December 17, 2024 • 31 mins
On this episode, we will hear from naturopathic gastroenterologist, Dr. Christine Bowen about Celiac Disease. The health consequences of this condition can be devastating. Find out the symptoms of celiac disease, why it is important to diagnose this condition, and what you can do about it.
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Five To Thrive Live is broadcast live Tuesdays at 7PM ET and Music on W4CS Radio – The Cancer Support Network (www.w4cy.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com).
Five To Thrive Live Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.
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Episode Transcript
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Speaker 1 (00:00):
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guests should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.
Speaker 2 (00:40):
Hello, welcome to five to Thrive Live, a podcast about
thriving for those who have been affected by cancer and
chronic disease. I'm doctor Lisa Alschuler and I co host
with my good friend Carolyn Gazella. You can find all
of our past shows on every major podcast outlet and
a schedule on ithriveplan dot com. Tonight, I will be
(01:01):
talking with doctor Christine Bowen about well, we're going to
kind of leave that a little bit of a mystery,
but essentially about silly Act disease and its connection to
cancer and you know the ins and outs. Doctor Christine
Bowen is a leading naturopathic, gastro entrologist, author, and international
keynote speaker specializing in autoimmune, digestive and complex conditions. She
(01:25):
offers innovative, integrative treatments through online group programs and personalized
patient care. She's the medical director of Baffel Natural Health
and co founder of the nonprofit Inside Health Institute. Doctor
Bowen is dedicated to education and professional growth. She received
her doctorate from Basteria University in two thousand and five
(01:46):
and her Fellowship in Nature Pathic gastro Entrology in twenty
twenty two. And outside of medicine, she enjoys her family, travel,
music and nature. So before we introduce her, I do
want to thank our sponsor. We have Emuse, a unique
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(02:10):
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(02:53):
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more at doctor Orhiro probiotics dot com. And with that,
(03:14):
Doctor Bow and welcome to five to Thrive Live.
Speaker 3 (03:17):
Thank you so much for having me, Lise, I really
appreciate being here.
Speaker 2 (03:21):
Absolutely, I'm delighted to have you as well. So you know,
I want to start by giving our listeners a little
bit of a chance to know you more. So, how
did you develop your interest in nature pathic medicine and
then in digestive diseases.
Speaker 3 (03:35):
Yeah, so this story starts way back when I was
a kid and I basically had failure to thrive. So
it was about seven and just not gaining weight, pretty sick,
you know, couldn't play with the other kids asthmatic, and
the answers that my mom was getting from conventional medicine
were not satisfying to her. So she took me to
one of our very talented colleagues, William Mitchell. So Bill
(03:58):
Mitchell was my childhood doctor, and he was great negotiated
things with me, and we figured out that I had
quite a few food allergies, so that was really underlying
a lot of the failure to thrive at the time.
So fast forward, you know, about a decade of really
good health, and then in my teen years it got
an antibiotic for a couple of procedures and then started
(04:21):
having really terrible digestive symptoms. And those continued all the
way until I was about thirty three. So even through
medical school and after, I was still struggling with my
own problems. But I figured that though I may be unhelpable,
others were still helpable, and so I definitely wanted to
double down on my knowledge for helping people with digestive conditions.
(04:43):
And eventually I stumbled upon the specific carbohydrate diet and
it changed everything for me. And so that's a nutritional
plan that's been around for over one hundred years that
took grains out all grains, not just some, and also
limited the amounts of certain types of carbohydrates. And so
(05:03):
that really helped me to see that nutrition was a
key that I could use to be able to really
help my health and health of others in a way
that I had not previous. And so that was probably about,
you know, almost twenty years ago. And so now I
specialize in complex digestive conditions and autoimmune conditions, and so
(05:25):
how I've landed at more specifically coeliac disease and focusing
on celiac diseases that I see that a lot of
the people who've seen up to ten or twenty other
providers before they see me. In the end, we may
circle back around and realize that celiac disease is the
underlying cause.
Speaker 2 (05:42):
So there's you earned your credentials. Honestly, so to speak.
Speaker 3 (05:50):
I'm a patient and a provider, and so I definitely
know what it feels like to be on both sides.
Speaker 2 (05:55):
Yeah, and that's important. Actually, So let's let's talk about
siliac disease, which is what really we're going to try
to focus on for the next period of time. So really,
I think we need to first understand what is siliac
disease and what is siliac what is not siliac disease?
Speaker 3 (06:15):
Perfect and so Celiac disease is considered a genetically linked
so typically somebody else in our family has it, and
that gene link is part of what sets the stage
for having Celiac. The other piece is that coeliac disease
is an autoimmune condition and it can affect many different
systems in our body, not just our digestive tract. So
(06:37):
when we look at the reaction to gluten, so what
is gluten. Gluten is a protein that's inside of many grains,
So wheat, rye, and barley are three main ones, but
there are other grains that can contain gluten. So gluten
then causes this immune system reaction in people with Celiac disease,
(06:58):
and it causes damage to the line of the small intestine,
and so we have these little fingers or little villai
and the intestine and those can be essentially cut off
or flattened by this condition. And then we also end
up with things like intra so they call it intra
epithelial olymphicydes, but it's basically like a type of white
(07:18):
blood cell that lands inside of a skin cellar that
surface lining of the gut. So many different ways that
celiac disease can present because it can affect many different
organs or systems in our body. It can have a
ton of different diseases. So what it is not, so
that's what Celiac disease is. What it is not is
(07:40):
that it's not gluten sensitivity. So it's not a preference
for gluten avoidance. It is not food intolerance. Instead, it
is a true allergy to gluten that then causes this
autoimmune cascade. So does that make make it there? Yeah?
Speaker 2 (08:02):
Yeah, so there is So just to restate that a bit,
there is a very serious condition, Siliac disease, which is
genetically kind of determined, I guess is the right words.
So those individuals cannot tolerate gluten ever, And then there
are people who are sensitive to gluten but don't have
(08:22):
Celiac disease. Those individuals, through various manipulations of diet and
potentially a program of restoration, typically avoid gluten but may
at some point be able to reintroduce it in small
amounts yep.
Speaker 3 (08:36):
And then there's the case there's a case that's somewhere
between those two, which is called non celiac gluten sensitivity.
And essentially it has to be managed the same as
coeliac disease with gluten avoidance down to the molecule, but
the symptoms can be very similar. They're just a little
bit less severe. So non celiac gluten sensitivity sounds so mild,
but it really is like coeliac lighte, but it just
(08:58):
doesn't test likes cliac.
Speaker 2 (09:01):
Got it. Okay, So what you've described kind of what
happens in the intestines, But what does that then cause
in the body? What are some of the typical symptoms
of siliac and why does that make it so easy
to miss? Because many people with siliac disease as kids
don't get diagnosed well, you know, to well into their
(09:22):
adolescence or even in some cases their adulthood.
Speaker 3 (09:25):
Yeah, I have diagnosed people as high as up into
their eighties, and so they've gone on and on. We're
having symptoms that nobody is really picking up on or
putting it together. And so one, we have a fractured
and fragmented healthcare system at times, and so different providers
might be operating in silos and not really talking to
(09:45):
each other, and so they're not comparing notes and being like,
what are you seeing over there? And what am I
seeing over here? You put it all together, it might
look like celiac. So celiac disease is a multi organ
autoimmune disease, and so the symptoms can depend on the
areas that are impacted. And so I would say, one,
there are intestinal or digestive symptoms, So those are the
classic you know, diarrhea, constipation, gas in, bloating, heartburn, nausea,
(10:11):
those sort of symptoms. But then there are a ton
of extra intestinal symptoms, which mean symptoms outside of the intestines.
So some of the really common ones that show up
in a classic case of coeliac disease would be fatigue
or brain fog. You get the digestive symptoms, maybe some
malabsorption of nutrients, so people might be anemic or iron
(10:32):
or B twelve or folic acid deficient and not know
why other nutrient deficiencies that might result in things like osteoporosis.
So classic coeliac disease is normally like fatigue and digestion issues,
But more and more we're seeing non classic coeliac disease symptoms,
and so sometimes that means that they're asymptomatic. Not a
(10:54):
single symptom is telling us that they have coeliac disease,
but then we have to be smart enough to try
to like tease it out or there might be something
that gives us a hunt. Even so, norm classic coeliac
disease symptoms might be things like psychiatric concern so like depression, anxiety,
even like schizophrenia or like seizure disorders. When we're talking
(11:18):
about like neurological impact then too, so neurological or psychiatric
impact is more and more becoming prevalent as symptoms that
we would pick up as possibly being associated with celiac disease.
So I don't know how many psychiatrists or neurologists are
screening for celiac disease, but hopefully more so things like
mouth ulcers or joint pain, other autoimmune decisions a sorry,
(11:41):
other autoimmune diseases like propping up might be associated with
a celiac disease. And so it really can be this
big constellation of symptoms and you have to just start
trying to connect the dots and tracing it back to
see if there's this one common condition underlying all of
those things.
Speaker 2 (12:00):
Mm hmm, yeah, wow, Yes, I got to be a
good detective with this. For sure. So let's say you
suspect celiac disease. The diagnosis is also not entirely straightforward,
so talk about how this is diagnosed.
Speaker 3 (12:14):
Yeah, So first I would say, if you're trying to
get a diagnosis, and this is the very first time
that you suspect the gluten is an issue for you,
or you're getting screened, that's the perfect time to get
all of the testing done. Anytime after somebody has eliminated
gluten from their diet can make it harder for us
to find. Celiac disease is a very clear condition. So
(12:36):
things like the blood tests. So typically there's about one
to two of these blood tests that are done, you know,
by standard providers, and so I like to do all
six always, and so I'm just going to rattle them off,
so bear with me. So total immunoglobulin A and total
immunoglobulin G because we have to check these two parts
(12:56):
of our immune system and see if they're functioning correctly
before we test the rest to the tests. And then
tissue transclutaminates IgG and I G A and then de
diamidated gleiodin IgA and IgG. And then there are a
couple of genes that we can test for celiac, which
are HLA Dq two and Dq eight, and some people
(13:16):
with celiac have Hla Dq seven, but it's much less likely.
And then once we suspect celiac, oftentimes you get shipped
off to a gasterenrologist and they will hopefully do an
endoscopy where they take the tube with the camera, put
it down your esophagusin into your small intestine, and then
(13:37):
they take a couple of biopsies of the small intestine tissue,
and so they're looking for those tissue changes that we described.
And then you know, basically, if all goes well, they've
done four to six biopsies of this of the duodenum,
which is a part of the small intestine. If all
doesn't go well, then they might do zero biopsies of
(13:58):
the duatenum or up to me three. But in order
for it to be this gold standard test that we
refer to it as for biopsy, we really need four
to six biopsies of that specific area of the small
intestine to say that we did it right.
Speaker 2 (14:15):
Yeah wow, so uh again, not like just sort of
a flippant little thing. You know, get a little tests
and you're one and done. So, Okay, we've had a diagnosis,
you've talked a little bit about some of the symptoms
of Siliac disease. Are there other and you mentioned a
few risks, but are there any other ways in which
(14:37):
this disease can adversely affect quality of life?
Speaker 3 (14:41):
Yeah, I was gonna say hugely so, mental, emotional, social impacts.
So it's not just the physical, whether it's intestinal or
extra intestinal conditions. Like even things like infertility could be
due to Celiac disease. You know, having a child that
has birth defects that could potentially be something caused by
(15:03):
coeliac disease. So in general, when somebody gets a diagnosis
of Celiac, then that's where the quality of life issues
really come up. And so you know, knowing that you
are under threat from this invisible invader because with the
gluten avoidance, you have to be down to the molecule
avoiding all cross contamination. So it's this individual or this sorry,
(15:25):
this invisible threat of something that's trying to hurt you
that you can't even see. To try to actually know
who this invader is or who this you know, where
the pathogen is. So we just have to have this
existential like hypervigilance of trying to prevent our environment from
harming us. So I really try to help people within
(15:47):
your diagnosis of Celiac strike that balance. And so in
the beginning, I have them avoid macroscopic or the very
obvious gluten, and then we really work our way towards
microscopic avoidance and avoidance of you know, cross contamination and
things like that, because this is huge, Like what if
your favorite thing to do is like pizza night with
your family out at your favorite restaurant, Like that's a
(16:09):
no go because even like cooking the pizza in the
same oven as as gluten containing pizzas is not possible
for many people with seeliac disease. I'd say that that's
pretty safe to say, like you should not cook them
in the same oven. So that and then the stress
of like having to change your environment, like I suggest
(16:30):
that people have a gluten free home so that they
have at least one safe place to be and prepare foods,
and so it just all can take a huge toll.
Oftentimes this is on top of them feeling unwell because
they've had seaiact disease that they've just gotten diagnosed for
so they might be fatigued, and they might have all
of these other symptoms going on, joint pain, digestive symptoms,
(16:52):
and then they're asked to do this huge amount of
work to really like clean up and unburden them their
lives from gluten. And it's just a huge undertaking.
Speaker 2 (17:02):
Yeah, well, I'm kind of just trying to said which
question to ask you next? So I want to leviate
for a second. So you met, you know, you mentioned
even microscopic or just like even tiny bits of gluten
can trigger the reaction to people and need to be avoided.
(17:24):
But let's just say somebody is doing their best but
they inadvertently eat some gluten because there was a mislabeled
product or whatever. What happens. Are they back to square zero?
What can they do to kind of preserve their health
that they probably have regained by avoiding gluten.
Speaker 3 (17:45):
Yeah, this is a great question because there is this
existential threat of like getting gluten in our environment. I
also like to teach my patients that you will get gluten,
like it will happen, So we think it's never going
to happen. We're kind of setting ourselves up instead of
saying well when it happens, because it will inadvertently happen.
We live in this world that's filled with gluten. It's
(18:06):
likely to happen. So what do we do when somebody
gets glutened? And so oftentimes people will have something like
some enzymes on hand that might help to break it
down faster. They might have some immune system calming treatments,
you know, they might do a little short period of
bowel rest, and then oftentimes they're not back at square one.
(18:27):
So if it was a significant amount of gluten, and
especially if they've just gotten diagnosed and they're just barely
into healing, it might take them back to where their
symptoms were. But normally it won't persist, it won't stay
there forever in that space because they have the tool
to get well again of staying gluten free. So you
just go back to making sure that you're having gluten
(18:49):
avoidance and they should come out of it. And so'd
say initially it will take people longer to recover from
a gluten exposure versus like as they've healed up and
that their intestine is in a better shape or in
better shape, their immune system is in better shape, it's
more resilient. It seems like they might, you know, have
just fewer symptoms and less severe and they'll be able
(19:12):
to recover faster from it because their immune system is
less vulnerable than at diagnosis it's normally the most vulnerable.
Speaker 2 (19:20):
Yeah, okay, good, that makes sense. So let's talk about
the link between ciliac disease and colon cancer. What is
the link there?
Speaker 3 (19:29):
I think of three things when I think of a link.
One of them is that both Celiac disease and with
colon cancer or cancer in general, that there's normally a
microbiome element or alteration. The other piece is that celiac
disease creates massive amounts of chronic inflammation, and so if
we want cells to change and to become abnormal and
(19:52):
potentially pre cancerous, then things like high amounts of chronic
inflammation is a way for the system to basically start
creating that process. The other thing that I think is
insult to entry is that with celiac disease, especially when
it's not diagnosed or addressed, people may be very deficient
in a lot of nutrients, and those nutrients might normally
(20:13):
show up to help the immune system in ways that
might help with preventiontive cancer or at least like you know,
giving you the right nutrients to be able to have
the healthiest possible immune system going into this. So if
you have an iron deficiency, be twelve deficiency, follic acid deficiency,
if you're not absorbing those nutrients from your food, even
(20:36):
if you eat you know, the healthiest nutrition for you,
you know, you may not be making the most out
of it because of malabsorption from celiac. So I think
of those three things, and then even that intra epithelial lymphocyte,
which is that white blood cell type inside of a
skin cell in the lining of the gut, that that
(20:57):
is considered to be a precancerous condition. So if that
goes on and on and it's later in diagnosis, then
it means that somebody is more likely to have, you know,
have some of those cell changes that might be precancerozed.
Speaker 2 (21:12):
Yeah. So again another reason why even though a lot
of gluten containing foods can be hard for people to
avoid because they you know, are tasty and very common,
very important to do so, and of course you know,
getting rid of that level of inflammation and hopefully that
disturbance to the microbiome is very important. So what about
(21:34):
some other health maintenance strategies that someone with siliac disease
should do on an ongoing basis to really address the
cancer risk and just the potential disease risk.
Speaker 3 (21:46):
Yeah, so definitely, you know, making sure that you have
a self advocacy as well as family advocacy. I feel
like that's huge for the mental health piece. But then
we're looking at a new diagnosis of celiac. If you
can have follow up tests the same six that I listed,
you know have to you don't have to retest the genes,
but the same six that I listed. If you retest
(22:08):
those periodically, it can tell you what state your celiac
disease is in. So are you still getting you know,
immune system triggers from your environment. You might pick it
up on just repeating that test. In repeating that test panel,
we're hoping to see that everything converts to negative and
that your immune system doesn't have any glutent exposures. So
(22:28):
retesting that panel can help us see you know, this
is this person with celiac disease responding to this gluten
free diet, So that would help to calm down inflammation.
And when we're looking at other things. It would be
like our regular screenings, So screening exams for colon cancer,
things like the colonoscopy depending on your family risk and
(22:51):
endoscopy can help to pick up some early like cell
changes in the stomach or small intestine or esophigus. So
really making sure that you're doing some of your annual
screening exams as well as some of these periodic screening
exams that we already have in place. We have these
recommendations in place, and I definitely want my patients to
(23:12):
take advantage of doing those recommended screenings so that they
could pick up something early, because we always know that
the outcomes could be potentially better the earlier we find something,
so at least we have more treatment options too write
the earlier we find something.
Speaker 2 (23:29):
What about faily risk, Like if a child's parent has ciliac,
is that child at greater risk?
Speaker 3 (23:36):
Yeah, so this is a fabulous question because the data
is changing. So we used to think that it was
one in four family members, immediate family members or first
degree relatives who would have seliac disease, but after some
mass screenings in places like Finland and Italy, they actually
realized that it could be up to like two and
a half percent, maybe even up to three percent and
(24:00):
so of the population, which would then bring that statistic
closer to forty four percent. So forty four percent of
our immediate relatives might have coeliac disease as well, versus
before we were saying twenty five percent. So it's almost
double what we thought it was, both like coeliac disease
occurring in the general population as well as coeliac disease
(24:22):
occurring within a family.
Speaker 2 (24:25):
Interesting, and you mentioned the studies in Scandinavia. Are there
certain ethnic populations where you see a greater prevalence of
siliac disease?
Speaker 3 (24:34):
Yeah, and so the two highest statistics that I saw
were Canada and Finland, But then Ireland and also Italy
have fairly high prevalence as well. So I definitely think
that and the prevalence is rising. I mean some of
that that were more aware or that there might be
some issues with our food. We're not sure, but we
(24:55):
definitely know that incidence is rising over time.
Speaker 2 (25:00):
Let me just ask you a little bit about gluten
sensitivity for a moment. So nonciliac gluten sensitivity, So these
are people who when they eat gluten containing grains. They
don't feel well. They have digestive issues, you know, maybe bloating,
maybe diarrhea, maybe constipation. They might feel foggy headed, joint pains, rashes,
(25:22):
you name it. Can you just talk a little bit
about why that's so different than ciliac disease and or
if there's any way in which you manage that differently.
Speaker 3 (25:32):
Yeah, So non celiac gluten sensitivity. Six percent of Americans
actually have non celiac gluten sensitivity, and it basically can
look almost identical to celiac but maybe a little bit
less severe across the board, so including both intestinal and
extra intestinal symptoms.
Speaker 2 (25:50):
They can feel.
Speaker 3 (25:50):
You know, you can have the same you can have
malabsorption of nutrients, but it's basically less severe, and so
then the management is the same. So this isn't somebody
just saying I'm going gluten free. This actually ends up
being somebody who needs to avoid gluten down to the molecule,
including cross contamination to be able to become fully well.
(26:12):
They might feel much better from taking out the main gluten,
but in true non celiac gluten sensitivity, they have to
abide by basically a gluten free diet for celiac in
order to become well, and so the main difference is
just how it tests and then the severity of symptoms.
Speaker 2 (26:31):
But isn't it true that in some people with gluten
sensitivity that do not have siliac disease, after a certain
period of avoidance, they might be able to reintroduce it
into their diet.
Speaker 3 (26:41):
I feel like that would be maybe general general gluten
sensitivity or gluten intolerance versus like the true diagnosis of
NCTS or non Celiac gluten sensitivity. The more it gets researched,
the more they realize that it's just a lighter version
of celiac that doesn't quite test or biopsy exactly like celiac,
(27:01):
but almost everything else can be identical.
Speaker 2 (27:05):
So basically, if people have adverse reactions to gluten, they
really should get comprehensive testing to figure out what's going
on and whether or not they are on a lifelong
plan of avoidance, or whether they might have a gluten
intolerance that might require some period of avoidance but maybe
not lifelong.
Speaker 3 (27:24):
Yeah, yeah, I definitely think that there can be different
degrees of avoidance, but that a lot of people who
are still symptomatic. They might have to do even a
short trial of you know, down to the molecule avoidance
to see is there significant change in how I'm feeling
when I'm mostly avoiding gluten versus when I'm avoiding it
down to the molecule. And so that's the sort of
(27:45):
thing that you know, I help people kind of look,
you know, look at the different columns and see how
they feel. And then we will not tell somebody to
go and take all the gluten out of their house
just because we have to have a really convincing reason
to have them do is short trial of full glunovoidance
down to the molecule, and then that information goes into
(28:07):
our work up and so then we're able to help
give long term advice based off of how they do
with that.
Speaker 2 (28:13):
Right. Well, very interesting stuff. So we just had a
couple of minutes left. Any final thoughts you'd like to
leave with our listeners.
Speaker 3 (28:21):
Yes, I feel like one if you were suffering with
digestive symptoms and you feel like I felt and felt unhelpable,
just know that there are many many different conditions that
could be causing what's going on. Something like just living
with digestive symptoms and not knowing why. I don't think
(28:42):
is really an acceptable way for us to go about
living our lives. It's really hard on our quality of life.
Sometimes it can take up to thirteen years from having
symptoms of Celiac disease to finally getting diagnosed. So the
mental health implications and impact is huge. Even when somebody
has symptoms and they're like on the path to diagnosis,
(29:05):
it still could take up to ten years for them
to get diagnosed. So if you still have symptoms, like
please persevere with finding answers because I don't want any
of you to be walking around with miserable guts when
we definitely know that there are some wonderful ways that
we can help to address and you're changing your digestive
health can change your greater health, and so yeah, it's
(29:26):
a lost opportunity if we're not able to keep on
persevering until we really get answers. Yeah.
Speaker 2 (29:33):
Good good advice, really good advice. Well, you clearly are
in your wheelhouse. Your expertise is obvious, and I'm really
grateful for you and your time and being on the show.
Where can our listeners find out more about you? Do
you have in a social media website you'd like to share.
Speaker 3 (29:49):
Yes, and so my private practice I have an associate
there who sees clients as well. Doctor to you. So
Baffelnaturalhealth dot com is my practice website. And then social channels.
I do have free access to some information on YouTube
at our Immune Recovery website. And then Boffel Natural Health
(30:11):
has all the social channels. And then also doctor Christine
Bowen has all the social channels as well. So definitely
like Instagram and Facebook. And I believe we have some tiktoks.
I might not be as active on TikTok as.
Speaker 2 (30:25):
I all right, well, thank you so much, doctor Bowen.
It's really been a very enlightening show. And keep up
the good work. And that wraps up this episode of
five to Thrive Live. So we thank our sponsors Cognizance
Ofticoline to help enhance memory, focus and attention. Immuse a
(30:46):
post biotic for immune support doctor or here is Probiotics
award winning pre and probiotic formulas and pro thrivers wellness
supplements designed specifically for thrivers. And may you listener enjoy
your evening. Thank you for joining us me you experienced joy,
lefter and love it's time to thrive. Everyone scy.
Speaker 1 (31:09):
Scots.
Speaker 2 (31:17):
The scene Jan the city stre
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guests should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.
Speaker 2 (00:40):
Hello, welcome to five to Thrive Live, a podcast about
thriving for those who have been affected by cancer and
chronic disease. I'm doctor Lisa Alschuler and I co host
with my good friend Carolyn Gazella. You can find all
of our past shows on every major podcast outlet and
a schedule on ithriveplan dot com. Tonight, I will be
(01:01):
talking with doctor Christine Bowen about well, we're going to
kind of leave that a little bit of a mystery,
but essentially about silly Act disease and its connection to
cancer and you know the ins and outs. Doctor Christine
Bowen is a leading naturopathic, gastro entrologist, author, and international
keynote speaker specializing in autoimmune, digestive and complex conditions. She
(01:25):
offers innovative, integrative treatments through online group programs and personalized
patient care. She's the medical director of Baffel Natural Health
and co founder of the nonprofit Inside Health Institute. Doctor
Bowen is dedicated to education and professional growth. She received
her doctorate from Basteria University in two thousand and five
(01:46):
and her Fellowship in Nature Pathic gastro Entrology in twenty
twenty two. And outside of medicine, she enjoys her family, travel,
music and nature. So before we introduce her, I do
want to thank our sponsor. We have Emuse, a unique
patented post biotic that gives your immune system a key advantage.
Amuse is an ingredient in many immune supporting dietary supplements,
(02:10):
so look for Immuse on the label go to immuse
health dot com. We also thank Cognizance cticolin to keep
your brain firing on all cylinders, enhance your memory, focus
and attention. You can look for Cognizant on the label
of brain support programs such as Prothriver's Brain, which is
a product that contains cognizant in addition to some other
(02:31):
brain supporting nutrients and herbs. You can find more information
about Prothriver's Brain at Pure Formulas dot com. You can
also look for other pro Thrivers supplements including pro Thrivers
Wellness Sleep, pro Diriver's wellness flavonoids and pro Thriver Wellness vitamin.
And you can look for more information on Cognizance specifically
(02:53):
on cognizant dot com. And we then thank doctor Orhis
probiotics best selling probiotic for over thirty years contains twelve
probiotic strains which are shelf stable without refrigeration due to
a unique three year fermentation process, and you can learn
more at doctor Orhiro probiotics dot com. And with that,
(03:14):
Doctor Bow and welcome to five to Thrive Live.
Speaker 3 (03:17):
Thank you so much for having me, Lise, I really
appreciate being here.
Speaker 2 (03:21):
Absolutely, I'm delighted to have you as well. So you know,
I want to start by giving our listeners a little
bit of a chance to know you more. So, how
did you develop your interest in nature pathic medicine and
then in digestive diseases.
Speaker 3 (03:35):
Yeah, so this story starts way back when I was
a kid and I basically had failure to thrive. So
it was about seven and just not gaining weight, pretty sick,
you know, couldn't play with the other kids asthmatic, and
the answers that my mom was getting from conventional medicine
were not satisfying to her. So she took me to
one of our very talented colleagues, William Mitchell. So Bill
(03:58):
Mitchell was my childhood doctor, and he was great negotiated
things with me, and we figured out that I had
quite a few food allergies, so that was really underlying
a lot of the failure to thrive at the time.
So fast forward, you know, about a decade of really
good health, and then in my teen years it got
an antibiotic for a couple of procedures and then started
(04:21):
having really terrible digestive symptoms. And those continued all the
way until I was about thirty three. So even through
medical school and after, I was still struggling with my
own problems. But I figured that though I may be unhelpable,
others were still helpable, and so I definitely wanted to
double down on my knowledge for helping people with digestive conditions.
(04:43):
And eventually I stumbled upon the specific carbohydrate diet and
it changed everything for me. And so that's a nutritional
plan that's been around for over one hundred years that
took grains out all grains, not just some, and also
limited the amounts of certain types of carbohydrates. And so
(05:03):
that really helped me to see that nutrition was a
key that I could use to be able to really
help my health and health of others in a way
that I had not previous. And so that was probably about,
you know, almost twenty years ago. And so now I
specialize in complex digestive conditions and autoimmune conditions, and so
(05:25):
how I've landed at more specifically coeliac disease and focusing
on celiac diseases that I see that a lot of
the people who've seen up to ten or twenty other
providers before they see me. In the end, we may
circle back around and realize that celiac disease is the
underlying cause.
Speaker 2 (05:42):
So there's you earned your credentials. Honestly, so to speak.
Speaker 3 (05:50):
I'm a patient and a provider, and so I definitely
know what it feels like to be on both sides.
Speaker 2 (05:55):
Yeah, and that's important. Actually, So let's let's talk about
siliac disease, which is what really we're going to try
to focus on for the next period of time. So really,
I think we need to first understand what is siliac
disease and what is siliac what is not siliac disease?
Speaker 3 (06:15):
Perfect and so Celiac disease is considered a genetically linked
so typically somebody else in our family has it, and
that gene link is part of what sets the stage
for having Celiac. The other piece is that coeliac disease
is an autoimmune condition and it can affect many different
systems in our body, not just our digestive tract. So
(06:37):
when we look at the reaction to gluten, so what
is gluten. Gluten is a protein that's inside of many grains,
So wheat, rye, and barley are three main ones, but
there are other grains that can contain gluten. So gluten
then causes this immune system reaction in people with Celiac disease,
(06:58):
and it causes damage to the line of the small intestine,
and so we have these little fingers or little villai
and the intestine and those can be essentially cut off
or flattened by this condition. And then we also end
up with things like intra so they call it intra
epithelial olymphicydes, but it's basically like a type of white
(07:18):
blood cell that lands inside of a skin cellar that
surface lining of the gut. So many different ways that
celiac disease can present because it can affect many different
organs or systems in our body. It can have a
ton of different diseases. So what it is not, so
that's what Celiac disease is. What it is not is
(07:40):
that it's not gluten sensitivity. So it's not a preference
for gluten avoidance. It is not food intolerance. Instead, it
is a true allergy to gluten that then causes this
autoimmune cascade. So does that make make it there? Yeah?
Speaker 2 (08:02):
Yeah, so there is So just to restate that a bit,
there is a very serious condition, Siliac disease, which is
genetically kind of determined, I guess is the right words.
So those individuals cannot tolerate gluten ever, And then there
are people who are sensitive to gluten but don't have
(08:22):
Celiac disease. Those individuals, through various manipulations of diet and
potentially a program of restoration, typically avoid gluten but may
at some point be able to reintroduce it in small
amounts yep.
Speaker 3 (08:36):
And then there's the case there's a case that's somewhere
between those two, which is called non celiac gluten sensitivity.
And essentially it has to be managed the same as
coeliac disease with gluten avoidance down to the molecule, but
the symptoms can be very similar. They're just a little
bit less severe. So non celiac gluten sensitivity sounds so mild,
but it really is like coeliac lighte, but it just
(08:58):
doesn't test likes cliac.
Speaker 2 (09:01):
Got it. Okay, So what you've described kind of what
happens in the intestines, But what does that then cause
in the body? What are some of the typical symptoms
of siliac and why does that make it so easy
to miss? Because many people with siliac disease as kids
don't get diagnosed well, you know, to well into their
(09:22):
adolescence or even in some cases their adulthood.
Speaker 3 (09:25):
Yeah, I have diagnosed people as high as up into
their eighties, and so they've gone on and on. We're
having symptoms that nobody is really picking up on or
putting it together. And so one, we have a fractured
and fragmented healthcare system at times, and so different providers
might be operating in silos and not really talking to
(09:45):
each other, and so they're not comparing notes and being like,
what are you seeing over there? And what am I
seeing over here? You put it all together, it might
look like celiac. So celiac disease is a multi organ
autoimmune disease, and so the symptoms can depend on the
areas that are impacted. And so I would say, one,
there are intestinal or digestive symptoms, So those are the
classic you know, diarrhea, constipation, gas in, bloating, heartburn, nausea,
(10:11):
those sort of symptoms. But then there are a ton
of extra intestinal symptoms, which mean symptoms outside of the intestines.
So some of the really common ones that show up
in a classic case of coeliac disease would be fatigue
or brain fog. You get the digestive symptoms, maybe some
malabsorption of nutrients, so people might be anemic or iron
(10:32):
or B twelve or folic acid deficient and not know
why other nutrient deficiencies that might result in things like osteoporosis.
So classic coeliac disease is normally like fatigue and digestion issues,
But more and more we're seeing non classic coeliac disease symptoms,
and so sometimes that means that they're asymptomatic. Not a
(10:54):
single symptom is telling us that they have coeliac disease,
but then we have to be smart enough to try
to like tease it out or there might be something
that gives us a hunt. Even so, norm classic coeliac
disease symptoms might be things like psychiatric concern so like depression, anxiety,
even like schizophrenia or like seizure disorders. When we're talking
(11:18):
about like neurological impact then too, so neurological or psychiatric
impact is more and more becoming prevalent as symptoms that
we would pick up as possibly being associated with celiac disease.
So I don't know how many psychiatrists or neurologists are
screening for celiac disease, but hopefully more so things like
mouth ulcers or joint pain, other autoimmune decisions a sorry,
(11:41):
other autoimmune diseases like propping up might be associated with
a celiac disease. And so it really can be this
big constellation of symptoms and you have to just start
trying to connect the dots and tracing it back to
see if there's this one common condition underlying all of
those things.
Speaker 2 (12:00):
Mm hmm, yeah, wow, Yes, I got to be a
good detective with this. For sure. So let's say you
suspect celiac disease. The diagnosis is also not entirely straightforward,
so talk about how this is diagnosed.
Speaker 3 (12:14):
Yeah, So first I would say, if you're trying to
get a diagnosis, and this is the very first time
that you suspect the gluten is an issue for you,
or you're getting screened, that's the perfect time to get
all of the testing done. Anytime after somebody has eliminated
gluten from their diet can make it harder for us
to find. Celiac disease is a very clear condition. So
(12:36):
things like the blood tests. So typically there's about one
to two of these blood tests that are done, you know,
by standard providers, and so I like to do all
six always, and so I'm just going to rattle them off,
so bear with me. So total immunoglobulin A and total
immunoglobulin G because we have to check these two parts
(12:56):
of our immune system and see if they're functioning correctly
before we test the rest to the tests. And then
tissue transclutaminates IgG and I G A and then de
diamidated gleiodin IgA and IgG. And then there are a
couple of genes that we can test for celiac, which
are HLA Dq two and Dq eight, and some people
(13:16):
with celiac have Hla Dq seven, but it's much less likely.
And then once we suspect celiac, oftentimes you get shipped
off to a gasterenrologist and they will hopefully do an
endoscopy where they take the tube with the camera, put
it down your esophagusin into your small intestine, and then
(13:37):
they take a couple of biopsies of the small intestine tissue,
and so they're looking for those tissue changes that we described.
And then you know, basically, if all goes well, they've
done four to six biopsies of this of the duodenum,
which is a part of the small intestine. If all
doesn't go well, then they might do zero biopsies of
(13:58):
the duatenum or up to me three. But in order
for it to be this gold standard test that we
refer to it as for biopsy, we really need four
to six biopsies of that specific area of the small
intestine to say that we did it right.
Speaker 2 (14:15):
Yeah wow, so uh again, not like just sort of
a flippant little thing. You know, get a little tests
and you're one and done. So, Okay, we've had a diagnosis,
you've talked a little bit about some of the symptoms
of Siliac disease. Are there other and you mentioned a
few risks, but are there any other ways in which
(14:37):
this disease can adversely affect quality of life?
Speaker 3 (14:41):
Yeah, I was gonna say hugely so, mental, emotional, social impacts.
So it's not just the physical, whether it's intestinal or
extra intestinal conditions. Like even things like infertility could be
due to Celiac disease. You know, having a child that
has birth defects that could potentially be something caused by
(15:03):
coeliac disease. So in general, when somebody gets a diagnosis
of Celiac, then that's where the quality of life issues
really come up. And so you know, knowing that you
are under threat from this invisible invader because with the
gluten avoidance, you have to be down to the molecule
avoiding all cross contamination. So it's this individual or this sorry,
(15:25):
this invisible threat of something that's trying to hurt you
that you can't even see. To try to actually know
who this invader is or who this you know, where
the pathogen is. So we just have to have this
existential like hypervigilance of trying to prevent our environment from
harming us. So I really try to help people within
(15:47):
your diagnosis of Celiac strike that balance. And so in
the beginning, I have them avoid macroscopic or the very
obvious gluten, and then we really work our way towards
microscopic avoidance and avoidance of you know, cross contamination and
things like that, because this is huge, Like what if
your favorite thing to do is like pizza night with
your family out at your favorite restaurant, Like that's a
(16:09):
no go because even like cooking the pizza in the
same oven as as gluten containing pizzas is not possible
for many people with seeliac disease. I'd say that that's
pretty safe to say, like you should not cook them
in the same oven. So that and then the stress
of like having to change your environment, like I suggest
(16:30):
that people have a gluten free home so that they
have at least one safe place to be and prepare foods,
and so it just all can take a huge toll.
Oftentimes this is on top of them feeling unwell because
they've had seaiact disease that they've just gotten diagnosed for
so they might be fatigued, and they might have all
of these other symptoms going on, joint pain, digestive symptoms,
(16:52):
and then they're asked to do this huge amount of
work to really like clean up and unburden them their
lives from gluten. And it's just a huge undertaking.
Speaker 2 (17:02):
Yeah, well, I'm kind of just trying to said which
question to ask you next? So I want to leviate
for a second. So you met, you know, you mentioned
even microscopic or just like even tiny bits of gluten
can trigger the reaction to people and need to be avoided.
(17:24):
But let's just say somebody is doing their best but
they inadvertently eat some gluten because there was a mislabeled
product or whatever. What happens. Are they back to square zero?
What can they do to kind of preserve their health
that they probably have regained by avoiding gluten.
Speaker 3 (17:45):
Yeah, this is a great question because there is this
existential threat of like getting gluten in our environment. I
also like to teach my patients that you will get gluten,
like it will happen, So we think it's never going
to happen. We're kind of setting ourselves up instead of
saying well when it happens, because it will inadvertently happen.
We live in this world that's filled with gluten. It's
(18:06):
likely to happen. So what do we do when somebody
gets glutened? And so oftentimes people will have something like
some enzymes on hand that might help to break it
down faster. They might have some immune system calming treatments,
you know, they might do a little short period of
bowel rest, and then oftentimes they're not back at square one.
(18:27):
So if it was a significant amount of gluten, and
especially if they've just gotten diagnosed and they're just barely
into healing, it might take them back to where their
symptoms were. But normally it won't persist, it won't stay
there forever in that space because they have the tool
to get well again of staying gluten free. So you
just go back to making sure that you're having gluten
(18:49):
avoidance and they should come out of it. And so'd
say initially it will take people longer to recover from
a gluten exposure versus like as they've healed up and
that their intestine is in a better shape or in
better shape, their immune system is in better shape, it's
more resilient. It seems like they might, you know, have
just fewer symptoms and less severe and they'll be able
(19:12):
to recover faster from it because their immune system is
less vulnerable than at diagnosis it's normally the most vulnerable.
Speaker 2 (19:20):
Yeah, okay, good, that makes sense. So let's talk about
the link between ciliac disease and colon cancer. What is
the link there?
Speaker 3 (19:29):
I think of three things when I think of a link.
One of them is that both Celiac disease and with
colon cancer or cancer in general, that there's normally a
microbiome element or alteration. The other piece is that celiac
disease creates massive amounts of chronic inflammation, and so if
we want cells to change and to become abnormal and
(19:52):
potentially pre cancerous, then things like high amounts of chronic
inflammation is a way for the system to basically start
creating that process. The other thing that I think is
insult to entry is that with celiac disease, especially when
it's not diagnosed or addressed, people may be very deficient
in a lot of nutrients, and those nutrients might normally
(20:13):
show up to help the immune system in ways that
might help with preventiontive cancer or at least like you know,
giving you the right nutrients to be able to have
the healthiest possible immune system going into this. So if
you have an iron deficiency, be twelve deficiency, follic acid deficiency,
if you're not absorbing those nutrients from your food, even
(20:36):
if you eat you know, the healthiest nutrition for you,
you know, you may not be making the most out
of it because of malabsorption from celiac. So I think
of those three things, and then even that intra epithelial lymphocyte,
which is that white blood cell type inside of a
skin cell in the lining of the gut, that that
(20:57):
is considered to be a precancerous condition. So if that
goes on and on and it's later in diagnosis, then
it means that somebody is more likely to have, you know,
have some of those cell changes that might be precancerozed.
Speaker 2 (21:12):
Yeah. So again another reason why even though a lot
of gluten containing foods can be hard for people to
avoid because they you know, are tasty and very common,
very important to do so, and of course you know,
getting rid of that level of inflammation and hopefully that
disturbance to the microbiome is very important. So what about
(21:34):
some other health maintenance strategies that someone with siliac disease
should do on an ongoing basis to really address the
cancer risk and just the potential disease risk.
Speaker 3 (21:46):
Yeah, so definitely, you know, making sure that you have
a self advocacy as well as family advocacy. I feel
like that's huge for the mental health piece. But then
we're looking at a new diagnosis of celiac. If you
can have follow up tests the same six that I listed,
you know have to you don't have to retest the genes,
but the same six that I listed. If you retest
(22:08):
those periodically, it can tell you what state your celiac
disease is in. So are you still getting you know,
immune system triggers from your environment. You might pick it
up on just repeating that test. In repeating that test panel,
we're hoping to see that everything converts to negative and
that your immune system doesn't have any glutent exposures. So
(22:28):
retesting that panel can help us see you know, this
is this person with celiac disease responding to this gluten
free diet, So that would help to calm down inflammation.
And when we're looking at other things. It would be
like our regular screenings, So screening exams for colon cancer,
things like the colonoscopy depending on your family risk and
(22:51):
endoscopy can help to pick up some early like cell
changes in the stomach or small intestine or esophigus. So
really making sure that you're doing some of your annual
screening exams as well as some of these periodic screening
exams that we already have in place. We have these
recommendations in place, and I definitely want my patients to
(23:12):
take advantage of doing those recommended screenings so that they
could pick up something early, because we always know that
the outcomes could be potentially better the earlier we find something,
so at least we have more treatment options too write
the earlier we find something.
Speaker 2 (23:29):
What about faily risk, Like if a child's parent has ciliac,
is that child at greater risk?
Speaker 3 (23:36):
Yeah, so this is a fabulous question because the data
is changing. So we used to think that it was
one in four family members, immediate family members or first
degree relatives who would have seliac disease, but after some
mass screenings in places like Finland and Italy, they actually
realized that it could be up to like two and
a half percent, maybe even up to three percent and
(24:00):
so of the population, which would then bring that statistic
closer to forty four percent. So forty four percent of
our immediate relatives might have coeliac disease as well, versus
before we were saying twenty five percent. So it's almost
double what we thought it was, both like coeliac disease
occurring in the general population as well as coeliac disease
(24:22):
occurring within a family.
Speaker 2 (24:25):
Interesting, and you mentioned the studies in Scandinavia. Are there
certain ethnic populations where you see a greater prevalence of
siliac disease?
Speaker 3 (24:34):
Yeah, and so the two highest statistics that I saw
were Canada and Finland, But then Ireland and also Italy
have fairly high prevalence as well. So I definitely think
that and the prevalence is rising. I mean some of
that that were more aware or that there might be
some issues with our food. We're not sure, but we
(24:55):
definitely know that incidence is rising over time.
Speaker 2 (25:00):
Let me just ask you a little bit about gluten
sensitivity for a moment. So nonciliac gluten sensitivity, So these
are people who when they eat gluten containing grains. They
don't feel well. They have digestive issues, you know, maybe bloating,
maybe diarrhea, maybe constipation. They might feel foggy headed, joint pains, rashes,
(25:22):
you name it. Can you just talk a little bit
about why that's so different than ciliac disease and or
if there's any way in which you manage that differently.
Speaker 3 (25:32):
Yeah, So non celiac gluten sensitivity. Six percent of Americans
actually have non celiac gluten sensitivity, and it basically can
look almost identical to celiac but maybe a little bit
less severe across the board, so including both intestinal and
extra intestinal symptoms.
Speaker 2 (25:50):
They can feel.
Speaker 3 (25:50):
You know, you can have the same you can have
malabsorption of nutrients, but it's basically less severe, and so
then the management is the same. So this isn't somebody
just saying I'm going gluten free. This actually ends up
being somebody who needs to avoid gluten down to the molecule,
including cross contamination to be able to become fully well.
(26:12):
They might feel much better from taking out the main gluten,
but in true non celiac gluten sensitivity, they have to
abide by basically a gluten free diet for celiac in
order to become well, and so the main difference is
just how it tests and then the severity of symptoms.
Speaker 2 (26:31):
But isn't it true that in some people with gluten
sensitivity that do not have siliac disease, after a certain
period of avoidance, they might be able to reintroduce it
into their diet.
Speaker 3 (26:41):
I feel like that would be maybe general general gluten
sensitivity or gluten intolerance versus like the true diagnosis of
NCTS or non Celiac gluten sensitivity. The more it gets researched,
the more they realize that it's just a lighter version
of celiac that doesn't quite test or biopsy exactly like celiac,
(27:01):
but almost everything else can be identical.
Speaker 2 (27:05):
So basically, if people have adverse reactions to gluten, they
really should get comprehensive testing to figure out what's going
on and whether or not they are on a lifelong
plan of avoidance, or whether they might have a gluten
intolerance that might require some period of avoidance but maybe
not lifelong.
Speaker 3 (27:24):
Yeah, yeah, I definitely think that there can be different
degrees of avoidance, but that a lot of people who
are still symptomatic. They might have to do even a
short trial of you know, down to the molecule avoidance
to see is there significant change in how I'm feeling
when I'm mostly avoiding gluten versus when I'm avoiding it
down to the molecule. And so that's the sort of
(27:45):
thing that you know, I help people kind of look,
you know, look at the different columns and see how
they feel. And then we will not tell somebody to
go and take all the gluten out of their house
just because we have to have a really convincing reason
to have them do is short trial of full glunovoidance
down to the molecule, and then that information goes into
(28:07):
our work up and so then we're able to help
give long term advice based off of how they do
with that.
Speaker 2 (28:13):
Right. Well, very interesting stuff. So we just had a
couple of minutes left. Any final thoughts you'd like to
leave with our listeners.
Speaker 3 (28:21):
Yes, I feel like one if you were suffering with
digestive symptoms and you feel like I felt and felt unhelpable,
just know that there are many many different conditions that
could be causing what's going on. Something like just living
with digestive symptoms and not knowing why. I don't think
(28:42):
is really an acceptable way for us to go about
living our lives. It's really hard on our quality of life.
Sometimes it can take up to thirteen years from having
symptoms of Celiac disease to finally getting diagnosed. So the
mental health implications and impact is huge. Even when somebody
has symptoms and they're like on the path to diagnosis,
(29:05):
it still could take up to ten years for them
to get diagnosed. So if you still have symptoms, like
please persevere with finding answers because I don't want any
of you to be walking around with miserable guts when
we definitely know that there are some wonderful ways that
we can help to address and you're changing your digestive
health can change your greater health, and so yeah, it's
(29:26):
a lost opportunity if we're not able to keep on
persevering until we really get answers. Yeah.
Speaker 2 (29:33):
Good good advice, really good advice. Well, you clearly are
in your wheelhouse. Your expertise is obvious, and I'm really
grateful for you and your time and being on the show.
Where can our listeners find out more about you? Do
you have in a social media website you'd like to share.
Speaker 3 (29:49):
Yes, and so my private practice I have an associate
there who sees clients as well. Doctor to you. So
Baffelnaturalhealth dot com is my practice website. And then social channels.
I do have free access to some information on YouTube
at our Immune Recovery website. And then Boffel Natural Health
(30:11):
has all the social channels. And then also doctor Christine
Bowen has all the social channels as well. So definitely
like Instagram and Facebook. And I believe we have some tiktoks.
I might not be as active on TikTok as.
Speaker 2 (30:25):
I all right, well, thank you so much, doctor Bowen.
It's really been a very enlightening show. And keep up
the good work. And that wraps up this episode of
five to Thrive Live. So we thank our sponsors Cognizance
Ofticoline to help enhance memory, focus and attention. Immuse a
(30:46):
post biotic for immune support doctor or here is Probiotics
award winning pre and probiotic formulas and pro thrivers wellness
supplements designed specifically for thrivers. And may you listener enjoy
your evening. Thank you for joining us me you experienced joy,
lefter and love it's time to thrive. Everyone scy.
Speaker 1 (31:09):
Scots.
Speaker 2 (31:17):
The scene Jan the city stre
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