Alison Conte

The Celiac Center: A group approach to care

Celiac disease is an autoimmune disease that triggers an inflammatory response in the small intestine when a person consumes gluten. Gluten, a protein found in wheat, barley, and rye, is in many types of food, beverages, and other everyday products such as supplements, drugs, lipstick, and toothpaste.

Celiac disease is a chronic illness and, over time, it can damage the small intestinal lining, leading to other complications such as micronutrient deficiencies, systemic illness, and overall poor health.

It’s important to note the key differences between what the popular media says about gluten and what celiac disease really is. Most commonly, media reports will use the term “gluten intolerance” or “gluten sensitivity” to segue into an advertised gluten-free product or diet. This can be confusing to our patients.

To put it simply, gluten intolerance means feeling unwell after consuming gluten. Symptoms can include abdominal discomfort, diarrhea, fatigue, or malaise.

However, damage can’t always be clearly confirmed through blood testing and biopsies of the intestine. Therefore, we consider this as a particular functional bowel disorder that is triggered by gluten consumption.

THE DIFFICULTY OF DIAGNOSING CELIAC DISEASE

Celiac disease should not be confused with gluten sensitivity, as celiac disease is genetically passed from generation to generation through HLA DQ2/DQ8 gene loci and will show changes through blood tests and intestinal biopsies. It also carries significant repercussions if not identified and treated appropriately.

Here’s why we need to reconsider our approach and accept a responsibility to educate ourselves and others.

• The public lacks awareness about the disease, its diagnosis, treatment, and complications.

• 1% to 2% of Americans unknowingly carry a diagnosis of celiac disease.*

• At least one-third of patients with celiac disease present with non-gastrointestinal symptoms.**

• When patients report ataxia, headaches, neuropathy, weakness, fatigue, memory loss, joint pains, and other constitutional symptoms, they often get mistakenly treated for migraine headaches or arthritis.

Our Celiac Center, in the Autoimmunity Institute at AHN West Penn Hospital, helps patients manage their diet, lifestyle, medications, and other associated illnesses. Our multidisciplinary team of gastroenterologists, dietitians, clinical nutritionists, and clinical psychologists spend time with each patient to answer their questions and have an in-depth conversation regarding celiac disease.

We see patients in groups and individually and connect with their referring physicians to facilitate their transition and continuity of care.

The Celiac Center was started in 2014 by Dr. Kofi Clarke, then director of the AHN GI Division, in collaboration with Dr. Jorge Vazquez. They saw a clear need to educate patients and providers regarding celiac disease. The center was initially localized within the GI clinics and later moved to the Autoimmunity Institute.

Dr. Heitham Abdul-Baki, gastroenterologist and director of the Celiac Center since 2016, focuses on chronic diseases such as celiac disease and inflammatory bowel disease.

“To my patients, I am a gastroenterologist able to treat and educate them. In my administrative role, I provide the optimal environment and workflow that will allow my teammates to function at the best of their capacities,” said Dr. Abdul-Baki.

He believes in developing an in-depth understanding of each patient’s medical history and coordinating connections with different providers for the interventions they need.

Lesley Gradone, RDN, LD, CNSC, is a dietitian who works with many patients at the Celiac Center. “Gastroenterology is part and parcel to everything that has to do with nutrition. We have very interesting patients and I love the daily challenges and stretching myself in new directions,” she said.

Lesley schedules her patient referrals for a telephone visit, video visit, or in-person visit, working closely with Dr. Abdul-Baki and Brianne Ludwick, LCSW, a behavioral health consultant at the Autoimmunity Institute.

Brianne started her career with AHN in January 2021. “I bridge the gap to provide support for patients who we identify as having mental health issues,” said Brianne. “There are daily life challenges and stressors that can come with managing a chronic condition, so I’m there to provide resources to our patients who need them.”

Brianne assists patients of all ages, many of whom are surprised and dismayed by their celiac disease diagnosis. She will visit with every patient and help them with any emotional or mental health issues. “A lot of times, conditions can hit a patient so quickly that they find it hard to process everything all at once.”

“I try to create awareness to any underlying problems they may have so that we can solve them together.” — Brianne Ludwick, LCSW

Dr. Abdul-Baki, Lesley, and Brianne believe that their strongest allies in treatment are education and knowledge.

“Unfortunately, I see a lot of patients who haven’t learned very much about their disease. My approach is to give them the time needed for proper understanding of the current state of health and future expectations,” said Dr. Abdul-Baki. His biggest goal is for patients to walk out of the clinic having a name for their diagnosis and knowing exactly what to expect.

For more information on the celiac center call 412-359-8900.

Alison Conte

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