Pizza, cake, and even spaghetti – these items all have one thing in common: they are made from grains. Unfortunately, if you have celiac disease, eating anything that contains wheat, barley, or rye can have serious consequences.

Celiac (pronounced SEE-lee-ack) disease goes by many names including celiac sprue, nontropical sprue, or gluten-sensitive enteropathy. Regardless of what it is called, a diagnosis of celiac disease means eating a significantly different diet than most people. But with the right information, making the essential changes in diet can be easy.

Causes

Celiac disease is an autoimmune disease. Gluten, a protein found in wheat, rye, triticale, and barley, is the culprit. When a celiac patient consumes gluten, it triggers an attack by the body’s immune system on the intestines, which destroys villi – the tiny protrusions that line the small intestine. This immune attack keeps major nutrients from being absorbed into the bloodstream, which can cause a host of digestive problems and lead to malnourishment.

Celiac disease can manifest as a variety of symptoms. The most common are diarrhea, bloating, and abdominal pain. Stool may be frothy or malodorous due to unabsorbed fats. Anemia and unexplained weight loss are also common because the body cannot absorb essential nutrients. In addition, celiac patients might have a skin rash, depression, brittle bones, bone and joint pain, mouth ulcers, fatigue, tingling or numbness in hands and feet, and even infertility. Some people can have celiac disease and not experience symptoms until adulthood.

Fifteen to 25 percent of patients with celiac disease may have an itchy and blistering skin rash on areas like elbows, knees, and buttocks. The rash, a condition known as dermatitis herpetiformis (DH), might be the only sign of celiac disease and digestive problems or other complaints may be entirely absent.

Many times, symptoms first appear after surgery, pregnancy, childbirth, viral infection, or severe emotional stress. Those with celiac disease may be at risk to develop other autoimmune disorders like type 1 diabetes or thyroid disorders, although the reason for this connection is unknown. Because celiac is a genetic disorder, someone with a family member diagnosed with the disease is at a higher risk. 

Celiac disease is diagnosed by detecting antibodies in blood. These are proteins produced by the hyperactive immune system. You may need to undergo an endoscopy, where flexible tubing with a camera mounted tip is inserted into the digestive system to view the interior. During this procedure a doctor may remove a sample of your intestine for a detailed microscopic and laboratory examination.

If you are diagnosed with celiac disease, you should also have your family screened. Your doctor may request that everyone being tested go on an unrestricted gluten diet for a few days to facilitate the diagnosis. 

While symptoms often do not appear until adulthood, there are signs to watch for in children. Babies and children might be unusually irritable and show behavioral problems. They may be pale and deficient in red blood cells and have anemia. Kids might have diarrhea, bloating, abdominal pain, weight loss, delayed puberty, and stunted growth over the growing years. If your child is experiencing these issues, take them to the doctor for diagnosis.

Children with autism frequently experience numerous food allergies, especially to grain. Since these gluten sensitivities are also found in individuals with celiac disease, some doctors have suggested that celiac disease may be among the causes of autism.

Although this theory is controversial, some parents have instituted a gluten–free diet as a form of treatment for their autistic children. The gluten-free treatment plan is based on the belief that autistic children process foods containing gluten differently than others, and this may cause their symptoms to worsen.

A decrease in neurological function has been reported in some autism patients who ingest gluten-containing foods. Conversely, gluten-free diets have reportedly improved the symptoms of autism in several cases. Parents who report improvements in symptoms often claim that their children demonstrate enhanced speaking skills and better behavior.

Celiac disease is serious indeed. If steps aren’t taken to control it, you can develop deficiencies of vitamins and minerals. For example, you could develop anemia due to iron deficiency or you might bleed or bruise easily due to vitamin K deficiency. Celiac disease can affect numerous organs like the liver, pancreas, gallbladder, bones, heart, and the nervous system, all due to impaired nutrient absorption. Problems with absorption can also cause gynecological problems and fertility issues.

There is no cure for celiac disease. The best management for the disease is to remain on a gluten-free diet. As your body responds to gluten restriction, the intestine heals from the previous immune attacks and symptoms subside. Change your food habits and learn to avoid even small amounts of gluten. Read food labels carefully, and beware – “wheat free” does not mean gluten free. Wheat-free products can still include rye, barley, einkorn, kamut, spelt, and triticale. You might need to avoid gluten-containing foods like breads, broth, commercial cereals, wafers with grains, pastas, cakes, marinades, sauces, stuffing, food starch, and dextrin.

Avoid cross contamination with gluten products – even a tiny amount can trigger a reaction. Keep a separate toaster for yourself. Do not use a knife that has been used to spread jam or butter on a bread slice. Buy your food in a bakery that has separate gluten free machinery. If you dine out, make sure your food is prepared using clean, uncontaminated utensils.

The amount of restrictions in your diet might seem overwhelming, but do not get too down. You can still enjoy a wide variety of foods; a few examples are fruits, vegetables, eggs, corn, rice, buckwheat, potatoes, meat, fish, milk, and cheese. Many grocery stores have gluten-free aisles with various gluten-free options including cereals, cake mix, flour, and bread.

Although you might need nutritional supplements to make up for nutrient deficiencies the disease has caused, no other medication is typically required. Rarely, you might need steroids to suppress the immune activity. A drug called dapsone might also help if you suffer from dermatitis herpetiformis, the skin condition associated with celiac disease.

Resources for People with Celiac Disease

Your doctor might be able to help you find a local support group for celiac disease. Connecting with people who have similar problems can provide a resource for encouragement and a platform to share helpful information. If you don’t personally suffer from celiac, try going gluten-free anyway to support a spouse or loved one with the disease. Seek help from a dietician to plan your diet to provide you with enough diversity. Extensive archives of gluten-free recipes can be found online and gluten-free cookbooks are widely available.

Remaining gluten free is a lifelong commitment. But with support and proper information, it doesn’t have to be a daunting one. Know how to manage your disease and you can improve your quality of life.