Celiac disease is a genetic, autoimmune disease that causes damage to the villi of small intestine lining. When these fingerlike projections in the intestine are damaged the result is malabsorption of nutrients. This can cause the host of issues associated with celiac disease. There are no medications or treatments other than a gluten free diet. Celiac disease is an allergy to gluten which is a protein found in wheat, rye and barley and even the smallest amount of gluten can be dangerous to someone with celiac disease. Of the estimated 3 million people in the United States with celiac disease, 5% have been diagnosed. Symptoms can range from, no symptoms at all, to mild indigestion, bloating and weight loss. Severe cases can manifest in anemia, malnutrition, osteoporosis, infertility, cancer, blood in stool, depression, dental issues and severe diarrhea to name a few. Celiac disease can manifest in the skin as a condition called dermatitis herpetiformis. UNSAFE GRAINS: wheat, rye, barley, bulgur, couscous, durum, farina, faro, graham, kamut, matzo, malt flavor, malt vinegar, semolina, tritcalae and udon. Avoidance of gluten isn’t always as easy as avoiding bread, since gluten can be hidden in foods such as condiments, processed meats, low fats foods, and additives that are gluten containing. Additives such as dextrin, hydrolyzed vegetable proteins and hydrolyzed plant protein, modified food starch, soy sauce, brown rice syrup, bouillon all can have gluten. Patients should search for foods labeled gluten free. Dairy can be consumed by celiacs but usually tolerance is best after the bowel villi heal. A gluten free diet can be healthy since fresh protein, fruits and veggies will all be gluten free, Starches such as rice, brown rice, potato, sweet potato, quinoa, buckwheat, legumes, polenta, rice noodles, are all gluten free. Getting creative and baking and cooking with wheat flour alternatives is helpful. Oats do not naturally contain gluten but cross contamination can happen in the milling process so caution should be used when purchasing oats. Prevention of cross contamination in the home is essential, so washing food preparation surfaces and cooking equipment is needed to keep celiacs safe. Gluten can also be hidden in makes up, over the counter medications, prescription medication, vitamins, toothpaste and deodorant. All need to be gluten free. A gluten free diet is a lifelong commitment and even a tiny amount of gluten can cause intestinal damage. A consult with a Registered Dietitian to get started on a gluten free diet is usually essential.
~ Elizabeth Bongo, R.D., C.D.E.