancer causing chemicals carcinogens) from tobacco smoke are absorbed from the lung into the blood circulation, filtered through kidneys and concentrated in urine. Toxic effect of these chemicals damage the internal lining of the bladder and increase the chances of development of cancer. Beta-naphthylamine , aromatic amines and benzidine used in dye industry can cause bladder cancer in industrial workers associated with textile & dying industry. Industrial workers associated with industries making rubber, leather goods and paints are also at high risk. Workers of printing companies are also at risk due to exposure to aromatic amines in printing inks. Painters and hairdressers are equally at risk of developing urinary bladder cancer. The risk of developing urinary bladder cancer increases with advancing age. It has been observed that urinary bladder cancer is more prevalent in men than women probably due to variation in exposure to carcinogenic chemicals and smoking habits.

Urinary bladder cancer can be treated through intravesical therapy and/or chemotherapy after surgical cystectomy. Cytological study of urinary deposit can be helpful in establishing a diagnosis of urinary bladder cancer. Pathological diagnosis of transurethral biopsy of urinary bladder is also sometimes required to establish the diagnosis. Superficial bladder cancer (early stage) can be treated through transurethral resection(TUR) using a rigid cystoscope called resectoscope, by an expert urologist. When the bladder cancer has deep roots or it is of invasive type, radical cystectomy may be required to remove all parts of the urinary bladder and further reconstructive surgery is performed to construct artificial bladder from a short piece of intestine. Just trust your urologist.

Chemistry of Life: A convergence of organic and Inorganic matter

The chemistry of life is very complex subject. Our body is made-up of very complicated chemical compounds built up from about one dozen elements. Several dozen chemicals produced from about a dozen basic elements make the living matter in unicellular as well as multi-cellular plants and animals. The most common elements, which are constituents of various organic and inorganic compounds in our body are: Hydrogen (H), Oxygen (O), Carbon (C), Nitrogen (N), Calcium (Ca), Phosphorus (P), Iron (Fe), Iodine (I), Magnesium (Mg), Sulphur (S), Sodium (Na), Potassium (K) and Chlorine (Cl). Sodium is the main constituent of the living matter in all body fluids in animals and human beings. Potassium is present in the cells in animals and humans but present in abundant in plants. Hydrogen and Oxygen are the constituents of water (H₂O). Water is the vehicle of life force as life is not possible without water. Hydrogen, Oxygen and Carbon are the constituents of carbohydrates. Proteins are composed of Hydrogen, Carbon, Oxygen, Nitrogen, Phosphorus and Sulphur, however all proteins do not contain Sulphur. Though we have been successful in analyzing the chemical constituents of living matter but life can not be created by just mixing of these chemicals. These chemicals act as a fuel for the propagation and preservation of life. Water and Oxygen have a vital role in creation of bioenergy and its transportation to various cells and tissues of the body. Exocrine and endocrine glands of our body play a vital role in the production and regulation of various bio-compounds required for normal health. Kidneys play excretory and regulatory function for maintaining a state of homoeostasis.