My daughter, Rose, had lived with many of the typical symptoms of Celiac Disease since she was very young, but when she moved into college housing, her health took a scary turn!
Even though she shared her on-campus apartment with roommates who understood her gluten intolerance and were careful to keep their food separate from hers, gluten cross contamination is always a risk in a shared kitchen, and before long she was having problems with inflammation that caused stiff, swollen fingers which made writing her exams difficult. Thankfully, her instructor allowed her to speak her answers and a student-worker penciled them in for her. Also, her ankles swelled and her hips became so stiff that she had trouble walking across campus, but she worked through it and graduated with honors!
At the time, we didn’t really understand the connection between her bouts of inflammation and gluten intolerance. We were convinced that her symptoms were evidence of Rheumatoid Arthritis – so we asked a doctor to do an arthritis blood panel, but that came back negative. No anti-inflammatory meds were prescribed or even suggested by the doctor. Go figure!
After graduation, Rose moved 11 hours away for an internship, where she was once again in a shared kitchen environment and she once again developed a severe reaction to gluten. One morning at 3:00 AM, I received a phone call from a very distressed Rose,
“Mom, I feel like I’m having a heart attack!”
Nothing like waking up to THAT kind of phone call! She had a feeling of fullness or pressure in her chest and abdomen, sharp pains all the way through her chest to her back, and pain radiating down her left arm. She also had sharp pains in the area of her gallbladder (which had been removed several years earlier) and they radiated down to her appendix. She was nauseated and lightheaded, and she felt that she was about to pass out.
A trip to the ER revealed that her inflammation levels were very high, she had a low grade temp, an alarmingly low blood pressure, and she was dehydrated due to chronic diarrhea (an unlovely symptom of elevated and long term inflammation). It was determined that she was not having a heart attack, but the doctor did hear a “rubbing” sound when he listened to her chest cavity. A CT scan indicated that she was not having appendicitis, but there was some concern that she could have an obstruction in her bile duct, causing the inflammation and pain in the area of her gallbladder which radiated down toward the appendix.
The doctor referred Rose to a GI specialist, and for the first time in her life, she met with a health care provider who “really” listened to her history of digestive problems and actively engaged in nailing down a proper diagnosis. She ordered:
- A Celiac Blood Panel which Rose had never had before;
- A special type of MRI (called MRCP) to check her liver, bile ducts, pancreas, and pancreatic duct;
- A series of abdominal x-rays called Barium Radiology;
- A special type of Endoscopy that used a disposable camera to record the entire journey through her digestive system.
- And a Prometheus Test to determine if she might also have Crohn’s Disease.
I will share more about these specialized tests later, but in this post I want to focus on the “rubbing” sound the ER doctor heard when he listened to her heart.
Pericardial Friction Rub
A pericardial friction rub1 is a grating, scratching sound (much like two pieces of sandpaper being rubbed together) which is often heard in patients with acute pericarditis. According to an article from the Mayo Clinic:
Pericarditis is swelling and irritation of the pericardium, the thin saclike membrane surrounding your heart. Pericarditis often causes chest pain and sometimes other symptoms. The sharp chest pain associated with pericarditis occurs when the irritated layers of the pericardium rub against each other.2
The article goes on to say that chronic pericarditis is usually associated with chronic inflammation and that it “may” result in fluid around the heart. It also says that most cases are mild and usually improve on their own.
The blood panel at the ER indicated that Rose did have chronic inflammation which is typical with Celiac Disease3, but by the time she saw the new GI specialist, the pericardial friction rub had cleared up on it’s own. Evidently, Rose is super sensitive to gluten and her body had been overwhelmed by long term exposure – to the extent that her liver, her duodenum, and her small intestines had become extremely inflamed and the inflammation had caused a scary pericardial attack that mimicked a heart attack!
Make A List And Take It With You To Your Physician
If you are gluten intolerant and have a persistent low-grade temp and chronic diarrhea, you could have elevated levels of inflammation that can lead to a pericardial attack. Review this article as well as the typical symptoms of Celiac Disease, and make a note of all the symptoms you are experiencing that might be related to Celiac Disease. Don’t forget to add the names of any relatives who also suffer from digestive issues and could have passed this “inheritance” down to you. It might be worthwhile to have a candid conversation with those relatives. Chances are, they will be willing to discuss this issue with you. They may even learn something they don’t know about their own health because of your research!
Also, ask around to see if anyone can refer you to a doctor who treats other patients with Celiac Disease. We had a long and frustrating journey before we finally found a doctor who was willing to engage in a real conversation about the symptoms and was up to date with their testing methods and treatment plans for this disease.