Celiac disease is a common disorder, especially in European countries. It is estimated that about 10 percent of the people in Finland have the disease, while one in 300 people in Northern Ireland are affected. It seems to be less common in the US, but experts believe that the prevalence of the disease is underestimated, because many people have symptoms which only appear later in life.
What is Celiac Disease?
Celiac disease is a chronic disorder that affects the digestive function of the intestines, resulting in malabsorption of nutrients. It affects both children and adults, and is caused by an allergic reaction to a protein called gluten. This protein is found in grains such as wheat, rye, barley, and oats, and eating any food that contains these leads to destruction of the inner lining of the small intestine, where most nutrients are normally absorbed.
Symptoms of celiac disease include diarrhea, steatorrhea (fatty stools), weight loss, weakness, and gas. Patients are usually found to have iron deficiency anemia, weak bones (osteoporosis) and abnormal bleeding tendencies. Some people, however, experience mild symptoms only, which include abdominal discomfort, bloating, and gas. In children, the disease may result in stunted growth due to nutritional deficiency.
The exact cause of celiac disease is unknown, but scientists believe that it results from the overreaction of the immune system to gluten, which is found in certain grains (barley, rye, wheat and oats). Other factors that increase one’s risk of developing the disease include genetic mutations and hereditary factors. Triggering factors include pregnancy, childbirth, surgery, viral infection, and severe stress.
Diagnosis of Celiac Disease
Specific blood tests are used to diagnose celiac disease, even in people who have mild symptoms. These include tests for anti-tissue transglutaminase antibodies, endomysial antibodies, and anti-gliadin antibodies. A biopsy of the small intestine can show damage to the inner lining. People who have no symptoms of the disease are not advised to undergo a screening test, but those who experience chronic diarrhea, steatorrhea and unexplained weight loss may need to be tested. Children with stunted growth and adults who have unexplained anemia and have a family history of the disease are also advised to take the tests. It is important to make a proper diagnosis of the disease so that dietary adjustments can be made to restore health.
Treatment of Celiac Disease
No cure has been found for celiac disease, but one’s health may be restored within a few weeks by shifting to a gluten free diet. Adjusting one’s diet can even result in symptom improvement within two days. Children can resume their growth by adhering to a diet without gluten.
There is no need for medications, and a strict adherence to a gluten-free diet is usually all that it takes to improve one’s health. However, some may fail to improve, even after many months of diet adjustment. In these rare cases, corticosteroids (prednisone), and immunosuppressant drugs (azathioprine, cyclosporine) may be prescribed.
Some individuals who suffer from severe malabsorption due to destruction of the small intestinal lining can develop deficiencies in vitamins and minerals. It is important for these patients to take vitamin and mineral supplements daily. Individuals who have iron deficiency anemia must be treated with supplemental iron, and those with anemia due to vitamin B12 or folic acid deficiency should be treated with vitamin B12 or folic acid. In individuals with abnormal bleeding, it may be necessary to treat them with vitamin K, while those with low blood calcium levels or osteoporosis should receive daily vitamin D and calcium supplements.
Diet for Celiac Disease
Foods to Avoid
People who have celiac disease must pay attention to all food they eat, especially processed foods that may contain wheat, rye, barley and oats. These include not only breads, cereals, crackers, cakes, pasta, pies, and cookies, but also these commonly eaten food products:
- bouillon cubes
- brown rice syrup
- potato chips
- cold cuts, salami, hot dogs, sausage, luncheon meat
- french fries
- communion wafers
- gravy, sauces, ketchup, mustard
- salad dressings
- imitation fish
- rice mixes
- self-basting turkey
- soy sauce
- canned soups
- instant coffee
- ice cream, yogurt
- vegetables in sauce
This list is not complete, so you must always check the ingredients of the foods you buy from supermarket or restaurants. In addition, some medicines and health supplements may include gluten-containing ingredients, which you have to watch out for.
Foods You Can Eat
Consult your doctor, dietitian and national celiac disease society for a list of gluten-free foods. Read the food and product labels before you buy or consume any product.
Grains such as rice and corn do not contain gluten. You can also eat fruits and vegetables to avoid constipation. In addition, these foods may be safely eaten:
- Indian rice grass
- Job’s tears
- nuts and seeds
- wild rice
This information should not take the place of medical advice. We encourage you to talk to your health care providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health.
MedicineNet. Celiac Disease.
WebMD. Celaic Disease- Topic Overview.
Mayo Clinic. Celiac Disease.
NDDIC. Celiac Disease.