Top 10 'Yuppie' Health Conditions

Doctors may swear an illness is real, but some conditions still meet skepticism.

ByABC News
December 16, 2008, 8:43 PM

Dec. 17, 2008— -- Some conditions just can't seem to get society's respect.

When chronic fatigue syndrome first came on to the scene, it was ridiculed as the "yuppie flu." Other pooh-poohed conditions got their negative associations by proxy -- "tennis elbow" became associated with country club snobbery. Irritable bowel syndrome, already embarrassing, was a perfect comedic tool for sensitive characters like Ben Stiller's portrayal of the uptight Reuben Feffer in "Along Came Polly."

Even after doctors find a genetic link, a blood test or a treatment, a number of conditions still get stuck with negative labels like "yuppie." Below is a list of 10 of the most besmirched conditions patients wish would be taken more seriously.

The plethora of health-nut "gluten-free" foods available makes it simultaneously easier for people to explain celiac disease and difficult for them to be taken seriously.

"Gluten-free now seems to be a fad diet," said Elaine Monarch, executive director of the Celiac Disease Foundation in Studio City, Calif., who added she's seen projections that gluten-free products will generate a billion dollars in food sales in the next few years.

Monarch said in 2004 the National Institutes of Health convened a consensus conference about celiac disease. The doctors estimated that 97 percent of people who have it have not been diagnosed, and that one out of 133 people likely had the condition.

"What they acknowledged was that the disease is much more prevalent than anyone thought before," Monarch said.

However, when Monarch was first suffering from symptoms of celiac disease, the public had hardly heard of gluten-free, never mind celiac disease.

"I was anemic, and everyone said, 'oh, you're female, maybe you had your period.' Or, 'oh, you have red hair.' That has nothing to do with it," she said.

Aside from anemia, celiac disease has a hodge-podge of symptoms -- from bloating, to vomiting, to constipation, to canker sores and in some cases infertility -- that are caused directly or indirectly by a genetic inability to digest a protein in wheat.

Doctors started drawing the connection between wheat and intestinal problems after the end of World War II, according to Dr. Alessio Fasano, director of the Center for Celiac Research at the University of Maryland School of Medicine in Baltimore.

Fasano said that during WWII, when bread was made with potato flour in many parts of Europe, doctors noticed that many of their patients' intestinal symptoms stopped. Then after the war, all the symptoms came back when people started making wheat flour again.

Since then doctors have found a blood test for celiac disease and evidence of damage to the small intestine.

"The fact that we know the trigger is tremendous," Fasano said. "Celiac disease is the only autoimmune disease for which we have a treatment."

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Celiac disease is caused by a combination of genetic disposition and an environmental trigger, similar to diabetes and rheumatoid arthritis. But unlike those conditions, Fasano said he thinks celiac disease is less respected.

"If you have a condition that you don't die from, but it affects this part of your life so much, then it is important: You don't want to travel, you don't to go out with your friends, you don't want to go off to college," Fasano said.

"It deserves all the respect that we give to the other diseases that we spend so much time and money on," he said.

Now experts believe it strikes across the whole population. A major hurdle to gaining recognition was that the syndrome was so poorly understood by doctors.

By 1994, a group of international doctors convened to define the disease and create standard diagnosis criteria.

According to the U.S. Centers for Disease Control and Prevention, a patient must have severe fatigue for six months or more without another medical explanation and one or more of a whole host of symptoms that include memory problems, sore throat, joint pain, tender lymph nodes, muscle pain and more.

As of now there are no physical signs or lab tests to diagnose the syndrome. However the CDC estimates that between 1 million and 4 million Americans suffer from the disease.

According to the CDC, a person with the Epstein-Barr virus may have a sore throat, swollen lymph glands, fatigue and a general ill feeling. Because the symptoms of EBV and chronic fatigue syndrome are so similar, doctors may first mistake chronic fatigue syndrome for a longstanding EBV infection.

Unlike chronic fatigue, once a patient has an EBV diagnosis, they're likely to be taken very seriously. According to the National Institutes of Health, EBV is a prime contributor to mono, also known as mononucleosis or the "kissing disease" because it is highly contagious by saliva transmission even months after symptoms subside.

Most patients with an active EBV infection begin to feel better in a couple of months. However the virus has been known to cause anemia, ruptured spleens and death in rare cases, according to the NIH.

"Because you can't measure it on an X-ray, or a blood test, a lot of people will say things like 'was this made up by the drug companies?'" said Ross, who is also the director of the Ross Center for Anxiety and Related Disorders in Washington, D.C.

"That just perpetuates the stigma for those who have it and it perpetuates their fear of getting help," she said.

Shy is one thing, but the mental health world never really considered social anxiety a full-blown disorder until 1985 when Dr. Michael R. Liebowitz from Columbia University published a review calling "social phobia" a neglected disorder.

"That article really put it on the map," said Ross. Before then, Ross said, "Society treated it as, 'oh, it's really not that big a deal.' ... In a woman, it's 'oh, how cute she blushes.'"

Ross says because the disorder got full recognition in the 1990s and a lot of press from media and direct-to-consumer advertising, people with what's now called "social anxiety disorder" felt empowered to seek help.

According to Ross, when one of the estimated 5 million to 10 million people with social anxiety disorder in the United States comes forward to seek treatment, the line between a disorder and "shy" is as clear as day.

"For 30 years they've never gone into town because they can't talk to anybody," Ross said. "Or they may say: 'I dropped out of school, I'm suicidal, I've never had a date in my life, I can't go out to a restaurant and I can't call for tickets to a show.'"

Tennis elbow may be inflammation, soreness and/or pain on the outside of the upper arm near the elbow. According to the NIH, the injury can include a partial tear of a tendon near the elbow as well.

Besides pain near the elbow, signs that you've got tennis elbow include the inability to hold beverages like a cup of coffee (a good source for jokes about yuppies), forearm weakness and pain that shoots from the elbow to forearm and the back of the hand when the person tries to twist something.

Luckily, most people with tennis elbow can resolve the issue in time by resting the muscle, icing it and learning to play with better tennis technique. However, according to the Mayo Clinic, about one out of 10 people with the condition will require surgery.

IBS has all the intestinal symptoms of celiac disease and many of the symptoms of Chron's disease: abdominal pain, diarrhea, constipation, cramps and spasms.

Fasano said it was only in the 1970s that a series of experts got together in Rome and drafted what is known as the "Rome Criteria" for diagnosing IBS. Research since has uncovered a connection between IBS and the "intestinal pacemaker" responsible for creating the wave contraction of the intestine to digest food.

Have a faulty "intestinal pacemaker," and a person can have spasms and intense digestive pain. Other research has uncovered links between IBS and an imbalance of good bacteria in the gut.

Still, Fasano said an IBS diagnosis is often one of exclusion, meaning doctors must run a myriad tests to see whether another cause is behind the IBS symptoms before coming to a conclusion.

"IBS is embarrassing, IBS is not socially acceptable," said Fasano. "You may discuss diabetes or cancer, but what is amazing in all this is that IBS and even celiac disease are much more frequent than diabetes."

According to Fasano, gastroenterologists estimate "IBS affects easily, 20 [percent] to 25 percent of the population."

According to the Mayo Clinic, SAD is a type of depression that can seriously affect someone's life. Sufferers of SAD show signs of hopelessness, anxiety, depression, oversleeping and difficulty concentrating. SAD sufferers may also crave food, particularly starchy or sugary food.

Since researchers noted the cause may be a lack of sunlight, it was quite easy to come up with a treatment: light therapy. According to the Mayo Clinic, people afflicted with SAD may find some relief in a special form of light therapy after a consultation with a mental health therapist.

"I think one of the reasons why people have skepticism about it, is because it's been very hard to pinpoint what causes it," said Dr. Roger Chou, an associate professor of medicine at Oregon Health and Science University in Portland.

Chou said the term fibromyalgia was coined in the 1970s. Ever since, doctors have theorized that the condition may be caused by a single underlying infection, as is the case in Lyme disease, or by an autoimmune disorder or a muscle disorder.

"None of that stuff has panned out," Chou said.

Although pharmaceutical companies have recently marketed treatments for fibromyalgia, Chou said the medication only helps some pain symptoms.

"It can be a really devastating disease," Chou said. "It can be so severe, that people can't get out of bed."

"Clinicians don't like to feel helpless, and we do feel like that with this condition," he said.

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