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Gluten-Free? Still Sick? It Could Be EPI! Find out more in Living Without's Gluten Free & More magazine June / July '15 issue featuring Dr. Rudert as interviewed by Christine Boyd
May 24, 2015
Gluten-Free? Still Sick? It Could Be EPI. Chances are you haven’t heard of EPI. It may not even be on your doctor’s radar. But everyone with celiac disease and gluten sensitivity should know about it, writes Christine Boyd in the latest Living Without's Gluten Free & More Magazine. In the article Dr. Cynthia Rudert says, "Because EPI interferes with digestion, it causes symptoms very similar to celiac disease and non-celiac gluten sensitivity...Patients experience gas, bloating, loose stools and, in some cases, weight loss." Read an excerpt from the article below.
Author CHRISTINE BOYD: After Annie was diagnosed with celiac disease last year, her brain fog and constipation went away. But Annie wasn’t symptom-free, despite a strict gluten-free diet. The 29-year-old from Wilmington, Delaware, still dealt with frequent and painful bloating. She also had worryingly low levels of vitamins D and K. Even with massive supplementation, the vitamin levels wouldn’t budge. Although celiac disease can cause vitamin deficiencies, Annie had another problem—exocrine pancreatic insufficiency (EPI).
If you were paying attention in high school biology, you know the pancreas makes insulin, which regulates blood sugar. But the pancreas also has another important job - producing enzymes that help digest your food. When the pancreas doesn't pump out enough of these enzymes, EPI develops.
"Because EPI interferes with digestion, it causes symptoms very similar to celiac disease and non-celiac gluten sensitivity, says Atlanta-based gastroenterologist Cynthia Rudert, MD. "Patients experience gas, bloating, loose stools and, in some cases, weight loss."
"Sometimes patients will even say, I don't feel like I'm digesting my food," says Rudert. "Often they'll notice that eating high-fat foods like sausages or cream-based dishes exacerbates symptoms." Digestion of fats is particularly problematic for many with EPI.
EPI can occur on its own or it can develop as a result of a number of other disorders, including celiac disease. Up to 90 precent of individuals with cystic fibrosis aslo have EPI.
Read more on EPI and how celiacs can get EPI - because inflammation of the small intestine in celiacs can obstruct the pancreatic duct. For a link to the rest of the article, click here.