What the heck is celiac disease?
Celiac Disease, Celiac Sprue, Non Tropical
Sprue, Gluten Sensitive Enteropathy, or
Coeliac condition….No matter what name
you use, chances are you are wondering
what it all means. If you have received
this diagnosis from your physician, you
are probably feeling surprised, confused,
frightened, and angry. It is important to
note, however, that you are very lucky to
have received a diagnosis for why you have
been feeling so rotten. The good news is
you will soon be feeling better than you
have in a long time. The better news is
YOU DON’T HAVE TO TAKE ANY MEDICATIOIN
OR HAVE ANY SURGERY TO GET BETTER! What
you do have to do is eliminate all forms
and traces of gluten from your diet for
the rest of your life.
OK, WHAT IS GLUTEN?
Wheat proteins are collectively called
"Gluten". Wheat is closely related to
other grains, such as rye, barley, and
oats. Gluten is a mixture of individual
proteins classified in two groups, the
Prolamines and the Glutelins. The
prolamine gliadin seems to be a major
problem in celiac disease; gliadin
antibodies are commonly found in the
immune complexes associated with this
disease.
The elimination of gluten containing foods
is a very complicated thing, as western
diets are based primarily of wheat.
Simply saying, “OK, I will just eat
white bread” is not going to do it.
There are many forms of hidden gluten in
the most innocent-seeming foods, such as
Soy Sauce, Ketchup, Malt Vinegar, Beer
(yes, Beer!) Pasta, Seasoned Instant
Foods, Tortillas, Ice Cream, and
obviously, most types of baked goods.
This site has been set up to serve as a
resource for Celiacs to keep them safe
from Gluten Poisoning (sometimes called
gluten accidents), and to connect them to
resources that will assist them in being
able to make choices that will make living
on the Gluten-Free diet a healthy and
rewarding experience, rather than a life
sentence.
DIAGNOSIS
Many Celiacs have fought a long and
arduous battle to reach “The Big D”
(diagnosis). Chances are, they have been
told they had Irritable Bowel Syndrome,
Acid Reflux, or some other vague syndrome.
By the time most Celiacs finally obtain a
referral to a Gastroenterologist they are
malnourished, anemic, osteoporitic, weak,
and tired of eating, knowing they will
just get sick within a couple of hours.
Celiac disease was long thought to be a
rare condition, only affecting 1 in
100,000 people. New research has been
done that indicates prevalence is probably
1 in 133 people in the United States. For
a helpful educational guide regarding
diagnosis, please refer to the following
link:
http://www.aafp.or
g/afp/980301ap/pruessn.html
Definitive diagnosis of Celiac Disease is
done using a number of diagnostic tests,
including blood tests, stool samples, and
a colonoscopy/endoscopy procedure. Blood
tests are done to check on levels of
IgA-Antigliadin Antibody,
EMA-Anti-Endomysial Antibody, and
tTg-Tissue transglutaminase. These tests
indicate that your body is producing
antibodies to fight ingested gluten and
treat it as an invading organism, like a
virus. Blood is also tested for levels of
Iron and protein, and inflammatory markers
such as C-reactive protein and
Sedimantation rate. Stool samples are
collected to determine the amount of fat
being eliminated. Persons with Celiac
Disease do not absorb much of the fat in
their diet, thus it is eliminated from the
body without being absorbed. If these
tests come back with results suspicious
for celiac disease, your doctor will
probably order a colonoscopy/endoscopy
procedure. A positive biopsy will show
the flattened villi which is most
characteristic of Celiac disease, and is
consequently the cause for feelings of
tiredness, nausea, gas, bloating, and
diarrhea.
Newly diagnosed celiacs
It is essential that anyone newly
diagnosed with Celiac Disease should
consult with a registered dietician with
expertise in this condition as soon as
possible. Also, connecting with a local
support group is also quite helpful in
obtaining information and resources on
gluten free products. Click on the
following link for a listing of support
groups in the United States:
http://www.celiac.com/cgi-bin
/webc.cgi/st_prod.html?p_prodid=310&p_
catid=35&sid=84X6ej0-KA3@A66-181040939
29.99 . Another important step is to
familiarize oneself with gluten free
products, vendors, and cooking. A
complete list of acceptable and
unacceptable foods is available at:
http://www.celiac.com
/st_main.html?p_catid=12&sid=84X6ej0-K
A3@A66-42104177129.91 . And many
regions have their own list of gluten free
products and vendors through their local
support group.
celiac disease and children
It was once thought that Celiac disease
was a childhood illness that came on with
the ingestion of solid foods containing
gluten, and that children would eventually
outgrow the disease once they reached
adulthood. Unfortunately, Celiac disease,
as it is known now, is not a condition
that will go away or lessen. A strict
gluten free diet must be followed for a
lifetime. Even if ingesting gluten
containing foods does not cause immediate
side effects, damage to the small
intestine is still occurring, increasing
the odds that one may eventually develop
other complications of Celiac disease. A
very helpful resource for additional
information on dealing with the challenges
of raising children with Celiac Disease
can be found through your local ROCK
(Raising Our Celiac Kids) chapter.
Complications with celiac disease
Damage to the small intestine and the
resulting problems with nutrient
absorption put a person with celiac
disease at risk for several diseases and
health problems. Lymphoma and
adenocarcinoma are types of cancer that
can develop in the intestine. Osteoporosis
is a condition in which the bones become
weak, brittle, and prone to breaking. Poor
calcium absorption is a contributing
factor to osteoporosis. Miscarriage and
congenital malformation of the baby, such
as neural tube defects, are risks for
untreated pregnant women with celiac
disease because of malabsorption of
nutrients. In addition, some women with
untreated celiac have difficulty with
problems associated with infertility.
Short stature results when childhood
celiac disease prevents nutrient
absorption during the years when nutrition
is critical to a child's normal growth and
development. Children who are diagnosed
and treated before their growth stops may
have a catch-up period. Seizures, or
convulsions, result from inadequate
absorption of folic acid. Lack of folic
acid causes calcium deposits, called
calcifications, to form in the brain,
which in turn cause seizures.
Dermatitis herpetiformis
A condition which is closely related to
Celiac Disease, but in addition to
intestinal damage, skin lesions consisting
of small watery blisters erupt (usually
bilaterally) on the body, in areas where
pressure points are located. These
individuals must also eliminate any gluten
containing skin care and beauty care
products from their usage. This includes
botanical shampoos using wheat germ oil,
and lotions using oatmeal. The person
with DH may not realize that they have
major disturbance in their digestive tract
but studies have shown similar if not
identical disease processes. The small
intestine is a site of vigorous T-cell
activity in gluten-sensitive individuals
and is consistent with the view that the
enteropathy of dermatitis herpetiformis
and celiac disease is the result of a
delayed-type hypersensitivity against
gliadin.
Gluten free flours
Any type of grain can be ground into a
flour. Commonly used gluten free flours
include rice, tapioca (cassava), potato,
garbanzo bean, fava bean, quinoa,
buckwheat, amaranth, corn, and soy bean.
Each flour has different properties, but
none by itself has the same elasticity and
lightness as wheat flour. (Bear in mind
that white flour is made out of wheat!)
However, when these flours are combined in
various ways, desirable effects can be
obtained in baking and cooking. Often
additional leavening ingredients such as
yeast and baking soda, as well as
additional protein, such as milk and eggs
are required to achieve an elasticity
which holds baked items together
appropriately. In addition, Xanthan Gum
or Guar Gum is also added to help baked
goods hold together. (A word of
caution-Guar Gum can often have a laxative
effect on individuals who are not used to
including it in their diet regularly.)
Celiac vendors
It is possible to create fluffy breads,
tasty brownies, cakes and cookies without
using traditional wheat flour. Once armed
with several good gluten free cook books
and a few months to practice, you should
be able to turn out some amazing foods.
In the mean time, there are many vendors
who have put together brownie mixes, bread
mixes, and pancake mixes that rival
traditional mixtures and are sometimes
even tastier than the “real thing”.
Bear in mind that these mixes are usually
much more expensive than their Betty
Crocker counterparts. The following are
several product lines that can be obtained
at local health food stores, and also
online. Some vendors offer discounts for
buying in bulk, which is another benefit
that can be utilized within your local
celiac society or support group.
Gluten Free Pantry at
http://www.glutenfree.com/
Gluten Free Mall at
http://www.glutenfreemall.com/
Bob’s Red Mill at
http://www.bobsredmill.com/
(not all products are gluten free)
‘Cause You’re Special at
http://www.causeyourespecial.c
om/
Ener-G Foods at
http://www.ener-g.com/
Arrowhead Mills at
http://www.arrowheadmills.com/
DeBoles at
http://www.hain-celestia
l.com/index.php
Tinkyada at
http://www.tinkyada.com/
Lundberg Farms at
http://www.lundberg.com/
http
://www.bakeryonline.com/storefronts/authen
ticfoods.html
Dietary Specialties at
http://www.dietspec.com/
Enjoy life Foods at
http://www.enjoylifefoods.com/
Glutano at
http://www.gardenspotd
ist.com/glutano.htm
Nu-World Foods at
http://www.nuworldamar
anth.com/retailers/
Shiloh Farms at
http://www.shilohfarms.com/
Chebe Bread at
http://www.chebe.com/
Notta Pasta at
http://www.nottapasta.com/in
dex.cfm
EnviroKids (not all products are gluten
free) at
http://www.envirokidz.com/
Miss Roben’s at
http://www.missroben.com/
For a comprehensive list of Gluten free
vendors and how to contact them, also see
http://www.enabli
ng.org/ia/celiac/vendors.html
About dairy products
Many Celiacs have difficulty handling milk
and other dairy products. This is because
the Villi in the small intestine which
have suffered damage are also in the same
area in which Lactase is produced.
Lactase is an enzyme that breaks down
Lactose in milk and dairy products. The
damage caused by gluten consumption
hinders the body’s ability to break down
Lactose, thus creating gas, bloating and
diarrhea. It is often necessary for
celiacs to steer clear from milk, and even
cheese and yogurt.
A note on vegetarianism
Many professionals and lay persons assume
that a Celiac diet is incompatible with
vegetarianism. Although there are
additional challenges to maintaining a
healthy diet which adheres to both, it is
not impossible. Vegetarian Celiacs do
need to cut out many vegetarian
substitutions from their diet, such as
commercial vegetarian burgers, most hot
dogs, “chicken” nuggets and patties,
vegetarian “bratwurst”, and any other
meat substitutes containing gluten. For
some vegetarians, this is a very daunting
task. However, through careful research
and planning, one can certainly live a
life which is filled with exciting and
flavorful food choices.
Protein is certainly an issue for Celiac
vegetarians Tofu and most tempeh varieties
are gluten free. Peanuts, Cashews,
Walnuts, Pumpkin seeds, and legumes are
all good sources of protein. Eggs are
also high in protein (if not a vegan), but
are high in cholesterol.
