What is Celiac Disease?
Celiac disease is often a debilitating and uncomfortable experience for patients who suffer from it. Sufferers have to make strict dietary changes in order to help prevent symptoms to the best of their ability and to start treating this disorder. Celiac disease is actually a type of improperly negative immune response to gluten. Gluten can be found in many food and dietary supplements. It is also a part of wheat, barley, and rye, for example. Gluten might also be found in products where it is not immediately obvious that it would be present. So patients with celiac disease must be extremely careful in order to avoid the hidden dangers. Food and cooking utensils that have come in contact with gluten also need to be avoided.
The consumption of gluten can cause the small intestines of a patient with celiac disease to become inflamed and damaged. Over time, this is likely to lead to malabsorption of nutrients, causing bloating, diarrhea, and weight loss. In the long run, without necessary nutrients, the liver, brain, and other organs can suffer damage. Loss of calcium and bone density, miscarriage, infertility, and cancer are also possible complications of celiac disease. In children, growth and other development can be impacted by CD. Early signs of celiac disease might be stomach pain after eating. Patients will need to narrow down what food is causing their discomfort and consult a doctor to diagnose their celiac disease.1
Possible Causes of Celiac Disease
People most at risk for CD are those who have family members with dermatitis herpetiformis or themselves have celiac disease, those with Down syndrome, Turner syndrome, autoimmune thyroid disease, Sjogren’s syndrome, or colitis, and people with Type 1 diabetes. There is no cure, but intestines can start to heal as soon as sufferers follow a strictly gluten-free diet. 15% of people with this disease, however, are non-responsive to even a GF diet. Typically, the latter situation is caused by the unintentional contamination of the diet with the presence of even traces of gluten. Those with nonresponsive celiac disease may have bacterial overgrowth, poor pancreas function, irritable bowel syndrome, or colitis.
Rarely, refractory celiac disease can occur. This can lead to other medical interventions besides a GF diet, such as steroids (to reduce inflammation) or a medication for immune suppression. Patients may need to supplement their nutrients with iron, vitamins (B-12, D, and K), zinc, folate, and calcium.2 If a person is already eating a GF diet, diagnosis is difficult. Antibody levels decline, and intestines heal, on a strict GF diet. Some of the diagnostic tests include blood tests (to investigate antibodies in the immune system) and endoscopic biopsy. Doctors will also look for iron deficiency, B-12 and calcium deficiencies, osteoporosis, and thyroid disease.3
The GF Diet
In general, following a strict gluten-free diet is the key to resolving celiac disease symptoms. People with this disorder should always avoid wheat, spelt, triticale, semolina, malt, rye, graham flower, durum, bulgur, barley, and farina. They should also be aware that some products may contain gluten. This includes processed meats, soups, salad dressings, sauces and gravies, candy, and beer. Oats are also questionable, as they might be contaminated with gluten during processing. Substitutes for these products, which are safe in that they lack gluten, are widely available. Unless a product is clearly labeled “gluten-free”, doctors recommend avoiding it in order to assure safety.
Foods that are safe for patients with celiac disease to consume include fresh meats, fruits, and vegetables, some dairy, wine, and spirits. As for grains/starches, allowable ones on a GF diet would include quinoa, rice, tapioca, corn, “gluten-free flours (rice, soy, corn, potato, bean)”, buckwheat, amaranth, and arrowroot. Today, there are many more options available–and clearly labeled GF–in the grocery aisles.
Again, utensils and cookware which touch food that is not gluten-free before being used by those with celiac disease could also cause harm. Some are more sensitive than others, even requiring entire kitchens to be completely gluten-free in order to circumvent a negative physical reaction from contact with the substance that could potentially harm the patient due to the disease.4 While some forms of alcohol are allowed, Dr. Andrew Weil recommends that patients should only moderately use it or avoid it completely. In addition, NSAIDs (ibuprofen, naproxen) should also be avoided. He recommends taking a probiotic and following an “anti-inflammatory diet, including essential fatty acids like fish oil and GLA”. Weil also suggests glutamine supplementation.5
Gluten Found in Places Other Than Food
There are some cases where a patient’s celiac disease will affect them even when they are not directly ingesting the gluten. For those patients who regularly visit a practitioner of massage for therapy or relaxation, they should consider the potential risk of contact with gluten. Patients should talk to their massage therapist and keep this in mind for any other applicable situations, about skin products like lotions and oils that could contain gluten like wheat germ or hops. These products could potentially irritate the patient’s skin.6
1, 2, 4 http://www.mayoclinic.com/health/celiac-disease/DS00319