Celiac Disease

 

Photo of some gluten-free products such as bread, flour, pasta and grains

What is celiac disease?

Today it’s trendy to eat gluten-free food, but for the 1 percent of the U.S. population diagnosed with celiac disease, it’s absolutely necessary. When people with celiac disease eat a meal containing gluten, their body is unable to fully absorb the nutrients. This can severely damage the lining of the small intestine and lead to debilitating symptoms. The condition impacts both children and adults. It is more common among Caucasians and more diagnosed in females.

Celiac disease is not an allergy or food intolerance – people with the condition do not go into anaphylactic shock if they eat gluten-containing food. Instead, celiac disease is an autoimmune disease – the body’s immune system attacks healthy cells, causing a reaction that is sometimes severe and immediate.

What are the symptoms of celiac disease?

Digestive problems are common among celiac patients, especially children. Symptoms include:

  • stomach pain
  • bloating
  • cramping
  • vomiting
  • diarrhea
  • constipation
  • headaches
  • weight loss
  • fatigue

Adults may also experience anemia, bone or joint pain, weak bones, numbness in the hands and feet and mouth problems such as canker sores.

Celiac disease can be very serious. For children, being unable to absorb nutrients that are so important to normal growth and development can lead to slowed growth, weight loss, delayed puberty, damage to teeth enamel and mood changes. In adults, the condition can cause long-term complications such as malnutrition, osteoporosis, nervous system problems and infertility issues.

A study published in The Journal of Allergy and Clinical Immunology suggested those with celiac disease may be at greater risk of developing asthma in their lifetimes. The link may be malnutrition and low levels of Vitamin D, which can affect immune cells.

Most serious is the long-term damage to the intestines, especially among those who do not always show symptoms.

How is celiac disease diagnosed?

Celiac disease is difficult to diagnose because so many symptoms are reminiscent of other diseases such as irritable bowel syndrome. Many people bounce from doctor to doctor before finally getting an accurate diagnosis.

An antibody blood test is often used to diagnose celiac disease (but only if the patient is not on gluten-free diet). Oftentimes, the doctor will order the antibody blood test and then refer the patient to a gastroenterologist or celiac disease specialist for further testing, evaluation and treatment.

A physical exam, medical and family history, and dental exams are part of a diagnosis, but the most accurate assessment is the upper endoscopy test: the gastroenterologist inserts a tiny tube with a camera into the mouth and down to the small intestine to visually assess inflammation and sometimes take a tissue sample.

How is celiac disease treated?

Avoiding foods with gluten – a protein found in wheat, rye and barley – is critical in the treatment of celiac disease. Removal of gluten from the diet will help improve symptoms and heal damage to the small intestine.

Foods that contain meat, fish, fruits, vegetables, rice and potatoes without additives or seasonings do not contain gluten and are part of a well-balanced diet. Other gluten-free food products include quinoa, buckwheat and bean flour.

Many gluten-free foods are increasingly available in supermarkets and restaurants. When shopping or eating out, remember to read food labels for ingredients that contain gluten and ask for gluten-free menu options at restaurants. Talk with servers and chefs about how their food is prepared to avoid the risk of cross-contact with gluten.

What foods contain gluten?

  • Cereals
  • Breaded foods
  • Wheat
  • Oats and oatmeal (unless certified gluten-free)
  • Soups and broths
  • Cold cuts
  • Meatballs
  • Hot dogs
  • Veggie burgers
  • Sausage
  • Canned baked beans
  • Soy sauce and teriyaki sauces
  • Fried vegetables/tempura
  • Imitation crab meat
  • French fries
  • Processed cheese
  • Mayonnaise
  • Ketchup
  • Salad dressings
  • Gravy
  • Marinades
  • Egg substitutes
  • Non-dairy creamer
  • Fruit fillings and puddings
  • Ice cream
  • Syrups
  • Flavored coffees and teas
  • Beer
  • Root beer
  • Roasted nuts

Many lip balms and lipsticks, hair and skin products, toothpastes and vitamin and nutrient supplements contain gluten.

Who needs to be on a gluten-free diet?
For people with celiac disease, eating gluten-free is a medical necessity. However, in recent years, many people without celiac disease are adopting a gluten-free diet, believing that it’s healthy or could help them lose weight.

According to the National Institutes of Health (NIH), there’s no data that suggests eating a gluten-free diet helps with better health or weight loss. In addition, a gluten-free diet may not provide enough of the nutrients, vitamins and minerals the body needs, such as fiber, iron and calcium.

If you think your digestive issues stem from celiac disease, don’t remove gluten from your diet without first speaking with your doctor.

Patient Resources

• Beyond Celiac: beyondceliac.org
• Celiac Disease Foundation: celiac.org

Rachel’s Story

Most people with celiac disease remember their last meal before going gluten-free. Mine was a gigantic plate of chicken Parmesan from an Italian restaurant.

I had spent years visiting countless doctors for debilitating symptoms like stomach pain, headaches, inability to gain weight, and many others. Finally, when I was 12 years old, my gastroenterologist informed me that both my antibody blood test and endoscopic biopsy test results confirmed that I had something called celiac disease.

As a moody, brooding pre-teen, I was embarrassed to tell my friends why I now carried crumbly, gluten-free millet bread in my lunchbox. It would be a while before I could fully come to terms and cope with the fact that I now had to eliminate wheat, rye and barley – in all forms – from my diet because of celiac disease.

Many of us would give anything for just a bite of gluten-filled chicken Parmesan (or birthday cake, pizza, doughnuts…you get the picture), but even the tiniest crumb will set off an autoimmune response. The gluten-free diet is our medicine, and our only defense against other serious health concerns.

Rachel Rieger
Stow, Ohio

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