Recommendations for controlling Celiac Disease

Celiac Disease is a genetic (or inherited) disease that affects about 1 in 133 people and can develop at any age. It is an autoimmune digestive disease where one's own immune system attacks the digestive tissues. In the small intestine, nutrients from food get absorbed into the bloodstream through millions of little fingers called villi.  When people with Celiac Disease eat foods that contain gluten, their immune system responds by damaging the villi in their small intestine. Without healthy villi, they cannot absorb nutrients from food and will become malnourished no matter how much food they eat which can cause even more health problems.

Gluten is a protein found in wheat, rye, and barley (and maybe oats*). It is found in many commonly eaten grain products like bread, cereals and pasta. Gluten may also be present in food items like sauces, gravies, seasonings, fillers, additives and preservatives, and everyday products like medications, vitamins, postage stamps and envelope adhesives.
* Studies continue to evaluate the effect of oats in people with Celiac Disease.

Symptoms of Celiac Disease can range from the list below to virtually no symptoms at all.

• Abdominal gas, pain and bloating
• Diarrhea
• Constipation
• Fatigue or irritability
• Weight loss
• An itchy skin rash (called Dermatitis Herpetiformis)
• Infertility
• Joint pain
• Unexplained iron-deficiency anemia
• Delayed growth

The ONLY treatment available for Celiac Disease is through diet. This involves avoiding foods that contain gluten. This is known as a gluten-free diet.
Some individuals develop symptoms of gas or bloating after eating foods that contain gluten but DO NOT have Celiac Disease. The symptoms go away when they stop eating foods containing gluten. These individuals are considered to be gluten sensitive and are often referred to as having a gluten sensitivity. Persons with gluten sensitivity may also choose to follow a gluten-free diet.

How is Celiac Disease diagnosed?

There are simple blood tests your doctor can order to help determine if you have Celiac Disease. Depending on the results, your doctor may suggest you go for further testing to confirm if you have Celiac Disease.
It's important to note that these tests may produce a "false negative" result if a gluten-free diet is followed before testing for Celiac Disease. Why? You need to be reacting to dietary gluten in order for the tests to be accurate. If you suspect yourself or a loved one may have Celiac Disease or gluten sensitivity ask the doctor for a test before starting on a gluten-free diet.

What foods can be eaten on a gluten-free diet?

It can be overwhelming to think of the long list of foods you can not eat on a gluten-free diet. Good news—lots of foods are naturally gluten-free and are safe to eat. These include:

• Fresh, unseasoned fruits & vegetables
• Plain, unseasoned meat, poultry, fish, eggs, nuts, peas, and beans
• Plain milk
• Naturally gluten-free grains: Amaranth, Buckwheat, Rice, Corn, Potato, Tapioca, Bean, Sorghum, Soy, Arrowroot, Quinoa, Tef, Nut Flours, or Wild Rice
• Also allowed are vinegars (except for malt vinegar) and vanilla

Anytime one of the above foods is combined with other ingredients you need to take a closer look to see if a gluten-containing ingredient is used. You also need to consider if the food was produced in a facility where it could have come in contact with gluten (known as cross-contact).
The following are three lists of ingredients that are considered safe, unsafe (need to be avoided) or questionable (as they may be derived from unsafe grains).
Safe
The following are generally safe to use: Amaranth, Buckwheat, Rice, Corn, Potato, Tapioca, Bean, Sorghum, Soy, Arrowroot, Quinoa, Tef, Nut Flours, or Wild Rice. Also allowed are Beans, Peas, Nuts, Unseasoned Meats, Poultry, Fish, Eggs, Fruits, Vegetables, Vinegar (except for malt vinegar), Vanilla, Milk, and Plain Cheeses.
Unsafe
Avoid Wheat (durum, semolina), Rye, Barley, Spelt, Triticale, Kamut, Farina, and possibly Oats.  Although oats do not contain the specific type of gluten that triggers the Celiac Disease response, oats are likely to be cross-contaminated by other gluten-containing grains. Until final research can be done, oats should be avoided or only eat oats that are certified to be gluten-free.
Safe foods prepared in areas where gluten-containing flours or bread crumbs are used or displayed have the potential for cross-contact and may not be safe. Cookies, service salads, and prepared food cases are examples of service areas where cross-contact might occur.
Questionable
These ingredients may be derived from unsafe grains. Do not consume the following ingredients unless you can verify they are gluten-free: Brown Rice Syrup (frequently made with barley), Dextrin (usually corn, but may be derived from wheat), Flour or Cereal products, Hydrolyzed Vegetable Protein (HVP), Vegetable Protein, Hydrolyzed Plant Protein (HPP), or Textured Vegetable Protein (TVP), Malt or Malt Flavoring (usually made from barley; okay if made from corn), Modified Food Starch or Modified Starch, Natural and Artificial Flavors, Soy Sauce or Soy Sauce Solids (most soy sauces contain wheat), Blue Cheese (may be cultured on rye or dusted with flour).
You may typically find these ingredients in processed meats, sauces, bouillon, selected condiments, salad dressing, baking powder, sour cream, ice cream, processed cheeses, etc.
The only way to know if a food item is gluten-free or free of the risk of cross contact is to read ingredient statements (or ask food suppliers) every time you shop. For example, if a label or package states “wheat-free” it does not necessarily mean the product is “gluten-free.” Because it is important to verify if a product is gluten-free, it means it may take longer to grocery shop

Though a gluten-free diet helps reverse the ravages of Celiac Disease, it can be low in B vitamins. That issue and the continuing poor nutrient absorption meals that a multivitamin providing 100% of the Daily Value is generally advisable. But always discuss your vitamin, mineral, and herbal supplements with your doctor first to find out which ones are right for you. Some dietary supplements may contain gluten, so be sure to check the label before purchasing.