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Nothing Silly About Celiac Disease

By Riva Preil

May marks National Celiac Disease Awareness Month. Celiac Disease (CD) is an autoimmune disorder of the small intestine that can occur in people of all ages, many of whom have a genetic predisposition. This genetic predisposition is a variation of the typical HLA allele (with the variant being either HLA-DQ2 or HLA-DQ8), however some people who have the variant allele do not develop CD. It is a polyfactorial disease, which means that several genes are involved with the development of or lack thereof of the disease.

The pathophysiology of CD is that the body responds negatively to gliadin (a gluten protein found in wheat), and the immune system creates an inflammatory reaction in the small intestine. This interferes with nutrient absorption through the microvilli of the small intestine walls. Spelt, semolina, durum, barley, rye, triticale, and Kamut may also create celiac-like symptoms. The symptoms of CD include chronic constipation and/or diarrhea (pale and foul smelling), abdominal pain, discomfort, and cramping, fatigue (due to impaired ability of the small intestine to absorb essential and energy providing nutrients), and failure to gain weight, especially in children. In addition, failure to absorb iron can lead to anemia, and failure to absorb calcium and/or vitamin D can create osteopenia or osteoporosis (if severe). Ulcers of the mouth may also be present. Furthermore, CD is associated with increased risk of developing adenocarcinoma (cancer of the small intestine) and lymphomas. CD can be confused with irritable bowel syndrome (IBS), so it is important to undergo appropriate testing to ensure proper differential diagnosis. These tests include serological blood tests and tissue biopsy (with or without endoscopy).

The best form of treatment for CD is a GLUTEN FREE DIET to prevent symptoms. Corn-based cereals, rice, wild rice, millet, sorghum, quinoa, buckwheat, potatoes, and bananas are recommended for individuals with gluten sensitivity. Not all “gluten free†foods are created equally- in fact, the FDA allows the term “gluten free†to be used with foods that contain up to 20 ppm (parts per million) of gluten due to the fact that most people with CD will not respond adversely to such low levels of gluten.

—FAQ

Frequently Asked Questions

Pelvic Floor Disorders and Treatment

What is pelvic floor dysfunction and why does it happen?

Pelvic floor dysfunction is extremely common and occurs when the muscles, tissues, or nerves of the pelvic floor are weakened, tightened, or injured by trauma, chronic strain, or overuse. Pelvic floor disorders can result from traumatic injury such as a fall, from sporting activity, surgery, or childbirth. They can also happen from more chronic issues, such as infection or chronic inflammation such as endometriosis. Pelvic floor disorders can be a consequence of poor alignment or posture, overuse, or improper movement. The pelvic floor muscles surround the urethra, rectum, vagina and prostate; therefore, if there is a dysfunction in these muscles it can result in urinary, bowel, or sexual dysfunction in people of all ages.

Who should I see to get a proper diagnosis?

Many healthcare providers don’t assess – or don’t know how to assess – the pelvic floor muscles and nerves, so it’s important to get a proper diagnosis from a practitioner who specializes in pelvic floor dysfunction and pelvic pain. Too often patients tell us that they’ve been to 10 different doctors and healthcare providers and their symptoms have not improved, or have worsened. Find a specialist right away and get on the path to healing as quickly as possible.

Why do healthcare providers miss (or misdiagnose) pelvic floor dysfunction?

Long story short, the medical practice is divided into areas of the body: Urology. Orthopedics. Gynecology. But the body itself doesn’t have walls; every system interacts with everything else. Sometimes providers are so laser-focused on what they treat that they miss the whole picture. 

As more and more research emphasizes the importance of physical therapy as part of a complete treatment regimen, more and more physicians are learning how to recognize and treat pelvic floor disorder. In the meantime, if you’re not getting relief from your current treatment, make an appointment with a pelvic floor specialist to learn more.

How does pelvic floor dysfunction affect sex?

Pelvic floor muscles have a huge impact on sex. Muscles that are shortened or tight and are unable to elongate will not allow for good blood flow into the genitals. This can result in pain, weaker erections, diminished sensation, inability to orgasm, and even decreased lubrication. Pelvic floor PT can help with these issues by enhancing blood flow and improving muscle function. 

How can pelvic floor dysfunction cause bloating?

Pelvic floor dysfunction, a condition characterized by the inability to correctly relax and coordinate pelvic floor muscles, can significantly contribute to bloating due to its impact on gastrointestinal functions. When these muscles are not functioning properly, it can impact the ease of emptying and make it difficult for your body to pass stool and gas through the intestines. This obstruction leads to an accumulation of waste and gas in the gastrointestinal tract, causing bloating and abdominal discomfort.

Is it true there’s internal massage?

There can be. We do perform internal soft tissue mobilization of the pelvic muscles that are inside your pelvis and are accessible only through the vagina or rectum. We never do internal treatment without your consent and understanding.

What makes someone a pelvic floor PT vs a regular PT?

All pelvic PTs get additional training in pelvic floor internal treatment through continuing education and at our clinic. 

We pride ourselves on the level of training we provide, not just at the beginning but throughout the time our therapists spend at Beyond Basics. We know that learning is a life-long process.  We also provide additional training in physiology of the GI system and urinary system as well as sexual health and function and nutritional training. Most PT programs and schools do not provide the depth and breadth of knowledge that we provide all our PTs at Beyond Basics.

Get help now from a pelvic floor therapist.

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