Eating Disorder, Celiac Sprue & Barrett's
My 17 year old daughter was just diagnosed with Barrett's Esophogitis. Two 1/2 years ago she was diagnosed with Celiac Sprue. In the time shortly after that she had a torn esophagus and we discovered she had been bulimic for almost 1 1/2 years. After dealing with the eating disorder and following a gluten free diet she seemed to be doing great. She began eating normal foods again and no recurrence of the Celiac Sprue so we thought there was a mis-diagnosis. She has developed polyps on her vocal cords so the dr's did an EGD and gave us the news about the Barrett's and that the duodenum was also inflamed. She seems terribly young for Barrett's. Can anyone tell me if there could be a correlation between all three or is there somewhere that deals with this? Thanks!
Barrett's knows no age boundaries. If your daughter was a bulimic then the damage done from constant regurgitation could definitely cause the kind of damage required for the onset of Barrett's. In fact, there have even been some cases of esophageal cancer in <30yr olds, all associated bulimia. (Very, very, very few; I've only ever seen 2 documented cases.) The polyps on her vocal chords are very likely also due to the bulimia.
That said, the fact that she's a Celiac means that this tendency might have actually been borne out of that condition, which can cause a LOT Of problems.
Remember one thing: Once a celiac, always a celiac. If she was diagnosed with Celiac Spruce there's no going back to a regular diet. (For them to make this diagnosis it means there was damage in her small intestine indicative of this; very plain to see in an EGD.) She must follow that regimen for the rest of her life. Luckily, with "gluten-free" foods becoming fashionable, this is easier now that at almost any point previous. Even if symptoms don't show up right away after the introduction of gluten-containing foods that doesn't mean damage wasn't being done. For more info, check out Celiac.com and the forums there. Very helpful.
So could they be related? Probably, with the first domino being Celiac Spruce. That must first and foremost be addressed. The Barrett's will likely never be healed, at least not unless a successful technique is developed and administered. (There are a few in the works.)
I should explain one thing about my comment: It's theorized that esophageal cancer doesn't happen unless there's Barrett's already present, although obviously Barrett's can exist without there being EC, hence it's mention.
Thanks. One thing confusing to me is that she has been off the gluten free diet for almost 9 months with no cramping or diarrhea. The only thing noticeable was in the EGD with the inflammation in the duodenum. If she truly had Celiac, wouldn't there be more symptoms being seen or does it take awhile to cause problems again? The esophageal cancer is one of the biggest concerns to me at this point. Do you know of anyone doing research or studies in this area?
Again... thank you.
No, there may not be symptoms from the celiac when she went back on 'normal' food because the body will fight hard to remain 'normal.' Whether or not the symptoms are there, she's GOT to remain gluten-free. Celiac is an autoimmune problem and the effects of not following the diet could be absolutely horrendous - if not now, then in the future. And those effects cannot be reversed. There are SO many people who are mis-diagnosed for years before celiac is finally found and those people then have to try to manage to live with neuropathic issues and cripling pain that can be caused by this disease. In some individuals the results can mimic M.S. or other conditions.
Esophageal cancer may be a concern, but celiac issues should be right up there with that issue.
Sign into Medscape and go to the GERD resource board and read up on Barrett's progression to cancer. In most people it can take years for that step to take place, but it's necessary to be vigilant with treatment in the form of diet and medication.
There is no correlation that I know of between the conditions you mentioned, however, celiac can at times mimic the symptoms of GERD issues.
I have had Barretts for over 7 years. I have to have the EGD every year. But so for so good. But, my brother-in-law, really had not many symptoms. But his throat was really bothering him, had a cough. It was cancer, They went stright to Houston to MD Anderson. He had a very big surgery, after almost 6 years M D released him 2 weeks ago. And it does not know age, and with her history make sure you take her to the best Dr.'s. I will be oraying for her.
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