Celiac Disease

What is Celiac Disease?

Celiac disease is a chronic autoimmune intestinal disorder triggered by eating gluten. Sometimes referred to as nontropical sprue, gluten intolerance, celiac sprue, or gluten-sensitive enteropathy, this condition is often misdiagnosed and misunderstood. When a person with gluten intolerance eats foods containing gluten, an immune reaction occurs in the small intestine. The result is damage to the villi (small, finger-like projections) on the surface of the small intestine. The villi become inflamed and flattened (villous atrophy), which causes an inability to absorb many different types of nutrients from food. As many as one in 133 adults, or 1% of the population, in the United States suffer from an intolerance to gluten.

What is gluten?

Gluten is a protein found in wheat and other flours. Grains that contain gluten include wheat, barley, and rye. Ingredients in foods made from these grains also contain gluten-things like farina, graham flour, semolina, durum wheat, bulgur, Kamut, kasha, matzo meal, spelt, and triticale. Common foods that contain gluten include white or whole wheat bread, flour tortillas, pita bread, crackers, many cereals, pasta, cookies, gravies, and sauces.

What are the symptoms of celiac disease?

The range and severity of symptoms can vary widely, and effect many systems in the body (not just the gastrointestinal system), which is one reason it is so difficult to diagnose. Common symptoms include diarrhea, abdominal pain, and bloating that comes and goes. Symptoms may be similar to those of irritable bowel syndrome, Crohn’s disease, gastric ulcers, parasitic infections, or anemia. Some people have “silent celiac disease,” meaning they have no gastrointestinal symptoms.

What is the cause of celiac disease?

The exact cause of celiac disease is unknown. However, it can be inherited. If someone in your immediate family has it, you may have it as well. Celiac disease can occur at any age but sometimes emerges after some form of trauma such as pregnancy, surgery, or a physical injury.

How is celiac disease diagnosed?

Celiac disease can be identified by specific blood tests that detect antibodies that are present when a person with celiac disease has eaten gluten. Unfortunately these tests are not 100% accurate. The only definitive test for diagnosing celiac is a biopsy of the small intestine.

How is celiac disease treated?

Celiac disease has no cure. It can be managed by completely removing gluten from the diet for life. Once you have done that the intestinal villi can heal completely. Sometimes additional vitamins and minerals may need to be supplemented to correct deficiencies.

What can I eat if I have celiac disease?

If you are on a gluten-free diet you can enjoy fresh meats, fish, and poultry, most dairy products, fruits, vegetables, rice, potatoes, and gluten-free flours such as rice, soy, corn, and potato flour.

What should I avoid if I have celiac disease?

Breads, cereals, crackers, pasta, cookies, cakes, pies, gravies, and sauces can all contain gluten. Gluten-containing grains are often found in food additives such as malt flavoring and modified food starch. Gluten may also be found in foods like commercial pie fillings, canned meats, condiments, soup mixes, non-dairy creamers, and many other foods. Keep in mind that if you will be using processed foods, it is extremely important that you become well versed in reading labels and knowing where “hidden sources” of gluten may be. Marquette Nutrition & Fitness, LLC can help you learn how to identify these hidden sources of gluten.

There is controversy as to whether or not oats should be omitted in a gluten-free diet because some people can eat them without having symptoms.

How can I locate gluten-free foods?

Today there are many gluten free products on the market that can often be found in regular grocery stores (in addition to specialty markets). Some products can also be purchased via the Internet. An example of a gluten-free market is The Gluten-Free Mall.

Here are two free handouts to get you started:

Go Gluten Free

Gluten Free Quick Start Guide

Next Steps

Contact Marquette Nutrition and Fitness to schedule an appointment for an analysis of your diet to ensure you are getting all the nutrients you need while at the same time avoiding all sources of gluten.

References:

Medline Plus Medical Encyclopedia: Celiac disease-sprue.  Accessed January 2007.

National Digestive Diseases Information Clearinghouse (NDDIC). Celiac Disease.  Accessed January 2007.

Gluten Free Diet: A Comprehensive Resource Guide, by Shelley Case. 2008