Celiac disease is one of the most common genetic conditions in the world, yet 97 percent of people with this disease go undiagnosed. The disorder is activated by eating gluten, the proteins found in wheat, rye and barley.
“Celiac disease has varying symptoms and problems, including gastrointestinal issues, bone or joint pain, behavioral changes, fatigue or weakness and infertility, to name a few,” says Dr. David Ruiz of Family Medicine of Southwest Washington.
PeaceHealth Southwest’s Diabetes, Endocrine and Nutrition Center is partnering with Dr. Ruiz to increase awareness and treatment.
Question: What is celiac disease?
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Answer: Celiac disease is an autoimmune disorder in which the absorptive surface of the small intestine is damaged in genetically susceptible individuals when they ingest gluten. The immune system sees gluten as a toxin.
Q: What causes celiac disease?
A: For some people, celiac disease runs in families. You may have a genetic disposition to inherit the disorder (HLA gene with DQ2 or DQ8 allele). In addition, type 1 diabetes and celiac disease are found on the same region on a specific HLA gene. For other people, celiac disease may be activated by illness, surgery, viral infection, stress or pregnancy.
Q: What are some symptoms of celiac disease?
A: Digestive problems include diarrhea, constipation, gas, cramps, bloating, vomiting or reflux.
Other problems may include:
▪ Behavioral changes: mood swings, depression, sleeping problems;
▪ Respiratory problems: wheezing, shortness of breath, sinus problems, throat clearing, dry cough;
▪ Skin problems: eczema, dry skin, hives or rashes, itchiness, flushed color, welts;
▪ Pain: aches in joints or muscle, loss of strength, migraines.
Q: Who should be treated for celiac disease?
A: Individuals with gastrointestinal symptoms, short stature, delayed puberty, iron-deficiency anemia, infertility or early osteoporosis should discuss testing with their doctor. Also, individuals with Type 1 diabetes, other autoimmune diseases or who have relatives with celiac disease should be tested.
Q: If I have celiac disease, where do I start to become gluten-free?
A: Simple but important steps include:
▪ Consult with a registered dietitian.
▪ Thoroughly clean the kitchen (including a separate toaster, hand towel, refrigerator shelf).
▪ Plan on simply prepared meals with the right ingredients.
▪ Always check labels (food, medications, cosmetics, toiletries).
▪ Keep separate toothpaste and dental floss.
▪ Avoid contact surfaces at work.
▪ Pack your own food when traveling.
Q: What foods should be avoided?
A: Breakfast cereals made with wheat, barley, or rye or that have the term “malt” or “malted” in their names. Malt is made from barley. Bread. Crackers. Pasta. Pizza.
Avoid all beer products unless they say they are gluten-free. Beers with and without alcohol-including lagers, ales, and stouts-contain gluten unless they specifically say they are gluten-free.
Avoid oats, at least, at first. Oats may cause symptoms in some people, perhaps as a result of contamination with wheat, barley or rye during processing. But many people who have celiac disease can eat moderate amounts of oats without having symptoms. Health professionals vary in their long-term recommendations regarding eating foods with oats, but most agree it is safe to eat those labeled as gluten-free.
Carefully read food labels. The U.S. Food and Drug Administration says that if a food sold in the U.S. is labeled gluten-free, then it must contain less than 20 parts per million of gluten. Look for hidden gluten. Foods such as ice cream, salad dressing, candy, canned and frozen soups and vegetables, and other processed foods may have hidden gluten.
Q: What can a person eat on a gluten-free eating plan?
A: Here are some options:
▪ Eggs and dairy products. Some milk products may make your symptoms worse. If you have questions about milk products, ask your doctor. Read ingredient labels carefully. Some processed cheeses contain gluten.
▪ Flours and foods made with amaranth, arrowroot, beans, buckwheat, corn, cornmeal, flax, millet, potatoes, gluten-free nut and oat bran, quinoa, rice, sorghum, soybeans, tapioca or teff.
▪ Fresh, frozen or canned unprocessed meats. Examples of processed meats to avoid are hot dogs, salami, and deli meat. Read labels for additives that may contain gluten.
▪ Fresh, frozen, dried or canned fruits and vegetables, if they do not have thickeners or other additives that contain gluten.
▪ Certain alcohol drinks, including wine, liquor (including whiskey and brandy), liqueurs and ciders.
Q: Is it possible to eat out on a gluten-free diet?
A: When you eat out, look for restaurants that serve gluten-free food. You might ask if the chef is familiar with cooking without any gluten. Also look for grocery stores that sell gluten-free pizza and other foods. The Internet can be another source of information on gluten-free foods.