Celiac disease is a serious disorder in which gluten – a protein found in wheat, rye and barley – damages the small intestine and prevents the absorption of essential nutrients such as vitamins, calcium, protein, carbohydrates, and fats. Celiac disease tends to run in families. If one person in your family has celiac disease, the odds are that one in 10 of family relatives also has or will develop the disorder.

Celiac disease can strike anyone from infants to seniors. In some cases, the disorder is latent for decades before finally being triggered by severe stress, physical injury, infection, childbirth or surgery.

Symptoms of celiac disease differ with age. For example, infants and young children are more likely to have digestive symptoms such as abdominal pain, vomiting and diarrhea, and may fail to achieve normal height and weight. Accompanying malnourishment may result in an abnormally large abdomen, abnormally small thighs and buttocks, and delayed puberty.

Instead of digestive symptoms, adults with celiac disease are more likely to have symptoms such as malaise and fatigue, bone or joint pain, irritability, anxiety and depression. Female patients may have irregular menstrual periods.

If not treated, celiac disease often leads to conditions such as osteoporosis and anemia. Many older patients with the disorder also have lactose intolerance (an inability to digest milk and milk products), dermatitis herpetiformis (an itchy, blistery skin problem) and canker sores in the mouth.
If you suspect that you or a family member has celiac disease, see your doctor. He or she can order a blood test that helps diagnose the disorder. If the blood test indicates celiac disease, an intestinal biopsy or a diagnosis of dermatitis herpetiformis can confirm its presence.

Diet Is Key to Treating Celiac Disease

The only effective treatment for celiac disease is a gluten-free diet. Complete avoidance of all foods that contain wheat, barley and rye products, including many breads, pastas, cereals and processed foods, can reverse damage to the small intestine and dramatically improve quality of life.

It’s not easy to adopt a gluten-free diet. Patients must learn to read ingredient labels, order meals carefully at restaurants, and go without many foods they may have previously enjoyed. Cheating on a gluten-free diet inevitably leads to relapse of celiac disease.

Fortunately, there are celiac disease support groups, gluten-free cookbooks and other resources that can help you live with the disorder.  Your doctor can help you find the resources your need to make a successful transition to a gluten-free life. Many grocery stores now carry free gain products including breads, cereals, flours, and even beer.

Foods to Avoid

In addition to wheat, barley, and rye, many people with celiac disease also avoid oat products because they are sometimes contaminated with wheat gluten. Because gluten is found in some medicines, it’s also important to talk to your doctor or pharmacist before taking a new medicine.

If you have celiac disease, it’s essential to avoid grain products made of any type of wheat, including farina, graham flour, semolina, and durum; barley, rye, bulgur, Kamut, kasha, matzo meal, spelt, triticale, couscous, emmer, and einkorn.

Common gluten sources include:

• Breaded foods
• Breads, bagels, croissants, buns
• Cakes, donuts, and pies
• Cereals (most)
• Cold cuts, hot dogs, salami, or sausage
• Crackers and many snacks bought at the store, such as potato chips and tortilla chips
• Gravy
• Pancakes and waffles
• Pasta and pizza
• Soups (most)
• Stuffing

Less-obvious gluten sources include:

• Beer
• Candies (some)
• Communion breads
• Croutons
• Marinades, sauces, soy and teriyaki sauces
• Salad dressings (some)
• Self-basting turkey

Foods That Are Safe

Staples of the gluten-free diet include:

• Cereals made without wheat or barley malt
• Fruits and vegetables
• Meat, poultry, and fish (not breaded or made with regular gravies)
• Milk-based items
• Oats (may be okay for some people with celiac disease, but work closely with your doctor or nutritionist and make sure to look for oats that are labeled “gluten free.”  Oats are often processed in plants that handle other grains that are not gluten free and this can result in contamination.)
• Potatoes, rice, corn, beans

Whether or not you have celiac disease, grains – especially whole grains – are an important part of a healthy disease because they contain complex carbohydrates, vitamins, minerals, and fiber. Because most gluten-free grain products aren’t enriched with vitamins, consider taking a daily multiple vitamin supplement..

Foods that are safe to eat include:

• Amaranth
• Arrowroot
• Buckwheat
• Cassava
• Corn
• Flax
• Indian rice grass
• Job’s tears
• Legumes
• Millet
• Nuts
• Potatoes
• Quinoa
• Rice
• Sago
• Seeds
• Sorghum
• Soy
• Tapioca
• Teff
• Wild rice
• Yucca

Bette Hagman, who has celiac disease, has written several cookbooks published by Henry Holt and Co. to help patients adjust to a delicious and varied gluten-free diet.  These include:

• The Gluten-Free Gourmet: Living Well Without Wheat
• More From the Gluten-Free Gourmet
• The Gluten-Free Gourmet Cooks Fast and Healthy

For more information about celiac disease, contact the Celiac Disease Foundation at http://www.celiac.org/

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