“Celiac disease (also called non-tropical sprue, celiac sprue, gluten intolerance, and gluten-sensitive enteropathy) is an intestinal disorder in which the body cannot tolerate gluten. Gluten is a natural protein in many grains, including wheat, barley, rye, and oats.

People with celiac disease have an immune reaction that is triggered by gluten. The immune reaction causes inflammation at the surface of the small intestine where it damages small structures (villi) on the surface of the intestine. It also damages smaller, hair-sized protrusions called microvilli. Healthy villi and microvilli are needed for normal digestion. When they are damaged, the intestine cannot absorb nutrients properly and you can become malnourished.

A tendency to develop celiac disease is genetic (inherited). Celiac disease is most common among people of northern European descent. Celiac disease is not always recognized because the symptoms can be mild and can be wrongly blamed upon other common intestinal issues. Celiac disease can be diagnosed at any age.”

Harvard Health Publishing (Celiac Disease (Non-Tropical Sprue) – Harvard Health)

Celiac disease, sometimes called celiac sprue or gluten-sensitive enteropathy, is an immune reaction to eating gluten, a protein found in wheat, barley and rye.

If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine’s lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications. Celiac Disease Foundation states “It is estimated to affect 1 in 100 people worldwide. Two and one-half million Americans are undiagnosed and are at risk for long-term health complications.”.

When the villi get damaged, nutrients cannot be absorbed properly into the body.

• Intestinal villi are tiny, finger-like projections made up of cells that line the entire length of your small intestine. Your villi (villus is the singular, villi is the plural) absorb nutrients from the food you eat and then shuttle those nutrients into your bloodstream so they can travel where they’re needed.

Celiac disease is hereditary, meaning that it runs in families. People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease.

Celiac disease can be difficult to diagnose because it affects people differently. There are more than 200 known celiac disease symptoms which may occur in the digestive system or other parts of the body. Some people develop celiac disease as a child, others as an adult. The reason for this is still unknown.

Celiac disease can develop at any age after people start eating foods or medicines that contain gluten. Left untreated, celiac disease can lead to additional serious health problems.  Some people with celiac disease have no symptoms at all, but still test positive on the celiac disease blood test. A few others may have a negative blood test, but have a positive intestinal biopsy. However, all people with celiac disease are at risk for long-term complications, whether or not they display any symptoms.

Long Term Problems that can arise from celiac disease are the following:

• Iron deficiency anemia
• Early onset osteoporosis or osteopenia
• Infertility and miscarriage
• Lactose intolerance
• Vitamin and mineral deficiencies
• Central and peripheral nervous system disorders
• Pancreatic insufficiency
• Intestinal lymphomas and other GI cancers (malignancies)
• Gall bladder malfunction
• Neurological manifestations, including ataxia, epileptic seizures, dementia, migraine, neuropathy, myopathy and multifocal leucoencephalopathy

“Gastrointestinal diseases are health conditions that affect your gastrointestinal (GI) tract. Your GI tract is the path food takes through your digestive system — from your mouth to your rectum. It also includes your liver, pancreas and gallbladder. Some digestive system diseases cause problems that go away relatively fast with treatment. Others cause problems that are more serious.”

Cleveland Clinic (Gastrointestinal Diseases: Symptoms, Treatment & Causes)

What is acid reflux?

A gastrointestinal (GI) disease that is caused by a valve located between the esophagus and stomach, which normally is a strong muscular ring of tissue. This valve normally opens and closes completely preventing food backing up (called reflux) in the esophagus allowing the contents to reach the throat to the mouth. With acid reflux, what happens is this valve gets over expanded frequently to the point the valve gets overstretched and no longer fits over the opening between the esophagus and the stomach with a tight fit. Due to loss of the elasticity it now is allowing leakage from the stomach with both food and fluids going up the esophagus to the throat to the mouth due to the action of reflux, during the digestion process. What happens during digestion the stomach contents with digestive fluids from the stomach (which are acidic) are refluxed, that are NOT normally in the esophagus. In conclusion, reflux sends stomach contents that’s returning (an acidic environment) upward in the esophagus which is now in an environment not use to being exposed to the digestive fluids=acidity, which are needed to perform the digestion process of our foods/fluids that are in the stomach only. This leakage of the valve is the cause of this problem occurring=GERD or GASTROINTESTINAL REFLUX.

When you don’t have GERD food and fluids, the nutrients we swallow goes down the esophagus to the valve where it opens letting the contents into the stomach.  Than digestion takes place in about 1-2 hours after eating with no feeling of heartburn or foods or fluids we ate don’t come back up in our throat to the mouth. Normally the valve is tight enough in preventing reflux=no leakage going back up to the mouth with food and acid during digestion (the primary purpose of its function).  This means during digestion the food gets into the stomach which is broken down into smaller particles by the digestive acid fluids allowing the nutrients to pass into the bloodstream with the waste products staying in the stomach to reach the rectum.  So when stomach digestion is complete it passes all the waste products onto the smaller intestines to the larger intestines to the rectum to be evacuated, without leakage or reflux.  With GERD this contents does go backward sending it to the mouth again.

The signs and symptoms (s/s) of GERD or acid reflux:

1-Heartburn is the classic GERD symptom. It’s best described as a burning sensation in the chest and/or discomfort in the upper belly or abdomen accompanied by a feeling of fullness.

2- Regurgitation is the involuntary return of partially digested food from the stomach into the mouth. This uncomfortable symptom is commonly caused by GERD, since the esophageal sphincter (valve) is damaged to such a severe degree that the stomach juices (acidotic) can freely reflux to the level of the throat or mouth.

3-Pain present behind the sternum (chest pain) to the upper mid abdomen (where the stomach is). If severe call your M.D. or doctor to have evaluated (especially if in the chest).

4-Chronic cough to hoarseness

5-Recurrent pneumonias

6-Bloating

7-Nausea

8-Vomiting (yellow/green)

9-Lump in the throat

10-Difficulty swallowing

11-Chronic sore throat

12-Laryngitis

13-Post nasal drip

14-Ear Aches

15-Tooth decay or gingivitis (inflammation of the gums) or bad breath this is due to the acid fluids with the foods and fluids regurgitated back to the mouth from the stomach.

Complications that are caused by GERD when left untreated:

1-Narrowing of the esophagus called esophageal stricture. This is due to damage to cells in the lower esophageal from acid exposure that leads to scarring of the tissue. The scar tissue narrows the food pathway causing difficulty to swallow called dysphagia.
2-Esophagitis – inflammation of the esophagus. This constant backwash of acid can irritate the lining of your esophagus. Over time, the inflammation can cause complications such as bleeding or breathing problems leading into the next problem. 3-Esophageal Ulcers – Due to frequent exposure to acidic fluids and foods to the esophagus the mucosa gets irritated so bad it will even erode the mucosa causing skin ulceration. The esophagus environment is not use to the stomach’s = acidic. Take the outer skin of the body, if exposed long enough to acidic chemicals the skin will burn. Same principle for the esophagus constantly exposed to the environment of the stomach’s content of acidic fluids every time digestion takes place.
4-Precancerous changes to the esophagus (Barrett’s esophagus). In Barrett’s esophagus, the color and composition of the tissue lining the lower esophagus change. These changes are associated with risk of esophageal cancer. The risk of cancer is low. Cancer is rare but can happen (adenocarcinoma of the esophagus).

Risk factors:

Conditions that increase the risk of GERD would
include: Obesity, Pregnancy, Smoking, Dry Mouth, Diabetes, Asthma, Connective Tissue Disorders like scleroderma, delayed stomach empting, Zollinger-Ellison syndrome (ZES) (This is a rare disorder characterized by one or more tumors in the pancreas, duodenum, or both. The tumors cause the stomach to make too much acid, leading to peptic ulcers in the duodenum. The tumors are sometimes cancerous and spread to other areas of the body.).

Treatment:

The key to treatment is prevention but if already diagnosed GERD than it would be maintenance. There is no one answer but start with being checked by your physician if you have any symptoms indicative of this diagnosis. Start with a getting a very good diagnostic tool ordered by your doctor called an Upper GI series (endoscopy) and when it’s done it will tell the M.D. a lot in what’s going on.

Then there is medications as a remedy, that can be useful, they are classified as proton pump inhibitors to H2 Inhibitors with more.

Another great key to the treatment is your LIFESTYLE=Diet (not eating acid foods, not eating fast), activity/exercise, your height compared to your weight (BMI or simply what you weigh) and lastly if you practice healthy vs. unhealthy habits.

If you would like to learn more about this come back tomorrow to my web page when I go further on the topic GERD (part 2) regarding the diet for the disease.

“GERD, diarrhea and colorectal cancer are examples of gastrointestinal diseases. When examined, some diseases show nothing wrong with the GI tract, but there are still symptoms. Other diseases have symptoms, and there are also visible irregularities in the GI tract. You can prevent and/or treat most gastrointestinal diseases.

GI diseases can be acute or chronic:

• An acute GI disease is one that happens suddenly and lasts a short period of time.
• A chronic GI disease can affect you for many months or years.

They can also be either functional or structural:

• A functional GI disease is when your healthcare provider can’t see any physical or structural issues when they examine your digestive tract.
• A structural GI disease is when your healthcare provider can see evidence of an issue when they examine you.”

Cleveland Clinic (Gastrointestinal Diseases: Symptoms, Treatment & Causes)

“The American Cancer Society’s estimates for the number of colorectal cancers in the United States for 2026 are:

• About 108,860 new cases of colon cancer (55,410 in men and 53,450 in women)
• About 49,990 new cases of rectal cancer (28,750 in men and 21,240 in women)

The rate of people being diagnosed with colon or rectal cancer has dropped overall since the mid-1980s, mainly because more people are getting screened and changing their lifestyle-related risk factors. From 2013 to 2022, incidence rates dropped by about 1% each year. But this downward trend is mostly in older adults. In people younger than 50 years of age, rates have increased by 2.9% per year from 2013 to 2022. In adults aged 50-64, the rate has increased by 0.4% per year during this time.

Deaths from colorectal cancer

In the United States, colorectal cancer is the third-leading cause of cancer-related deaths in men and the fourth leading cause in women, but it’s the second most common cause of cancer deaths when numbers for men and women are combined. It’s expected to cause about 55,230 deaths during 2026.

The death rate from colorectal cancer has been dropping by about 1.5% per year in older adults during the past decade. There are a number of likely reasons for this. One is that colorectal polyps are now being found more often by screening and removed before they can develop into cancers. Screening also results in many colorectal cancers being found earlier, when they are likely to be easier to treat. In addition, treatments for colorectal cancer have improved over the last few decades. In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s.”

American Cancer Society (Colorectal Cancer Statistics | How Common Is Colorectal Cancer? | American Cancer Society)

How does colon-recto cancer even start:

Most colorectal cancers start as a growth on the inner lining of the colon or rectum. These growths are called polyps.

Some types of polyps can change into cancer over time (usually many years), but not all polyps become cancer. The chance of a polyp turning into cancer depends on the type of polyp it is. There are different types of polyps.

• Adenomatous polyps (adenomas): These polyps sometimes change into cancer. Because of this, adenomas are called a pre-cancerous condition. The 3 types of adenomas are tubular, villous, and tubulovillous.
• Hyperplastic polyps and inflammatory polyps: These polyps are more common, but in general they are not pre-cancerous. Some people with large (more than 1cm) hyperplastic polyps might need colorectal cancer screening with colonoscopy more often.

• Sessile serrated polyps (SSP) and traditional serrated adenomas (TSA): These polyps are often treated like adenomas because they have a higher risk of colorectal cancer.

Other factors that can make a polyp more likely to contain cancer or increase someone’s risk of developing colorectal cancer include:

• If a polyp larger than 1 cm is found
• If more than 3 polyps are found
• If dysplasia is seen in the polyp after it’s removed. Dysplasia is another pre-cancerous condition. It means there’s an area in a polyp or in the lining of the colon or rectum where the cells look abnormal, but they haven’t become cancer.

The body is made up of trillions of living cells. Normal body cells grow, divide into new cells, and die in an orderly way. During the early years of a person’s life, while they are still growing, their normal cells divide faster. Once the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries.

Cancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer, but they all start because of out-of-control growth of abnormal cells.

Cancer cell growth is different from normal cell growth. Instead of dying, cancer cells continue to grow and form new, abnormal cells. In most cases the cancer cells form a tumor. Cancer cells can also invade (grow into) other tissues, something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell.

Cells become cancer cells because of damage to DNA. DNA is in every cell and directs all its actions. In a normal cell, when DNA is damaged the cell either repairs the damage or the cell dies. In cancer cells, the damaged DNA is not repaired, but the cell doesn’t die like it should. Instead, this cell goes on making new cells that the body does not need. These new cells will all have the same damaged DNA as the first abnormal cell does.

People can inherit damaged DNA, but most often the DNA damage is caused by mistakes that happen while the normal cell is reproducing or by something in our environment. Sometimes the cause of the DNA damage is something obvious, like cigarette smoking. But often no clear cause is found.

Cancer cells often travel to other parts of the body, where they begin to grow and form new tumors that replace normal tissue. This process is called metastasis. It happens when the cancer cells get into the bloodstream or lymph vessels of our body.

No matter where a cancer may spread, it is always named for the place where it started. For example, breast cancer that has spread to the liver is still called breast cancer, not liver cancer

Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. This is why people with cancer need treatment that is aimed at their particular kind of cancer.

Not all tumors are cancerous. Tumors that aren’t cancer are called benign. Benign tumors can cause problems – they can grow very large and press on healthy organs and tissues. But they cannot grow into (invade) other tissues. Because they can’t invade, they also can’t spread to other parts of the body (metastasize). These tumors are rarely life threatening.

Their are risk factors in getting colon cancer as well as other cancer and noncancerous diseases BUT remember their are modifiable risk factors leading to disease which are factors we can’t control being 4 areas 1.)Race 2.)Age 3.) Sex 4.) Heredity in the family (particularly nuclear and grandparents meaning higher risk than a first cousin or second cousin and down the family tree).

Risk Factors to colon cancer can be:

Most colorectal cancers occur in people without a family history of colorectal cancer. Still, as many as 1 in 5 people who develop colorectal cancer have other family members who have been affected by this disease.  People with a history of colorectal cancer in one or more first-degree relatives (parents, siblings, or children) are at increased risk. The risk is about doubled in those with only one affected first-degree relative=Nuclear Family. It is even higher if that relative was diagnosed with cancer when they were younger than 45, or if more than one first-degree relative is affected.

The reasons for the increased risk are not clear in all cases. Cancers can “run in the family” because of inherited genes, shared environmental factors, or some combination of these.

Having family members who have had adenomatous polyps is also linked to a higher risk of colon cancer. (Adenomatous polyps are the kind of polyps that can become cancerous.)

1-Inherited syndromes

About 5% to 10% of people who develop colorectal cancer have inherited gene defects (mutations) that can cause family cancer syndromes and lead to them getting the disease. These syndromes often lead to cancer that occurs at a younger age than is usual.

The most common inherited syndromes linked with colorectal cancers are familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC), but other rarer syndromes can also increase colorectal cancer risk.

Familial adenomatous polyposis (FAP): FAP is caused by changes (mutations) in the APC gene that a person inherits from his or her parents. About 1% of all colorectal cancers are due to FAP.

The most common type of FAP causes people to develop hundreds or thousands of polyps in their colon and rectum, usually in their teens or early adulthood.

Hereditary non-polyposis colon cancer (HNPCC): HNPCC, also known as Lynch syndrome, accounts for about 2% to 4% of all colorectal cancers.

The cancers in this syndrome also develop when people are relatively young, although not as young as in FAP. People with HNPCC may also have polyps, but they only have a few, not hundreds as in FAP. The lifetime risk of colorectal cancer in people with this condition may be as high as 80%.

Turcot syndrome: This is a rare inherited condition in which people are at increased risk of adenomatous polyps and colorectal cancer, as well as brain tumors. There are actually 2 types of Turcot syndrome:

• One can be caused by gene changes similar to those seen in FAP, in which cases the brain tumors are medulloblastomas.
• The other can also be caused by gene changes similar to those seen in HNPCC, in which cases the brain tumors are glioblastomas.
• MUTYH-associated polyposis:Racial and ethnic background  1. Jews of Eastern European descent (Ashkenazi Jews) have one of the highest colorectal cancer risks of any ethnic group in the world. Several gene mutations leading to an increased risk of colorectal cancer have been found in this group. People with type 2 (usually non-insulin dependent) diabetes have an increased risk of developing colorectal cancer. Both type 2 diabetes and colorectal cancer share some of the same risk factors (such as excess weight). But even after taking these factors into account, people with type 2 diabetes still have an increased risk. They also tend to have a less favorable prognosis (outlook) after diagnosis.  

2-Night shift workers are prone to cancers (colon/rectal and breast cancer).

3-Previous treatment for certain cancers –

Several studies have suggested that men who had radiation therapy to treat prostate cancer might have a higher risk of rectal cancer because the rectum receives some radiation during treatment. Men should consider the many possible side effects of prostate cancer treatment when making treatment decisions. Some doctors recommend that the risk of rectal cancer should be considered as one of those possible side effects but the patient is always responsible in doing research on their own before making the final decisions of treatment.  They choose the treatment they feel is the best choice; not the doctor.

• Some studies have found that men who survive testicular cancer seem to have a higher rate of colorectal cancer and some other cancers. This might be because of the treatments they have received.

4-Factors less clear but can effect risk for colon cancer:

        1-Type 2 diabetes

       2-Racial Group African Americans have the highest colorectal cancer incidence and mortality rates of all       racial groups in the United States. The reasons for this are not yet understood.

        3-Peutz-Jeghers syndrome: People with this rare inherited condition tend to have freckles around the mout (and sometimes on the hands and feet) and a special type of polyp in their digestive tracts (called hamartoma). They are at greatly increased risk for colorectal cancer, as well as several other cancers, which usually appear at a younger than normal age. This syndrome is caused by mutations in the gene STK1.  People with this syndrome develop colon polyps which will become cancerous if the colon is not removed.

Patients undergo lifelong surveillance of organs to monitor for cancer and prevent secondary problems from the polyps.

REVISED 3/05/2023

“Protecting bone health is important throughout your life. Understand how diet, exercise and other lifestyle choices can affect bones.

Bones do a lot for your body. They provide structure, protect organs, anchor muscles and store calcium. While it’s important to build strong, healthy bones during your childhood and teen years, you can take steps to protect bone health when you’re an adult too.

Bones change all the time. The body constantly makes new bone and breaks down old bone. This process is called remodeling. When you’re young, new bone is made faster than old bone is broken down. So the amount of bone mass you have goes up. Most people reach peak bone mass around age 30. After that, bone remodeling continues. But you lose slightly more bone mass than you gain.

The infrastructure of the human body that allows us to perform our daily activities from standing, to sitting, to walking, or even climbing is our skeletal system. The major pillar or beam in the skeletal system is the vertebral column (spinal column). This bone structure allows us to bend, stand upright, twist, to dancing up a storm down the happy trail of life, if taken care of properly. If not, you may not be considering your life a happy tune, during that time of injury that can be a short or long haul before resolved, if ever. This infrastructure is so vital in our activities of our daily life. Many of us don’t realize that until the injury or damage sets in. There is one way you can bypass this disaster, don’t have it become a part of your life which is taking preventative measures; especially if you do heavy lifting in your life; like in my job as a nurse. One major ingredient to preventative measures is proper body mechanics but the trick here is never lift heavy items from below your waist level without bending your legs or even better without a second person helping you or some form of support but there is more to it than just that. There are more factors involved in helping you keep your back with all other bones strong. That would be healthy dieting, maintaining a good weight for your height (body mass index), and good exercise (not necessarily work out but if that is what you enjoy doing, it’s even better and don’t stop). All these ingredients to a better development and maintenance of your skeletal system=HEALTHY HABITS. A plus and benefit that many choose to do is going regularly to a chiropractor who can keep your spine in alignment (see one before injury starts). Recommended in Rockland County, NY is Dr. Diane Gregory, who I go to for my back and who has done both prevention & Rx; www.gregorychiropractic.com.

The key is to be living a healthy life. This consists of diet, exercise, activity and healthy habits learned and practiced in your routine of daily living that will help prevent or assist you in treating bone and back injuries; even problems caused by the inactivity with doing heavy lifting (Ex. lack of any muscle tone or muscle knots), which can inflict bone or back injuries. The better we treat ourselves EVERYDAY regarding health the higher the odds we will live a longer life. One common problem in America that can occur if not living healthy and/or using improper body mechanics with heavy lifting, especially frequently, can increase the risk of sciatica nerve damage. The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and radiating down below the knee. The sciatica nerve is the largest nerve in the body that begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock to send the nerve ending down the lower limb to the foot. Depending on the precise cause of the sciatica symptoms with the duration, the outlook for recovery from sciatica ranges from excellent to having long term chronic symptoms. This can be prevented to some extent by avoiding low back trauma injuries. Thinking before lifting is the one of the best ideas. Osteoporosis is a common bone problem that is a abnormal loss of bony tissue resulting in fragile porous bones attributable to a lack of calcium, most common in postmenopausal women. This progressive bone disease that’s characterized by a decrease in bone mass and density leads to an increased risk of a fracture.

The causes of this disease that are modifiable (can be changed) would be: Vitamin D deficiency, menopause, excess alcohol, tobacco smoking, malnutrition (identified risk factors include low dietary calcium and/or phosphorus, magnesium, zinc, boron, iron, fluoride, copper, vitamins A,K,E, and C; also D where skin exposure to sunlight provides an inadequate supply. Excess sodium is a risk factor. High blood acidity may be diet related, and is a known antagonist to the bone. Some have identified low protein intake as associated with lower peak bone mass during adolescence and lower bone mineral density in elderly populations.

Other risk factors are inactive, underweight, heavy leads-a strong association between cadmium and lead with bone disease has been established. Low-level exposure to cadmium is associated with an increased loss of bone mineral density readily in both genders. Some studies even show soft drinks can increase the risk of osteoporosis related to high phosphoric acid. Others suggest soft drinks may displace calcium containing drinks from the diet rather than causing osteoporosis.

Another bone disorder is osteomalacia that is a softening of the bones caused by defective bone mineralization secondary to inadequate amounts of available phosphorus and calcium. The most common cause of the disease is a deficiency in vitamin D, which is normally obtained from the diet and/or from sunlight exposure. We can help our bones in many ways. There is not just one food to eat or one type of exercise to do or one healthy habit to practice to keep you healthy with strong bones, there are choices.   Wouldn’t you want less risk of bone or back injury or disease for yourself and for others throughout the nation including the future generations? Than join me and others. If you like what you see spread the good cheer. Let’s build a stronger foundation regarding HEALTH in America.

Adults need 700mg of calcium a day. You should be able to get all the calcium you need by eating a varied and balanced diet.

Foods healthy for bones and good sources of calcium include:

• milk, cheese and other dairy foods.
• green leafy vegetables, such as broccoli, cabbage and okra, but not spinach.
• soya beans.
• tofu.
• plant-based drinks (such as soya drink) with added calcium.
• nuts.
• bread and anything made with fortified flour.
• fish where you eat the bones, such as sardines and pilchards.