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HEALTH

Treating Celiac Disease in Gaza

Jul, 2021

A medical aid donation from Direct Relief allows patients at Ard El Insan Association to manage their wheat allergies.

Mona Sahweel is a physician at Ard El Insan Palestinian Benevolent Association. She often treats celiac disease patients. The doctor says the wheat allergy is an auto-immune disease. People with the condition can't eat gluten because it will damage their small intestine.

“When the disease is diagnosed, our pediatric clinic instructs patients to change to a strict gluten-free diet that can help manage symptoms and promote intestinal healing,” she says. “That simple change in diet can help protect patients from serious complications affecting the digestive system.”

Celiac disease is a life-long disorder but there are medicines that can offer daily relief. Naproxen is one. The nonsteroidal anti-inflammatory drug is used to relieve pain and reduce swelling and inflammation.

Ard El Insan depends on Anera for its supply of medication for adult sufferers of celiac disease. Recently, Anera distributed a shipment of naproxen donated by Direct Relief to Ard El Insan Association and 17 other clinics and hospitals in Gaza.

Sahweel oversees an estimated 70 cases of the disease. It affects both adults and children, some as young as six months. Although it’s a hereditary disease, symptoms do not develop right after childbirth, and not everyone who has a genetic disposition toward celiac disease develops it.

She explains that a child's parents may not show symptoms of the disease but nonetheless carry the gene that predisposes them to celiac. “If their child has been exposed to gluten and carries the gene, the child is more likely to develop the disease.”

Common symptoms include chronic diarrhea, general fatigue, joint and muscle pain and osteoporosis. Others, Sahweel says, do not experience these symptoms but still can suffer the disease’s effect on their small intestine. Celiac can also affect pregnancies and menstrual cycles. In rare cases, it can even elevate a patient’s risk of cancer.

Sahweel explains some patients cannot absorb nutrients like iron, folic acid and calcium. Inflammation results when these nutrients are not easily absorbed. She says naproxen reduces inflammation in addition to being an analgesic. “Some patients suffer from vitamin D deficiency, which causes general weakness. So, when I give naproxen to a patient with a vitamin supplement that is enough to restore the patient’s strength.”

Sanaa, a patient at the Ard El Insan Association gets medicine for her celiac disease.
Sanaa, a patient at the Ard El Insan Association gets medicine for her celiac disease.

Sanaa and Said, Two Celiac Patients in Gaza

“If I don’t take my medicine, my joints hurt so bad that I can’t walk,” says 55-year-old Sanaa, who's lived with a wheat allergy most of her life.”

Sanaa went to many clinics and doctors over the years seeking relief. A surgeon at Al-Awda Hospital finally diagnosed her with celiac disease and referred her to Ard El Insan.

“I have so many chores at home, but I feel tired all the time,” she says. “One day I felt so dizzy and I cried out in pain. I had no strength at all.”

When she went to see a doctor at Ard El Insan, she advised Sanaa to avoid foods with gluten and to load up on salads with arugula, parsley, carrots, cucumbers, and other vegetables. “Now, I don’t touch bread,” Sanaa says. “I eat a salad with some lemon and the prescribed medicine. Medicine alone is not enough to improve my health. I need to stick to a healthy diet to live.”

Said has had celiac disease for more than 15 years. The 37-year-old says he sought medical help after experiencing dramatic weight loss, joint pain and constipation. His doctor conducted an endoscopy, one of the best ways to diagnose celiac disease, and referred Saed to Ard El Insan Association.

“They checked my weight and height, and offered me gluten-free flour, which is expensive. We used to buy flour for eight shekels ($2.50). But now Ard El Insan gives it to us free-of-charge each month.”

Said says he also finds naproxen very effective for relieving the inflammation and other symptoms.

He says that after learning he has a wheat allergy, he has become very careful about the foods he buys, checking labels closely.

“We double check everything because we’re afraid of buying something that has hidden gluten in it. I guess it has become a bit of a phobia. But being careful can save my life.”

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