The pages of the current issue of “Digest This” are filled with many facts and figures about celiac disease, a topic we decided to focus on because the disease and its prescribed gluten-free diet are

currently garnering a lot of attention in the media and in public discourse.

We hope that the information will help clear up misconceptions about celiac disease and raise awareness so that more people will seek treatment, get a proper diagnosis and get on track to a healthier life.

I always say that celiac disease is the great masquerader because it presents in so many different ways. The autoimmune digestive disease causes malabsorption of fat soluble vitamins, so a person suffering from celiac disease may suffer from skin lesions, brittle bones or problems with their eyesight - problems not typically associated with the digestive system.

I encourage you to pay attention to the information contained in this newsletter and to signals your body may be sending you. If you think there’s a problem, see your physician for a proper diagnosis.

DIGEST THISwww.gihealthcare.com

Facts and tips for your good health Winter 2012

IN THIS ISSUE1 The Great Masquerader1 Are you the one?2 Celiac and gluten-free facts3 Gluten-free cooking

3 What is gastroenterology?3 Celiac disease can develop at any age 4 Physician Profile4 How to be worry-free

One in 133 Americans suffers from celiac disease. Are you the one?

You’re one in a million! Who doesn’t love hearing that compliment? But what if your doctor says you’re one in 133 suffering from celiac disease?

Celiac disease is one of the most common genetic conditions in the world, affecting more people than Crohn’s disease, cystic fibrosis, multiple sclerosis and Parkinson’s disease combined.

Yet, an alarming 95 percent of people with the disease are undiagnosed or misdiagnosed with other conditions.

Diagnosing celiac disease can be difficult because the symptoms often mimic those of other diseases such as irritable bowel syndrome, Crohn’s disease or colitis.

Those with celiac disease may experience intermittent diarrhea, abdominal pain, bloating, upset stomach, irritability, depression, joint pain, muscle cramps or anemia. Dental and bone disorders, unexplained weight loss, or tingling of the legs and feet may also be indicators of malabsorption from celiac disease.

Celiac disease is due to an allergy to gluten, a protein commonly found in certain foods. The allergic reaction causes your body to attack itself and produce certain antibodies. Therefore, blood tests to detect and measure those antibodies are the first step in a proper diagnosis. Often, a biopsy of the lining of the intestine is conducted to confirm the diagnosis.

Although celiac disease can affect anyone, people with a family history of the condition are at a much greater risk. Also commonly affected are people with

Dr. Meade Edmunds

Celiac Disease: The Great Masquerader

continued on page 2

diabetes, Down’s syndrome, autoimmune thyroid disease and microscopic colitis.

Today, celiac disease is garnering more national attention, and gluten-free products are more prevalent on grocery store shelves. That’s both good and not so good. It’s good if it leads people to see their doctor for a proper diagnosis. Not so good if they self diagnose and go gluten free on their own.

For people with celiac disease, a gluten-free lifestyle is essential and the only treatment for celiac disease. For others, a gluten-free diet may lack necessary vitamins, minerals and fiber.

Additionally, if you stop eating gluten before you are tested, your test results may not be accurate.

If you suffer from symptoms of celiac disease, see your physician to find the cause. Only proper testing will determine whether or not your symptoms and pain are caused by celiac disease. You may just be one in 133, and going gluten-free will free you up to enjoy a healthier life.

2 Gastrointestinal Associates P.C. | Digest This Winter 2012

Celiac disease is an allergic reaction to gluten, a common food substance, that damages the lining of the small intestine and interferes with absorption of nutrients from food. An estimated 3 million Americans across all races, ages and genders suffer from celiac disease. 95% of celiacs are undiagnosed or misdiagnosed with other conditions. The average person waits six to 10 years to be correctly diagnosed. Up to 22% of celiac patients have an immediate family member who also has celiac disease.

Celiac disease can lead to a number of other disorders including infertility, reduced bone density, neurological disorders, some cancers, and other autoimmune diseases. $5,000-$12,000 is the average cost of misdiagnosis per person/per year of celiac, not including lost work time. There are NO pharmaceutical cures for celiac disease. A 100% gluten-free diet is the only existing treatment. Gluten-free sales reached more than $2.6 billion by the end of 2010

and are expected to exceed more than $5 billion by 2015.

Fast facts: celiac diseasecontinued from page 1

Gluten-free cookingThe diagnosis of celiac disease requires a significant change in diet. It doesn’t mean you have to give up all your

favorite foods. It just means you will have to be a little more creative in preparing them. Gluten-free cookbooks and recipes are abundant and help you learn ways to prepare your old favorites gluten free, such as this easy recipe for fried chicken from www.celiac.com.

Oven-Fried Chicken – Gluten-FreeBlend in plastic bag:

½ cup gluten-free flour (such as Hagmans first blend) 1 teaspoon salt2 teaspoon paprika ¼ teaspoon pepper

Preheat oven to 400. Melt ½ cup butter or margarine in shallow baking pan in oven. Shake chicken pieces in flour mix, dip in melted butter, turning to coat evenly. Bake uncovered for 1 hour, turning at 30 minutes. Bake boneless chicken for 30 minutes, nuggets for 15 minutes or until cooked through.

This recipe can also be used for coating pork chips. Bake at 425 for 15 minutes for ½ inch thick chips, 5 to 10 minutes longer for thicker chops.

Did you know? In addition to being in wheat, rye, oats and barley foods, gluten can be found in condiments, makeup, lipstick, medications and perfumes.

Celiac disease can develop at any age, which means a person who previously tested negative for the autoimmune intestinal disorder may test positive later in life. A recent study published in the Annals of Medicine reported that there has been a fivefold increase in the prevalence of celiac disease over the past 30 years, with many of the cases occurring in elderly people.

Previous wisdom assumed that the disease started in childhood but went undiagnosed until later in life. The study, which included 3,500 adults

who were tested at two 15-year intervals, showed that the incidence of celiac disease rose as participants aged.

Researchers concluded that you can’t write off celiac disease at any age or because a person previously tested negative. A person who tested negative at age 50 but has symptoms at age 65 should be tested again because gluten intolerance can develop at any age.

What is gastroenterology?

3Gastrointestinal Associates P.C. | Digest This Winter 2012

Celiac disease can develop at any age

A gastroenterologist is a medical specialist who is broadly trained in internal medicine and who then takes special training in the diagnosis and treatment of diseases of the digestive system (esophagus, stomach, small and large intestine, liver, pancreas and gallbladder). All of the partners at Gastrointestinal Associates are board-certified by the American Board of Internal Medicine and the subspecialty Board of Gastroenterology.

After completing college and four years of medical school, each of our doctors has had at least five additional years of training with the last 2-3 years focused on gastrointestinal diseases. We update our knowledge each year by engaging in specialized training and attending professional meetings as well as by independent reading.

Our physicians are on the staff of all the local hospitals: Physicians Regional Medical Center, North Knoxville Medical Center, Fort Sanders Regional Medical Center,

Parkwest Medical Center, and the Thompson Cancer Survival Center. We also provide GI

consultative and endoscopic services at Jefferson Memorial Hospital.

One of a gastroenterologist’s most important responsibilities is to detect cancers. Cancers within the esophagus, stomach, colon, rectum and liver can all be successfully treated with early detection. A gastroenterologist is specially trained to evaluate diseases of the digestive system, and regular gastrointestinal screenings such as colonoscopy can be life-saving.

A complete gastrointestinal evaluation usually includes specialized studies in addition to a thorough interview and physical

examination. X-rays (barium studies of the digestive system) are ordered and reviewed as

indicated. Endoscopy, which uses a flexible lighted instrument to inspect the lining of the digestive

tract, may be suggested and blood specimens may be required for accurate diagnosis or analysis of

body functions.

If you think you have celiac disease, don’t go on a gluten-free diet before seeing your physician. Doing so may obscure the test results.

Did you know?

DIGEST THIS

Gastrointestinal Associates P.C. | 801 Weisgarber Road | Knoxville, TN 37950 | (865) 588-5121 | www.gihealthcare.com

Dr. Meade Edmunds believes that: “The true art of medicine involves not only maintaining the knowledge needed to diagnose medical diseases, but also to be able to apply it in a compassionate, caring way.”

A graduate of the University of Virginia Medical School, Dr. Edmunds completed his internship and residency

training at the University of Rochester School of Medicine in New York, where he later was elected Chief Medical Resident and served as the medical attending. He subsequently completed a three-year fellowship in Gastroenterology at the University of Virginia Medical Center.

Dr. Edmunds currently serves as a member of the American Society for Gastrointestinal Endoscopy, American College of Gastroenterology and the American Gastroenterological Association. He is on the medical

staff at Physicians Regional Medical Center and North Knoxville Medical Center (Tennova).

Dr. Edmunds is married to Dr. Kathleen Edmunds, an active obstetrician and gynecologist in private

practice in Knoxville. They have three children. Leisure activities include fishing, farming and spending time with his family. He is extremely involved in child athletic programs and has been a youth football coach for years.

Meade C. Edmunds, MD, FACG

Physician Profile

Digest This is a quarterly newsletter dedicated to facts and tips for your good health.

801 Weisgarber Road | Knoxville, TN 37950

How to be worry-free about gluten-free

A diagnosis of celiac disease means a complete lifestyle change. There is no pharmaceutical treatment or cure for the disease; the only existing treatment is a 100-percent gluten-free diet.

Fortunately for those suffering with celiac disease, more and more gluten-free products are appearing on the shelves of major chains and neighborhood grocery stores, and many restaurants are adding gluten-free selections to their menus.

What does the label “gluten-free” actually mean? In general, gluten-free is anything that doesn’t include wheat, rye, barley or possibly oats. Being gluten-free means eliminating traditionally prepared foods like breads, cakes, candy, cereal, condiments, cookies, pasta, pizza, pretzels and soups.

With the increased availability of gluten-free products and some easy substitutes and recipes, however, a gluten-free diet doesn’t have to restrict all your favorite foods. A gluten-free lifestyle is getting better all the time.

Facts and tips for your good health Winter 2012