Celiac disease also known as gluten intolerance/ gluten-sensitive enteropathy/celiac sprue is a condition that damages the lining of the small intestine and prevents it from absorbing parts of food that are important for staying healthy. The damage is due to a reaction to eating gluten, which is found in wheat, barley, rye, and possibly, oats.
The exact cause of celiac disease is unknown. The lining of the intestines contains areas called villi, which help absorb nutrients. When people with celiac disease eat foods or use products that contain gluten, their immune system reacts by damaging these villi. This damage affects the ability to absorb nutrients properly. A person becomes malnourished, no matter how much food he or she eats. This disease can develop at any point in life, from infancy to late adulthood.
People who have a family member with celiac disease are at greater risk for developing the disease. This disease mostly affects Caucasians and European populations. Women are affected more often than men. People with celiac disease are more likely to have other diseases like thyroid, type 1 diabetes, intestinal cancer, rheumatoid arthritis.
Also Read: Why you should listen to your gut for a healthy life?
The symptoms of celiac disease can be different from person to person. For example, one person may have constipation, a second may have diarrhoea, and a third may have no problem with stools.
Other common symptoms may include:
Abdominal pain, bloating, gas, or indigestion, constipation, decreased appetite, diarrhoea, nausea and vomiting, foul-smelling or fatty stool, unexplained weight loss (although people can be overweight or of normal weight)
Because the intestines do not absorb many important vitamins, minerals, and other parts of food, the following symptoms may start over time:
* Depression or anxiety
* Growth delay in children
* Hair loss
* Itchy skin
* Missed menstrual periods
* Mouth ulcers
* Muscle cramps and joint pain
* Tingling or numbness in the hands or feet
* Unexplained short height
* Children with celiac disease may have:
* Defects in the tooth enamel and changes in tooth colour
* Delayed puberty
* Diarrhoea, constipation, fatty or foul-smelling stools, nausea, or vomiting
* Irritable and fussy behaviour
* Poor weight gain
* Slowed growth and shorter than normal height for their age
* A simple blood tests can detect the elevated levels of special antibodies, called antitissue transglutaminase antibodies (tTGA).The health care provider will order these antibody tests if celiac disease is suspected.
* Disease is usually confirmed by a sample, a piece of tissue (biopsy) from the small intestine (duodenum).
Delaying diagnosis or not following the diet puts you at risk for related conditions such as: anaemia, certain cancers, Bone diseases, liver disease
Celiac disease cannot be cured. However, your symptoms will go away and the villi in the lining of the intestines will heal if you follow a lifelong gluten-free diet. Do not eat foods, beverages, and medications that contain wheat, barley, rye, and possibly oats. This healing of intestines most often occurs within 3 – 6 months in children, but it may take 2 – 3 years in adults.
You must read food and medication labels carefully to look for hidden sources of these grains and ingredients related to them.
Your doctor will prescribe you vitamin and mineral supplements for correcting nutritional deficiencies.
Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods. They can use corn, potato, rice, soy, amaranth(rajgira), quinoa, tapioca, arrowroot, millets, buckwheat(kuttu), or bean flour instead of wheat flour. People can safely eat small amounts of oats, as long as the oats are not contaminated with wheat gluten during processing.
Gluten is also used in some medications. People with celiac disease should ask a pharmacist if prescribed medications contain wheat. Because gluten is sometimes used as an additive in unexpected products such as lipstick and play dough. Reading product labels is important
Foods to avoid:
Grains which contain wheat should be avoided: wheat, semolina (sooji), emmer, spelt, kamut. durum flour, couscous, semolina, spelt, bulgur and triticale, a grain crossbred from wheat and rye.
Processed foods that may contain wheat, barley, or rye*:
Brown rice syrup, candy, chips/potato chips, cold cuts, hot dogs, salami, sausage ,communion wafers, french fries, gravy, rice mixes, sauces, soups, soy sauce, vegetables in sauce
Hidden sources of gluten:
* Many vitamins and medications can contain gluten in their additives. Always check with your doctor or pharmacist before taking any medication.
* Be careful of cross-contaminating foods. This can happen in the toaster, deep fryer, griddle, etc.
* Imitation seafood and instant or flavoured coffees and teas
* Glue on envelopes and postage stamps
* Some lotions, creams, and cosmetics
Reading food labels
Don’t buy the items if they contain following:
Wheat, Wheat Starch, Bleached Flour, Unbleached Flour, Bulgar, Soy Sauce, Teriyaki Sauce, Semolina, Spelt, Millet, Kamut, Triticale, CousCous, Malt (like Malt Vinegar, Malt flavouring, etc.) Dextrin (can come from Tapioca too), Rye, Oats, Oat Flour, Barley, Barley-Malt
Here is a list of common ingredients that ARE gluten-free
Canola Oil, Cornmeal, Corn Gluten, Cornstarch, Dextrose, Food Starch, Maltodextrin (weird, I know, but it’s GF), Modified Food Starch, Olive Oil, Potato Flour, Potato Starch, Rice Flour (both white and brown), Rice Bran, Soybean Flour, Tapioca Flour, Tapioca Starch, Vegetable Oils, Xanthun Gum,Whey
(The writer is Clinical Nutritionist & Certified Diabetes Educator(CDE)/Certified Pump Trainer(CPT))
( Originally published on Oct 23, 2021 )