Celiac disease – also known as celiac sprue, nontropical sprue, sprue or gluten sensitive enteropathy – is an autoimmune, inheritable disease of the small intestine. When persons with celiac disease eat the protein gluten, which is found in wheat, rye and barley, the lining of the small intestine becomes inflamed and unable to absorb nutrients from food. If untreated, vitamin and mineral deficiencies and malnutrition may result. The presence and intensity of symptoms is highly variable. Symptoms may appear at any age and include diarrhea or constipation, gas, bloating, abdominal cramping and pain, fatigue, weight loss, anemia, headaches, bone thinning (osteopenia/osteoporosis) and, in children, growth failure. Emotional and psychological symptoms, such as depression, anxiety and irritability, may also be present.
A form of celiac disease that causes a skin reaction when gluten is eaten is called dermatitis herpetiformis (DH). Patches of itchy or burning hives or small blisters form. Although medicine is usually prescribed, following the gluten-free diet is essential to treatment. Avoiding skin applications of products containing gluten is also important.
The first step to diagnosis is a physical examination, including both a review of symptoms and a celiac antibodies (tTG and EMA) blood test. If indicated by the results of the blood test, biopsies of the small intestine may then be taken. If DH is present, skin biopsies may be taken. It is essential to stay on a gluten-containing diet during this testing to obtain accurate results. The diagnosis is finalized when one follows the gluten-free diet, and signs and symptoms of gluten sensitivity improve.
Although there is no cure for celiac disease or DH, following the gluten-free diet is the key treatment. The diet requires the total avoidance of all foods made from or including ingredients made from wheat, rye, barley and related grains. (See foods/ ingredients and nonfoods lists.)
Lifelong avoidance of gluten is necessary to prevent symptoms, allow the intestine and skin to heal and remain healthy, and to lower the risk of other autoimmune diseases, such as diseases of the thyroid and the liver.
Is it necessary to see a dietitian? According to recommendations by the National Institutes of Health (NIH) in 2004, consulting a skilled dietitian can help you achieve complete avoidance of gluten to include nonfoods, such as cosmetics, dental products, medications, postage stamps and envelopes. You will also receive guidance on meeting your personal nutrition needs tailored to your health history and food preferences, and an introduction to the array of tasty (!) gluten-free foods available.
Beginning January 2006, all food packages with a Nutrition Facts label must state the presence of major food allergens, including wheat. Guidelines for identifying gluten are being written. As ingredients may change over time, read the ingredients and food allergy panels on food packages every time you shop, unless a package is clearly marked “gluten-free.”
Amaranth, arrowroot, beans, buckwheat, corn, millet, poi, potato, quinoa, rice, sorghum, starch (in foods, check source in pharmaceuticals), soy, tapioca, teff, wild rice. Oats, if uncontaminated by gluten during harvesting and processing, may be tolerated. Follow your doctor’s or dietitian’s advice about including oats in your diet.
Celiac Disease Foundation
High Sierra Gluten-Free Support Group
Reno ROCK Group (Raising Our Celiac Kids)
Celiac Sprue Association/USA, Inc. (CSA) (See contact information above.)
Extension's Communication Team
Seymour, K. and Wilson, M., 2006, Living With Celiac Disease, Extension | University of Nevada, Reno, FS-06-15
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