Celiac Disease – The Ultimate Guide
“Celiac disease affects 1 person in every 141 in the United States” (1)
I think you will agree, with these kinds of statistics everyone must know someone who has this disease. However, there are also many out there who don’t know they have it.
For those that have been diagnosed with celiac disease, it can be bitter sweet news.
On one hand, they are relieved to know they have an explanation, on the other it’s a life changing one. Trying to absorb the essential information takes time to process and can be overwhelming.
I’ve put together a complete celiac guide for those who would like to discover more about the disease and for those who want to know how to learn to cope living with it.
The Basic Facts about Celiac Disease
Let’s start with the essentials and get to grips with the specifics surrounding celiac disease.
Definition of Celiac Disease
Celiac disease is a condition which affects the digestive system. It’s an autoimmune disease which means your immune system gets its wires crossed. Instead of protecting you, it attacks you.
The trigger comes down to eating foods containing gluten. (2) This abnormal reaction damages the lining in the small intestine and affects the body’s ability to absorb nutrients as well as other complications.
Is celiac disease the same as gluten intolerance?
Many people think celiac disease and non-celiac gluten sensitivity is one and the same. When you consider the symptoms, causes, and treatment all overlap in similarity, this is totally understandable.
However, the biggest difference, having a gluten intolerance doesn’t appear to damage the lining of the gut.
For those tested and not diagnosed with either celiac disease or a gluten allergy, they are defined as having non-celiac gluten sensitivity. (3)
Signs and Symptoms
The problem with celiac disease is that there are many symptoms and it can vary from person to person. Therefore, it creates a challenge for many to get a proper diagnosis.
With celiac disease, digestive issues are likely. Although these are more prevalent in children than in adults, it’s possible to experience symptoms such as: (4)
- Abdominal pains
In fact, for adults, it’s more common to display warning signs which are not directly related to the digestive system. You may experience one or more of the following issues:
- Headaches or migraines
- Skin rash (dermatitis)
- Tingling sensation in limbs (hands and feet)
- Joint pain
- Weight loss
- Mouth ulcers
Symptoms can be persistent, or they can come and go. In some cases, no signs are experienced whatsoever.
If any of this sounds all too familiar for you or your child, have a chat with your physician to discuss your concerns.
As we have learned, symptoms can often vary which is why pinpointing it to celiac disease can sometimes take time.
To determine an accurate diagnosis of celiac disease you should always consult with a doctor to confirm this for you. This is what you can expect from the screening process:
- Blood tests
- Endoscopic Biopsy
The first step for both children and adults is a blood test. The most common one is called the “tTG-IgA” test. This will establish whether there are any specific antibodies in the blood.
If the blood test indicates the possibility of celiac disease the only way to confirm an accurate diagnosis is by taking a small piece of tissue from the small bowel through a biopsy.
Reason and Risk of Celiac Disease
Although celiac disease can affect anyone, the exact reason as to why it develops still remains unclear. However, as more research is carried out, what has become clear is that there are certain risk factors and situations surrounding triggers. (5)
Celiac disease has a lot to do with genetic makeup.
If a close family member (parent, sibling, child) has been diagnosed with this condition, your chances of development increases. However, it doesn’t automatically mean you will follow suit.
Other autoimmune diseases are also linked to celiac disease. It’s not uncommon for people that have type 1 diabetes to also suffer from celiac disease.
A similar pattern is also followed with these conditions: (6)
- Rheumatoid arthritis
- Thyroid conditions
- Down syndrome
- Autoimmune liver disease
And that’s not all.
Even viruses have been associated with kick starting an inflammatory response to gluten. (7)
Complications of Celiac Disease
The small intestine contains a lining of tiny finger-like tissues called villi. It’s their job to take in all the goodness as the food passes through the digestive system.
With celiac disease, the reaction caused by gluten attacks and damages this tissue. It stunts the villi and renders them dysfunctional, making them unable to absorb nutrients properly.
As the body is not consuming nutrition properly, an imbalance is likely to occur. The knock-on effect of untreated or undiagnosed celiac disease results in vitamin and mineral deficiencies.
Here are some complications that are likely to arise:
- Lactose intolerance
- Weight loss
Calcium is essential to keep the bones strong and healthy. If your body is unable to absorb this through the villi, bones will weaken and the likelihood of developing osteoporosis becomes very real.
There is a clear association with fertility problems and untreated celiac disease. Women experience a higher rate of miscarriage, risk for abortion and low birth weight babies with celiac disease. This is down to the malabsorption of folic acid and other vital nutrients into the body. (8 9)
Consuming dairy foods could also prove to be an issue if celiac disease is left untreated. The small intestine is where the enzymes are generated to process foods containing lactose, the sugars found in dairy. (10)
Iron is vital for producing red blood cells which transport oxygen around the body. Untreated celiac disease will result in a shortage of this mineral causing the development of iron deficiency anemia. This can leave you feeling tired and lethargic.
For children with celiac disease that hasn’t yet been spotted, many aspects of development can be impacted.
- Slow growth rate
- Poor development of teeth
- Behavioural problems
- Delayed puberty
It’s clear to see why early diagnosis and treatment of celiac disease is essential to prevent complications. If left untreated, the long-term effects can be detrimental to health in more ways than one.
Treatment of Celiac Disease
The future may bring developments of treatments through ongoing research. Unfortunately, right now there is no known cure for celiac disease. This means once you are diagnosed, it is with you for life.
However, it doesn’t mean you should suffer.
There is a solution. And the best treatment at present is to remove the offender from your diet and go gluten-free.
For most people, cutting out gluten will bring notable improvement of symptoms. The small intestine is able to start the recovery process and further damage can be avoided.
The Celiac Guide to a Gluten-Free Diet
As a strict gluten-free diet is the best approach to control the disease, here is a run through of the essentials so that you can get to grips with your gluten-free goal.
All About Gluten
Gluten – you know you should avoid it, but do you know what it really is?
Gluten is a protein found in grains like wheat, rye and barley. It may appear to be harmless, yet for those with celiac disease it is toxic.
It’s responsible for gluing together foods in the baking process. If you have ever made bread, gluten in flour gives the dough that elastic consistency and helps it to rise when baked.
And it’s not just used for bread. Gluten can be found in many types of foods, it even manages to sneak into things that are not quite so obvious.
Getting to Grips with Going Gluten-Free
In the beginning, switching to a gluten free diet may feel overwhelming. This is completely understandable considering the changes you must make. However, once you understand the basics it will become completely natural and a way of life.
The best part?
On a gluten-free diet you can eat:
- Fruits and Vegetables
- Fresh Meat and Poultry
- Fish and Seafood
- Some Dairy Products
- Gluten-free grains
- Gluten-free food alternatives
If you are struggling to cope with the change, consult a dietician who can give you further advice on how to make a gluten-free diet work for you.
Know Your Grains
A celiac guide wouldn’t be complete without an overview of grains, cereals and other starchy foods to eat or avoid. Some will be familiar options, others less common. Check out this list and see how many you recognize. (11)
Beans & Pulses
Kamut – Khorosan
Note: * these are derivatives of wheat
Oats – Yes or No?
Oats deserve a special little mention, simply because you could put them in either the “eat” or “avoid” group.
Although oats don’t contain gluten, they are at substantial risk of cross-contamination with wheat or other grains during processing.
Experts suggest celiac patients should only consider adding oats into their diet once their gluten-free diet in full swing and symptoms have subsided. (12)
Foods to Avoid
Knowing what grains contain gluten is one thing, knowing what common foods contain them is another. If you have celiac disease, unless you have chosen a gluten-free substitute, steer clear of these popular foods:
- Cakes, cookies
- Breakfast cereals
- Breaded Coating mixes (on deep fried chicken, for example)
- Dressings, sauces & condiments
- Processed meats (hot dogs, deli meats)
If Italian cuisine is your thing, then you will have to look for gluten-free alternatives. Pasta, most commonly, is made from either semolina or durum which is a form of wheat.
Bread is prime gluten territory and an obvious choice to step away from. Say goodbye to white, rye, bagels and even pizza bases. However, if you can’t live without your loaf there are a wide variety of gluten-free options available to choose from.
Cakes and Cookies
All the home bakers out there will know one of the staple ingredients in cakes and cookies is wheat flour.
Dressings, Sauces & Condiments
Many bottled sauces and dressings contain gluten to thicken the liquid. Soy sauce is made from wheat and many dressings contain malt vinegar.
If you want to start the day the celiac way, it’s best to avoid traditional breakfast cereals. Many contain malt, wheat, rye or barley.
When going gluten-free you may have to get a little inventive with after dinner cheese and crackers. Most of these savory snacks are gluten’s best friend – wheat. Instead, try rice cakes for celiac friendly alternative.
Gluten-free products are becoming a common sight on the grocery store shelves these days. Which means if you really can’t live without something, many products containing gluten should also have a gluten-free doppelganger.
You can find pretty much anything if you are prepared to look. Foods ranging from buckwheat pasta and quinoa mac and cheese to snacks like gluten-free pretzels and brownie mixes.
Drinks and Alcoholic Beverages
On a gluten-free diet, most non-alcoholic drinks are considered suitable with a few exceptions. Beverages such as water, tea, and pure juices are made with ingredients that don’t contain gluten.
However, there is often some debate on the caramel coloring found in some sodas. This can be made from barley or from corn. Soda really has no health benefits at all – so I’d recommend avoiding it completely.
As for alcoholic beverages, most beers contain gluten as they are made from barley malts. However, liquor is deemed to be gluten free because of the distillation process.
One note to point out, alcohol has no nutritional value and the body cannot store it. To makes matters worse, we stop taking in goodness from other sources so that our bodies can clear the alcohol from our system.
If you have celiac disease, your body needs all the nutrition it can get. Therefore, drinking alcohol may not be the most suitable for speeding up the healing process.
Watch Out for Cross-Contamination
If you have celiac disease, actions that were once second nature may have to be rethought. Being more aware of certain practices in the kitchen will keep your exposure to gluten avoided.
It’s very important to keep your gluten-free foods far away from other food sources to prevent any form of cross-contact.
You might think this is going overboard, but if you take the fact a breadcrumb from the toaster could upset your entire day, you may rethink your prepping area.
Any area of preparation in the kitchen is a potential hazard for cross-contact unless your kitchen is totally gluten-free.
Cross-Contamination Hot Spots
- Chopping boards
- Food containers
- Preparation surfaces
However, there are ways to overcome any shared kitchen dilemmas. Designate utensils for gluten-free cooking and keep them separated from the “normal” chef tools in the kitchen.
For chilled foods, claim a shelf and designate it “gluten-free only” and stick to this rule. If someone accidentally uses your gluten-free peanut butter with a contaminated knife, ditch it straight away.
Keep all items clearly labeled so there is no confusion and risk of contamination.
These may seem like simple things, but they can make a big difference to your condition. Cross-contact could be one of the fundamental reasons many continue to suffer the symptoms of celiac disease.
Checking Food Labels
When you become gluten-free, checking food labels may feel like it’s time consuming effort, but it will save you a lot of pain in the long run.
To make things easier, authorities established regulations for the labeling of gluten foods. By law, foods must contain a gluten limit of less than 20 parts per million to be able to carry a “gluten-free” message. (13)
You may see these labels on foods:
- “Free of gluten”
- “No Gluten”
- “Without Gluten”
However, to make sure there are no hidden surprises, it’s still important to check the ingredients with a fine-tooth comb. Look out for signs of the main grain offenders on the labels.
And most important thing to remember.
If there is no clear indication it’s gluten free or you are unsure about an ingredient, pass on it and move on. Celiac disease can be unforgiving and you don’t want to jeopardize a flare up of symptoms because of doubt.
Finding out you have celiac disease may seem like the end of the world. But I hope this complete celiac guide can help to you understand it doesn’t have to rule your life.
Remember, there are lots of foods out there that are naturally gluten-free and many great gluten-free substitutes. So, take this complete celiac guide and put it to good use.
Check out the other installments below:
- Symptoms of Celiac Disease
- Testing for Celiac Disease
- Treatment for Celiac Disease
- Celiac Disease & Your Diet
- Awareness of Celiac Disease
- Celiac Disease & Our Anatomy
- Celiac Disease & Weight Gain
- Celiac Disease & Alcohol
- Celiac Disease FAQ
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