Celiac Disease
What is Celiac Disease?
Celiac disease is a condition in which an individual’s immune system reacts to the ingestion of gluten, a protein that is present in wheat, barley, rye, malt, brewer’s yeast, as well as autolyzed yeast or autolyzed yeast extract (unless a gluten-free source is listed in the latter two). This immune response causes damage to the lining of the small intestine, which can result in poor absorption of nutrients and can cause symptoms such as anemia, diarrhea, constipation, abdominal pain, and bloating. Continued poor absorption of nutrients by the damaged intestinal lining can lead to increased prevalence of other medical conditions including poor bone health and anemia.
Celiac disease is a genetic disease, and individuals with the disease can inherit it from direct relatives and can also transmit the gene for the disease to their offspring. Virtually all individuals with celiac disease have the genes of HLA DQ2 or HLA DQ8. The gold standard for the diagnosis of celiac disease includes a simple blood test panel and an endoscopy with small bowel biopsy. To get an accurate reading, prior to testing, the individual should be on a diet that contains gluten.
The Diet
Patients with celiac disease need to be on a gluten free diet for life to heal their intestines and prevent further damage to the intestinal lining. Patients with celiac disease should not eat wheat, barley, rye, spelt, semolina, bulgur, couscous, farina, malt, brewer’s yeast or autolyzed yeast or autolyzed yeast extract (unless a gluten-free source is listed in the latter two). Gluten-free grains that patients with celiac disease are permitted to eat include rice, amaranth, buckwheat, rice, corn, flax seed, millet, gluten-free oats, quinoa, sorghum and teff. Grains, flours, and products made from them should be labeled gluten-free. Gluten free oats may be tolerated by some people with celiac disease. Talk to your doctor before adding them into your diet.
In addition to being found in obvious foods such as bread, grains, and cereal, hidden sources of gluten can be found in ready-made foods, sauces, dressings, and some medications and supplements, among many other products, including cosmetics. It is important that patients read the ingredient labels carefully.
Finally, cross-contamination, which occurs when gluten-free food comes in direct contact with gluten as a result of actions such as placing gluten-free food on toasters or grills that have come in contact with gluten-containing food, or frying gluten-free food in fryers that have come in contact with wheat-based products, can also cause symptoms.
To avoid weight gain and increase nutrition while following a gluten-free diet it is important to watch your caloric intake, minimize consumption of processed food, and ensure that you get all the needed vitamins, minerals, protein, fat, healthy carbohydrates, fiber, and water for a well-rounded, healthy diet.
Resources
For detailed information on celiac disease and the gluten-free diet go to:
- The Celiac Disease Foundation
- The Celiac Support Association
- National Foundation for Celiac Awareness
- The Gluten Intolerance Group of North America
- Celiac Center at Beth Israel Deaconess Medical Center
- National Institutes of Health Publication No. 08-4269 September 2008
- Real Life with Celiac Disease: Troubleshooting and Thriving Gluten-Free. Eds. Dennis M, Leffler D. AGA Press. Bethesda, MD, 2010.
