Imagine what it would be like if eating pizza, pasta, most breads, cookies, cakes, candy bars, canned soup, luncheon meats or drinking beer left you with cramps, diarrhea, anemia and chronic fatigue. For many people with celiac disease, that's reality.
Celiac disease occurs when a protein called gluten - found in wheat, barley, rye, and possibly oats - generates an immune reaction in the small intestine of susceptible people. Food normally doesn't provoke a response by the body's immune system - the body's defense against microbes and other threats to health, but in a person with Celiac disease, the ingestion of gluten triggers a reaction from the immune system that causes the lining of the small intestine to become inflamed and swollen. This results in the ‘villi’, the tiny hair like projections in the small intestine to shrink and eventually disappear. In a healthy body, the villi absorb vitamins, minerals and other nutrients from food. With shrunken or no villi, a person with Celiac loses the ability to digest and absorb nutrients; resulting in malabsorption. Malabsorption can deprive the brain, nervous system, bones, liver and other organs of nourishment and cause vitamin deficiencies that may lead to other illnesses.
A hereditary disease
Although celiac disease, also called celiac sprue, is inherited and tends to occur in families of northwestern European descent, it can affect anyone. It can develop at any age. Symptoms in infants only appear after food containing gluten is introduced. The condition should be strongly suspected in pale, irritable infants who fail to thrive and who have a pot belly with flat buttocks and malodorous, bulky stools.
Pregnancy, severe stress, physical trauma, or a viral infection can trigger celiac disease in susceptible people for reasons that aren't well-understood. Celiac disease also is more common among people with type 1 diabetes and thyroid disease.
Diagnosis sometimes difficult
Some speculate that celiac disease has been around since humankind first switched from a foraging diet of meat and nuts to a cultivated diet that included high-protein grasses like wheat.
There is no "typical" celiac case. The disease has a broad range of symptoms but no common symptom. Some people with Celiac gastrointestinal symptoms while others can have a host of other symptoms like anemia, skin disorders, osteoporosis, neurological conditions, and many others.
Celiac disease can be diagnosed on the basis of blood tests and confirmed with an endoscopy. It is important that people not go on a gluten-free diet before seeking a medical evaluation. Doing so may change the results of blood tests and biopsies so that they appear to be normal.
Once thought to be a rare disease, it is now known that celiac is quite common, affecting approximately 3 million people in the U.S. (diagnosed) and several times that number undiagnosed. Celiac disease is incurable, but treatable by adhering to a 100% gluten-free diet.
Living with celiac disease
If you have celiac disease, a gluten-free diet is the only way to avoid doing further damage to your intestinal lining and villi. Once gluten, found in hundreds of common foods, is removed from the diet, the digestive tract may begin healing within several days. Significant healing and re-growth of the villi may take several months in younger people and as long as 2 to 3 years in older individuals.
Foods allowed in a gluten-free diet include:
- Fresh meats, fish and poultry
- Milk and unprocessed cheeses
- Dried beans
- Plain fresh or frozen fruits and vegetables
- Corn and rice
Foods not allowed in a gluten-free diet:
- Any bread, cereal or other food made with wheat, rye, barley and oat flours or ingredients byproducts made from those grains.
- Processed foods that contain wheat and gluten derivatives as thickeners and fillers like hot dogs, ice cream, salad dressings, canned soups, dried soup mixes, non-dairy creamers, processed cheeses, cream sauces, and hundreds of other common foods.
- Medications that use gluten to bind a pill or tablet together
Identifying gluten-free foods can be difficult. People with celiac disease should discuss their food selections with their physician and a registered dietitian. A dietitian also can advise how to best improve the nutritional quality of a diet. Food manufacturers can be contacted to find out if a product contains gluten. Celiac disease support groups and internet sites also may have information on the ingredients found in food products.