What is Celiac Disease?

What is Celiac Disease?
Celiac Disease (CD) is an autoimmune disorder of the small intestine. People with CD cannot tolerate a protein called gluten, which is found in wheat, barley, and rye.

When a person with CD ingests gluten, their immune system responds by damaging the small intestine. Villi are tiny, hair-like projections in the small intestine that absorb nutrients from food. When the villi are damaged, they cannot effectively absorb basic nutrients which can lead to malnourishment regardless of the amount of food eaten. CD is also classified as a disease of malabsorption because nutrients are not absorbed.

Celiac Disease is a genetic disease, meaning that it runs in families. CD affects people of all ages and can appear at any time in a person’s life. CD is also known as celiac sprue, endermic sprue, nontropical sprue, gluten enteropathy, gluten-sensitive enteropathy, and gluten intolerance.

Symptoms of Celiac Disease
Young children often have growth failure, vomiting, bloated abdomen, and behavioral changes including irritability.

Classic Symptoms
gas
abdominal cramping, bloating, and pain
chronic diarrhea
constipation
pale, foul-smelling, or fatty stool (steatorrhea)
unexplained anemia
weight loss/weight gain
failure to thrive in infants
delayed growth
fatigue
behavioral changes

Other Symptoms
tooth discoloration or loss of enamel
osteoporosis, osteopenia
bone or joint pain
tingling numbness in legs
pale sores inside mouth (aphthous ulcers)
muscle cramps
seizures
infertility
itchy skin rash (Dermatitis Herpetiformis)

Dermatitis Herpetiformis (DH) is a severe, itchy, blistering skin manifestation of Celiac Disease. Not all people with CD develop DH. The rash is most commonly found on the face, elbows, knees, and buttocks. Treatment for DH is the same as treatment for CD.

How is Celiac Disease Diagnosed?

A person seeking diagnosis of CD must be consuming a diet containing gluten prior to testing. The person can be screened for CD through a specific antibody blood test. This screening should include: IgA endomysial antibodies (EMA), IgA tissue transglutaminase (tTG), IgG tissue transglutaminase and Total IgA antibodies.

If tests and symptoms suggest CD, a small bowel biopsy should be performed to confirm diagnosis and assess the degree of damage. A biopsy is performed by inserting a long, thin tube called an endoscope through the mouth and stomach into the small intestine. The doctor then inserts instruments through the endoscope to obtain tissue samples.

Celiac Disease is commonly misdiagnosed as irritable bowel syndrome (IBS), iron-deficiency anemia caused by menstrual blood loss, Crohn’s disease, diverticulitis, intestinal infections, and chronic fatigue syndrome.

How is Celiac Disease Treated?

The only present treatment for CD is to follow a life-long gluten-free diet. There are no medications that exist that will prevent damage, or prevent the body from attacking the small intestine when gluten is present. In order to stay healthy, people with CD must avoid gluten for the rest of their lives. Even the smallest amount of gluten can cause damage to the small intestine.

If CD is left untreated, the damage to the small intestine can be chronic and life-threatening. This can cause an increased risk of nutritional and immune related disorders.

Long-term conditions related to Celiac Disease:
iron deficiency anemia
osteoporosis
Vitamin K deficiency associated with risk for hemorrhaging
vitamin and mineral deficiencies
central and peripheral nervous system disorders
pancreatic insufficiency
intestinal lymphomas and other GI cancers
lactose intolerance
neurological manifestation

Other auto-immune disorders associated with Celiac Disease:
Dermatitis Herpetiformis (DH)
Insulin-dependent Type I Diabetes Mellitus
Thyroid disease
Systemic Lupus Erythematosus
Liver disease

The Gluten-free Diet

A gluten-free diet means not consuming foods that contain wheat, rye, and barley.
Allowed Grains:
rice
corn(maize)
soy
potato
tapioca
beans
garfava
sorghum
quinoa
millet
buckwheat
arrowroot
amaranth
teff
Montina7
flax
nut flours
Job=s tears
sago
cassava
Indian rice grass
legumes
seeds
wild rice
yucca

Foods to Avoid:
Wheat – including
-einkorn, emmer, spelt, kamut, durum, faro, graham, semolina
-wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein
Barley
Rye
Triticale (a cross between wheat and rye)

Frequently Overlooked Foods that MAY contain gluten:
breading, coating mixes, Panko
brown rice syrup
croutons
energy bars
flour or cereal products
imitation bacon
imitation seafood
marinades
pastas
processed lunch meats
sauces, gravies
self-basting poultry
soy sauce or soy sauce solids
soup bases
stuffings, dressing
thickeners
communion wafers
vegetables in sauce
seasoned tortilla chips
french fries
hot dogs, salami, sausage
candy
chips/potato chips
bouillon cubes
herbal supplements
drugs and OTC medications
nutritional supplements
vitamin & mineral supplements
Play-dough (gluten does not pass through the skin, hands should be washed immediately after handling play-dough)

Written By: Amber, fiestagrill