Celiac disease

Celiac disease is a digestive condition in which the lining of the small intestine is damaged or destroyed and cannot normally absorb nutrients into the bloodstream. This damage is produced by an autoimmune response to eating certain types of grain protein called gluten. Found primarily in breads, pastas, and cereals, gluten is also an ingredient in many processed foods such as soy sauce, canned soups and ketchup. While most alcoholic beverages are gluten-free, beer must be avoided.


While some people with celiac disease may be symptom-free, most experience some type of digestive disorder, such as frequent indigestion, heartburn, acid reflux, and irritable bowel syndrome. Since the intestine cannot process food properly, weight loss and nutritional deficiencies are common among people with celiac disease. Another clear sign of celiac disease is dermatitis, an inflammation of the skin, and many patients suffer from fatigue and aching joints. New studies have revealed a strong link between celiac disease and an increased risk of osteoporosis. Calcium malabsorption also leads to dental problems, including decay and other tooth enamel problems.


There are essentially two tests used to diagnose celiac disease. The most common is an upper endoscopy, in which a plastic tube is inserted down the esophagus to take still photographs of the upper part of the gastrointestinal tract. This may also include a biopsy of the distal duodenum.


The second gold standard test for celiac disease is a serology screening, consisting of four tests looking for IgA antibodies, the presence of which indicates celiac disease. Doctors may recommend other tests, such as a full blood count or a liver enzymes count, but the two tests mentioned above are the standard rule for diagnosis. Because of its similarity to other ailments, celiac disease is frequently misdiagnosed.


There is no known direct cause for celiac disease, although scientists estimate most patients have a genetic susceptibility to the illness. The trigger could be anything from an environmental agent, to a virus, to early exposure to gluten. In fact, studies show that babies exposed to gluten early on, before the gut barrier is fully developed, have an increased risk of developing celiac disease later in life.


Strict adherence to a gluten-free diet is the only treatment available for celiac disease. Because there is no cure available, the dietary changes must be permanent. A gluten-free diet will result in improvements in just a few weeks. If the diet is maintained, the intestine will be completely healed in about three months.


Celiac Disease Symptoms

There are no typical signs and symptoms of celiac disease. Most people with the disease have general complaints, such as:



Sometimes people with celiac disease may have no gastrointestinal symptoms at all. Celiac disease symptoms can also mimic those of other conditions, such as irritable bowel syndrome, gastric ulcers, Crohn's disease, parasite infections and anemia.


Celiac disease may also present itself in less obvious ways, including:



Some indications of malabsorption of nutrients that may result from celiac disease include:



Another gluten-related condition

Dermatitis herpetiformis is an itchy, blistering skin disease that also stems from gluten intolerance. The rash usually occurs on the torso, scalp and buttocks. Dermatitis herpetiformis can cause changes to the lining of the small intestine similar to that of celiac disease. However, it may not produce noticeable digestive symptoms. This disease is treated with a gluten-free diet, in addition to medication to control the rash.


When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that worry you. If someone in your family has celiac disease, ask your doctor whether you may be at risk of the disease. Your doctor may recommend testing, because celiac disease tends to run in families.


Seek medical attention for a child who is pale, irritable and fails to grow, and who has a potbelly and foul-smelling, bulky stools. Other conditions can cause these same signs and symptoms, so discuss it with your child's doctor before trying a gluten-free diet.


Celiac Disease Diet

What foods are safe to consume with celiac disease?

There has been much advancement to assist with complying with a gluten-free diet. The Food Allergen Labeling and Consumer Protection Act (FALPCA) requires manufacturers to provide more information about the ingredients used to make their food products, by specifying the presence of allergens on the product label, including wheat. Wheat-free does not mean gluten-free so you will still need to read the rest of the ingredients.


Gluten-free foods

It's a good idea to get into the habit of keeping a food record. You can use the record to make sure that you are reaching your required nutrients and avoiding gluten containing foods.


These are the foods that are SAFE to consume:


Amaranth; Arrowroot; Buckwheat; Cassava; Corn; Flax; Garbanzo beans (chickpeas); Indian rice grass; Job's tears; Legumes; Millet; Nut flours; Potatoes; Quinoa; Rice; Sago; Seeds; Soy; Sorghum; Tapioca; Teff; Wild rice; Yucca.


The other foods that you are able to eat are:


Meats

Plan meat, poultry, fish, shellfish, and eggs


Dry peas and beans, nuts, peanut butter, and soybeans


Tofu


Fruit

Fruit


Fruit juice


Vegetables

Fresh, frozen, and canned vegetables


Dairy

Milk


Plain yogurt


Cottage cheese


Cheese


Beverages

Pure instant or ground coffee


Tea


Carbonated beverages


Alcohol - wine


Fats

Butter


Margarine


Vegetable oils


Lard


Shortening


Miscellaneous

Sugar


Honey


Jelly


Jam


Olives


Black pepper


There is a way to convert recipes that contain gluten into gluten-free recipes. You will need to experiment with the ingredient substitution, length of time, and temperature used for baking. Here are some substitutions that you can make in your recipes:


For 1 tablespoon of wheat flour, substitute one of these:



For 1 cup of wheat flour, substitute one of these:



A panel convened by the National Institutes of Health assessed all of the available scientific evidence on celiac disease and identified six elements essential to treating celiac disease once it is diagnosed:


C: Consultation with a skilled registered dietitian


E: Education about the disease


L: Lifelong adherence to a gluten-free diet


I: Identification and treatment of nutritional deficiencies


A: Access to an advocacy group


C: Continuous long-term follow-up.


You are going to need time, patience, persistence, and support with making these changes. These changes will probably affect you, but it will get easier as you'll get used to it. You are not alone in this so reach out to those who know what you are going through. The important thing to remember is that your body needs this diet to function correctly.