Episode Transcript

Dr. Dac: Hello, folks, and welcome to “The Colon Health Podcast” brought to you by colonoscopy.com. I’m your host, Dr. Dac Teoli. And I wanna thank you for listening today. In fact, on today’s episode, we’re going to be moving upstream from the colon to a nearby neighbor, that being the small intestine. In fact, we’re gonna be focusing in and talking about the small intestine condition known as celiac disease. What it is, how it’s diagnosed, and what you can do about it all on today’s episode. Our guest today is functional diagnostic nutrition practitioner, Jess Washington, of the fantastic website The Gut Healing Ninja. We’ll talk more about that website as this discussion kind of unfolds. But first, I wanna thank you for being here today, Jess.

Jess: Hey, Dac. Yeah. Thanks so much for having me.

Dr. Dac: So, it’s curious if we were to get down to at least a little bit of it right off the bat here in plain English. For some of our audience, they don’t like all the medicalese mumbo-jumbo stuff. In plain English, as best as you could do for us, what exactly is celiac disease?

Jess: Yeah. So, just kind of blanket term for celiac disease is a type of autoimmune condition. And then, if we were gonna step back a little bit from that and explain autoimmune conditions, in general, so those are just disorders of your immune system where oftentimes your immune system is just too active. So, it actually attacks and damages your body’s own tissue as a result of some sort of trigger. And then specifically, with celiac disease, your body’s immune system attacks the villi of the small intestine when it detects the presence of the gluten protein. And so, just to bring some significance to that because most people probably don’t know what a villi is, so your villi are actually part of just the inner lining of your small intestine. And they really just look like tiny finger-like projections, and they have a really, really important job and that’s to increase the surface area of your small intestine to that of about a tennis court. Which is crazy to think about, like, you have a tennis court inside your abdomen.

Dr. Dac: Wow.

Jess: So the only reason that’s possible is because of those villi. And so you need all that surface area in your small intestine because that’s where, like, 80% to 90% of your nutrients absorbed are absorbed from the foods you eat and the supplements you take. And so, the villi are super important. And then kind of bringing it all back to celiac disease, if those villi are damaged and blunted, you can just imagine that you’re gonna have a cascade of problems. You’re not gonna be absorbing nutrients. You’re not gonna feel so great if you can’t absorb things.

Dr. Dac: Yeah. No, it sounds like…well, one thing, my mind is a bit blown. Yeah, whole tennis court of surface area across, that is definitely important for, like you mentioned, absorbing all those nutrients in our diet and our supplements and our beverages. I’m curious because it sounds important. So, what would be some signs or symptoms folks would have if they’re suffering with celiac disease, and maybe they don’t know it?

Jess: Yeah. No, definitely important and definitely something to be aware of. But this is actually where it gets, like, super tricky and very confusing for a lot of people. Celiac disease can actually present in so many different ways. You can have one person who has the disease who presents with just traditional GI symptoms like you might expect, things like bloating, abdominal pain, diarrhea, fatigue, and then you might have someone else who may or may not be related to them who just also has celiac disease but who presents with just more, like, random symptoms, kind of nonspecific ones like neurological symptoms, depression, anxiety, neuropathy. It can, like, really run the gamut.

It’s actually interesting to get a little personal here. So, I have celiac disease, and I was the first one in my family to get diagnosed. So, I had no idea what was going on. But I had more traditional GI symptoms, along with another totally random thing, which now I know ties back to celiac disease, but it was canker sores. I just like all the time had canker sores in my mouth. It was so random. And now that I know what it was, I haven’t had one since, unless I accidentally eat gluten. So that can be a big celiac clue too. But anyway. So, after I got my diagnosis, both my mom and my brother got tested, and they were positive as well. But neither of them had any GI issues at all. They had always just had eczema was their, like, big, kind of, skin symptom and then some just like weird neurological and other unexplained autoimmune stuff, but just like, it can run the gamut, like I said, as a symptom.

So I think to boil it down for people, it’s like if you have any unexplained medical issues going on like anemia, infertility, recurrent miscarriages, migraines, skin issues, just anything in general that doctors are kind of like, “Well, I don’t know what explains this,” I’m just a huge proponent of getting tested for celiac, or other autoimmune diseases, because you just never know. It never hurts to get tested.

Dr. Dac: Thanks for sharing that experience with us. That’s not only brave to share your story, but also you’re helping a lot of people because you’re spreading awareness and just getting the word out there about it, people that might not have thought about it before. So, that’s phenomenal. Thanks for doing that. You mentioned family members, I wonder, is there a genetic component to this maybe? Or does it tend to kind of run in families sometimes?

Jess: It definitely does. Yeah. I think the stat on that is if you have a direct family member, so, like, a mom or brother, I don’t know if that extends to aunts and uncles, but you have a 1 in 10 chance of having celiac disease to, just in the general population, I think that stat is 1 in 100, which is actually a lot of people, probably most of them, unfortunately, undiagnosed. But, yeah, it’s 100% genetic. You have to have, I think, a combination of one or two genes that click on and then you have to have some sort of triggering event in your life. So you could have those genes, but then you might not express that celiac disease until you have that big, kind of, trigger.

Dr. Dac: So people can go decades in their life maybe. And if they’re kind of carrying this gene, as you mentioned, this genetic content that just puts them at risk and some of that happens, next thing, boom.

Jess: Exactly, yeah. And not to get to, like, on a rabbit trail, but I obviously have the genes because I have celiac disease. But then my trigger was not until I was like 20, I think, in college, and I went on a mission trip to Vietnam and just got exposed to, like, a whole bunch of bacteria and just the different water and different really just environment over there, and that was my trigger. And, you know, ever since then I couldn’t tolerate gluten.

Dr. Dac: And you mentioned just a few minutes ago, I jotted it down here, it is an excellent point. You talked about getting tested. So, it sounds like this, or some conditions are just purely a clinical diagnosis, there’s nothing really that can be tested for it. But it sounds like there’s some workup that would be available that would help the practitioner pointing them, “Hey, this might be celiac disease.” Is that right?

Jess: Yes, definitely. So, yeah, there’s kind of what most GI docs tend to do is, it’s kind of a two-tiered approach. So, usually, you’ll start out with a blood test or, and this is gonna get a little sciency, it’s called tissue transglutaminase IGA antibodies. So that’s when the doctor takes your blood, that’s what they’re testing for. And so, what that’s doing is looking for just immune activity in the form of antibodies against the gluten protein. So, if that ends up being positive, then you probably go on to the next step, which is the definitive diagnosis of celiac disease is an endoscopy and a biopsy of your small intestine. So how that works is they just like mildly sedate you and shove a tube down your throat, not to, you know, deter you from getting it done because it’s very important, but it’s not fun. So that helps them visualize the damage to the intestinal villi, which is that characteristic sign of celiac disease.

And I always like to tell people, in order for those tests to be accurate, you have to actually be consuming gluten. And I know, a lot of times people will be like, “Oh, I think gluten makes me not feel good,” and they’ll cut it out. It’s really hard to go back. And if you wanna know if you have celiac disease, you have to be eating gluten. So, I think for the blood test, I believe you have to be eating gluten for 12 weeks, and then the biopsy for about 2 weeks for those to be accurate at all, which again can be difficult if you’ve been off gluten and you’re feeling great. It’s like, well, I don’t really wanna go back in and eat it again. So, I always try to educate people upfront if you’re making the decision whether or not to start a gluten-free diet. But hey, if you end up feeling amazing without gluten, and you ever want to know if you have celiac disease, now is a good time to get on that testing.

Dr. Dac: That’s a phenomenal point too because like you mentioned, someone might cut gluten out of their diet and they’re thinking, you know what, I bet I have this and then eventually go and get tested. And then it sounds like maybe a false negative, kind of, workup…

Jess: Exactly.

Dr. Dac: …where they would go down and like, “Hey, no damage here.” So, and I also appreciated you, kind of, not sugarcoating it’s a serious diagnosis workup. It’s not just, no big deal. There’s some discomfort there and sedation involved and, you know, it’s serious, and I appreciate you kind of, like I said, not sugarcoating it for us. So, say someone is diagnosed and they’re a bit taken aback, they’re wondering maybe, I don’t know, do I need chemotherapy now, or they have no idea how this needs to be treated, whether from your personal experience or in your network within the, kind of, nutrition GI realm, what are ways in which this can be treated?

Jess: Yes. Honestly, I think ciliac disease is one of the, like, most fortunate autoimmune conditions that I could have had. I know that it’s easy to have an autoimmune condition. And I know a lot of people struggle with that and it’s a big life change. But, with celiac disease, there’s no medications, or no recurrent doctor visits. No, all you have to do is just strictly avoid gluten. And obviously, it’s a lot easier said than done with all the kind of cross-contamination, you can have gluten in your skincare products, and it can be hiding in random places. But that’s all you have to do is just not eat gluten. If you cut out all gluten from your diet, your villi should heal, your antibodies should go down, and you should start feeling better.

You will sometimes have people with celiac disease who still don’t feel 100% after strictly being off gluten and seeing all of the tests normalize. So, with them, you do have to dig a little bit deeper and see maybe what else could be going on. If they have any other gut stuff going on, any other autoimmune conditions still hanging around. So, in theory, it’s quite simple, but then you get into the nuances of each individual person, and there could be a little bit digging. But in theory, all you have to do is avoid gluten.

Dr. Dac: Yeah. So, it sounds like no guaranteed some of those nasty side effects or some of the other GI conditions, chemotherapies, radiations, amino therapies, things like that. As you mentioned one of the first steps, one of the major steps is kind of almost like lifestyle change, just switching up that diet.

Jess: Yeah. Yeah.

Dr. Dac: That’s really good to hear. That’s good news for a lot of folks. What about those other folks that maybe they were diagnosed and they’re, like, you know what, no, I’m just gonna tough it through, I’m not cutting out gluten, or maybe they’re afraid of being tested. And hopefully, we didn’t scare them away. We’re just being honest with them on how it’s being tested. But they’re like, “Yeah, I don’t want that scope done. And you know what, I’ll just continue living my life.” It sounds from how you explained it to us earlier, it sounds like there can be a lot of long-term, kind of, conditions or complications if it’s just totally ignored.

Jess: Yeah. And I totally feel…like, I get it. I get those people, and yeah, it’s not easy to make a big change, especially, it’s like you were diagnosed when you’re a kid or a teenager, and you just want to be normal and I totally feel that. But, this is something that you will eventually have to deal with now or in the future. And I think one of the main conditions that can arise if your celiac, and essentially your autoimmune disease, is untreated as your immune system is kind of running rampant. So, a lot of times, another autoimmune condition may pop up. And specifically, it’s interesting with celiac disease, autoimmune thyroid conditions are, like, very heavily related, especially Hashimoto’s and celiac often go hand in hand. And so the longer you’re undiagnosed with one, your likelihood of developing the other actually goes up, which is so interesting to me. And I imagine it has to do with your unchecked immune system just running around and causing havoc in there.

But then kind of less serious than that but still important to know is other things that you can develop because your villi … with celiac, you’re not absorbing the nutrients. There’s things like iron deficiency anemia, early-onset osteoporosis, infertility, lactose intolerance is a big one. And so, yeah, you definitely also see a lot of, like, vitamin and mineral deficiencies. Failure to fly and even delayed puberty if it’s a child that has developed this condition. So, it’s no joke. It’s nothing to play around with or eating gluten-free with no signs. But yeah, it’s something definitely to take seriously.

Dr. Dac: Right. And nutrition to serious science, which brings me to actually my next question, putting a pin in a moment for celiac disease. I’m sure some of our audience is familiar with it, but for the few that maybe aren’t, I was wondering if you could explain what is functional diagnostic nutrition.

Jess: Yeah. So, that is the particular nutrition certification that I have. So, at its foundational levels, the principles of functional diagnostic nutrition are really just to use a combination of really in-depth functional lab testing the client’s current symptoms and then that complete health history to kind of piece together and identify healing opportunities that can help this person get out of this cycle of trial and error that so many people are stuck in dealing with their health and symptoms that kind of just never go away. And what’s really awesome about kind of these techniques and these principles is that they allow me as a practitioner to help the client really dig into, like, the underlying causes of why they’re experiencing certain symptoms. So, we’re not staying super at surface level at the top, and just like, “Oh, here’s a [inaudible 00:15:24.540] for this symptom and this one.” But we’re gonna dig deeper, use more targeted lifestyle modifications. So, in-depth supplementation, and just some dietary changes to help them heal, really from the ground up, which I think is so important.

Dr. Dac: And as a functional diagnostic nutrition practitioner, do you kind of pivot some of that knowledge and expertise into the website, The Gut Healing Ninja?

Jess: Oh, yeah. I very much enjoy just kind of having fun with my website and just throwing around just a bunch of information that kind of can benefit anyone who’s just on Google trying to figure out why they’re having these symptoms. And then I also enjoy just kind of making fun recipes, especially gluten-free ones that maybe other people with celiac disease who have been feeling deprived can enjoy.

Dr. Dac: Yeah. And I was curious…I was going through there and I know I have my favorite recipes that I’ve seen on The Gut Healing Ninja. But I’m curious, and I’m gonna put you on the spot, do you have a favorite recipe on there?

Jess: So, I wanna say I like them all. But I think probably my favorite and probably because it’s, like, so significant to me, and it’s funny that we’re talking about avoiding gluten today is, like, if you’ve avoided gluten for any period of time, you kind of forget what real fresh baked bread tastes like. And actually, like, feels like, the texture is so different between “real bread” and, like, gluten-free bread. I developed this, what I think is really an amazing gluten-free homemade sourdough recipe. And it’s so fun to make. And the best part about it is my gluten-eating husband says it tastes just like regular sourdough bread. He loves it, he will eat he, like, half loaf in one sitting. So I think that’s probably my favorite and most impactful recipe on there.

Dr. Dac: Nice. I mean, and you read my mind, I didn’t tell you but that was actually one of the standout recipes to me too. So, I know what I’m gonna be doing this weekend because I love sourdough.

Jess: It’s a lot of fun.

Dr. Dac: What about other resources? Maybe it’s not recipes. Any other resources that folks could look forward to if they were to log on to theguthealingninja.com?

Jess: Yeah. So, I really just try to write blogs that can be just relatable. A lot of them are from my own health journey, just kind of things that I wish I knew when I was googling late at night trying to figure out what was going on. But also now that I’m a practitioner, I’m kind of starting some things up to help work more in-depth with people. And so, this project I’m working on now is developing just kind of a foundational gut healing course called the Gut Health Roadmap. And I’m really excited to kind of kick that off, hopefully in a few months once I get it finished. But I just really wanted to create something that could really educate people around just the main pillars of gut health, and not so that you can just have a quick fix and figure out what’s going on now, but so you can actually learn how your gut works and how just kind of your whole body ties into your gut health so you can figure out what’s going wrong with you now. And then also, if other things pop up in the future, you have that background knowledge, and you’ll be able to kinda troubleshoot that too. So, I’m super pumped about that and can’t wait to help people take charge of their health.

Dr. Dac: Right. Right. It’s important in the upcoming months, if someone wanted to learn more about that roadmap, the roadmap that you’re putting together, they’d be able to find that on the website?

Jess: Yes. Yeah. You just head to, I think it’s under the Work With Me tab. And then I think it’s called DIY programs. And there’s currently a waitlist. So, if they wanted to hop on there because I’m still working on it, but we’re getting close to being done. So, it should be up and ready soon.

Dr. Dac: Perfect. Perfect. Well, hey, I wanna thank you for being here with us tonight, Jess, and sharing your expertise with our listeners.

Jess: Yeah. Thank you so much for having me. And this si so much fun. I always love chatting about celiac disease anytime.

Dr. Dac: And again, for everyone at home, that’s www.theguthealingninja.com, spelled just like it sounds. And we’ll be having that website listed out right on our homepage. So, I wanna thank you folks at home listening in, or whether you’re on your commute, at the gym, wherever it is you are tonight, I wanna thank you for tuning in and listening to this episode. As always, we’re gonna have a summary of today’s episode as well as key points, some research articles as well, all on colonoscopy.com. And again, be sure to check out theguthealingninja.com. Please take care. Good night and good health.