A Nasty Gut Feeling
Sydney Morning Herald
Thursday June 26, 2003
As soon as I walked into the rooms of the fourth gastroenterologist I consulted, the secretary said, ``I know what you've got." She was correct in diagnosing my problem, which had escaped the notice of so many physicians, surgeons, dentists and general practitioners (including me).
This is all the more surprising since I was the son of a GP, served in an army medical unit and worked most of my life in hospitals in Australia and Britain, mainly as a radiation oncologist (cancer therapy specialist).
Ever since childhood, some 80 years ago, I was thin with minimal musculature, round-shouldered and plagued with aphthous ulcers in the mouth. This despite my love of sport cricket, tennis, football, squash and skiing at which I was a poor performer.
The big handicaps were fatigue and lack of concentration. Attacks of abdominal pain were put down to reluctance to attend school.
I found listening to teachers and lecturers tiring and studying frustrating and difficult. In other words, body and mind did not function properly.
My self-confidence was low and attacks of anxiety and depression struck from time to time. Relationships and coping skills suffered.
Now for those who are squeamish, ignore what follows. My intestines worked too well twice a day. In fact, I had the impression that food went straight from mouth to sewer, being only part-absorbed and I was right.
However, I had forgotten lectures by the late (and beloved) Sir Lorimer Dods at the Children's Hospital .
As time went on I was a serial pest to all my kind, patient friends and colleagues as I consulted them frequently and received a diagnosis of ``Oh, it's something-itis". ``Oh, it's irritable bowel", ``it's a virus", ``it's depression", ``it's gallstones", etc.
True, I did have surgery for the last two but the symptoms of ``reflux" and other abdominal pains persisted despite various medications. I almost forgot, until the diarrhoea came finally. Like the pains, it was savage.
Of course, I could only think that a cancer was lurking somewhere; in fact, this inherited, life-long disease is associated with cancer if untreated.
Numerous X-ray examinations and endoscopes (at both ends) failed to reveal the problem until the fourth endoscopist did a biopsy of my duodenum and . . . ``Eureka, it's coeliac disease!"
A pathologist tells me that the disease causes dysfunction from the mouth all the way down. The villain is gluten, which is present in wheat, barley, oats, rye and triticale. All allergic reaction takes place in the small bowel after these substances are eaten.
As a result, the villi, which are responsible for the absorption of food, are destroyed. Body and mind are in a state of semi-starvation.
In addition to the painful aphthous ulcers, a fiendishly itchy rash called dermatitis herpetiformis occurs.
Coeliac is the only disease treated by diet, which must be strictly gluten-free for life.
There is a coeliac society in every state which issues a journal and books on where to obtain gluten-free foods. Much help is given at meetings where fellow patients can share their problems.
A common complaint has been that, like me, many have been diagnosed with ``Oh, it's-ities".
Unfortunately, coeliac disease mimics other illnesses and can lie dormant. It used to be regarded as a ``children's only" complaint.
As well as cancer, it can lead to infertility, osteoporosis, diabetes, thyroid disease and many other maladies.
As I wander around the special gluten-free section of Coles and Woolworths supermarkets or shop at health food stores, I wonder how many people are walking around undiagnosed.
I also can't help but wonder how many drug addicts and prison inmates have a gluten problem as the cause of their misbehaviour as they ``self-remedied" for their feelings of fatigue due to coeliac disease.
Could a gluten-free diet restore both their physical and mental energy?
Experts now feel that there is a large population of coeliacs who are undiagnosed, perhaps labelled as suffering ``irritable bowel" or ``chronic fatigue".
In this column, you are invited to tell us your story. Send 700 words with your contact details, including daytime phone number, to knicoll@smh.com.au or fax 9282 2481. Submissions may be edited and also published on the internet.
© 2003 Sydney Morning Herald
