UPDATE: New video added below with Dr. Tom O'Bryan answering questions on the safety and gluten content of millet, oats, quinoa, ancient wheat (frankenwheat), sprouted grains, chia seeds, and amaranth.
If you were to ask most people what Celiac disease is, the chances are they won’t know. In fact, unless you or a loved one has Celiac disease (and are actually aware that you have it) you may not know much about it either.
The same can be said about gluten intolerance. Unless you’re faced with it, you may not be aware of it or even know what it is.
Celiac disease and gluten intolerance aren’t new conditions but they are now becoming more readily known. It’s not uncommon to go to a grocery store now and be able to find foods which are gluten free.
Learn the facts about Celiac disease and gluten intolerance by continuing to read. You may be surprised at what you learn. And you may be even more surprised to learn that you have been dealing with some of the symptoms of one of these two disorders!
What is Celiac Disease?
Celiac disease is a disease affecting the digestive system. Not only does it damage the small intestine, but it also keeps the nutrients in the food from being absorbed. The main culprit in the development of this disease appears to be gluten as there is an abnormal immune reaction to it.
Gluten is a protein found in barley, rye, and all forms of wheat (durum, semolina, spelt, einkorn and faro). You may think gluten is only found in foods but it can also be found in lip balms, vitamins and medicines as well.
How does the body react when someone with Celiac disease eats gluten? Their immune system destroys the villi, the tiny fingers which line the small intestine, which are necessary for food absorption. If the villi are destroyed, due to Celiac disease or any other reason, the small intestine does not absorb the nutrients from the food which is eaten and the person very quickly becomes malnourished. No matter how much food they eat, or the quality of that food, their body simply will not receive the benefit of those nutrients.
From everything scientists can determine, Celiac disease is hereditary and will run in families. It can affect children and adults alike. Once the disease becomes active it will continue to manifest itself throughout the remainder of that person’s life. Doctors believe the disease may be triggered by common occurrences in life such as surgical procedures, pregnancy and childbirth, severe emotional trauma or viral infections.
It is believed one out of every 133 people in the United States is affected by this disease. Celiac disease is not an allergy to gluten which can be outgrown. It is an autoimmune disease which can adversely affect one’s life if not treated. Some doctors recommend that everyone in the immediate family of someone diagnosed with Celiac disease be tested since the disease is so prevalent among family members.
If someone has Celiac disease, whether diagnosed or not, continuing to consume gluten can lead to other complications such as anemia, some forms of cancer, and osteoporosis. It is for this reason anyone having a reaction to gluten would want to check with their doctor about the possibility of their having Celiac disease.
What is Gluten Intolerance?
Many people believe Celiac disease and gluten intolerance is the same thing. While those with Celiac disease are intolerant to gluten, it is much more than that. Gluten intolerance can include any sensitivity to gluten no matter how small. So, even though there are some similarities between gluten intolerance and Celiac disease, they aren’t the same thing.
Some people who have intolerance to gluten may test positive to Celiac disease but most don’t test positive. People who are sensitive to gluten but do not have Celiac disease are called Non- Celiac Gluten Sensitive (NCGS). As many as 15% of all people will have some type of sensitivity to gluten but will not be diagnosed with Celiac disease.
The number of people with diagnosed Celiac disease could be as high as one in every 200 people. For NCGS, the numbers are nearly 30% higher with as many as one in seven people having this condition. The symptoms of either condition, if they go undiagnosed, the potential for damage continues to increase.
What are the Symptoms of Celiac Disease?
It is possible that symptoms of Celiac disease can vary greatly among people with the disease. Obviously there will be some symptoms which are associated with the digestive system but there may be symptoms in other areas.
Infants and children are somewhat easier to diagnose and those symptoms may include, but not be limited to: Abdominal bloating and pain, chronic diarrhea, vomiting, or constipation. Symptoms may also include pale, foul-smelling, or fatty stool and weight loss. The children can also become irritable.
If a child is not diagnosed properly their body will cease to absorb the nutrients their body needs. This will lead them to be diagnosed as failure to thrive or delayed growth. They may be short compared to their peers and reach puberty much later. They may also have damage to their teeth’s enamel which could lead to problems with their permanent teeth when they come in.
Celiac disease is a multi-symptom, multi-system disease. Rather than having only symptoms associated with their digestive system, adults will experience seemingly non-related symptoms in other parts of their body.
Symptoms of celiac will include, but not be limited to:
- Arthritis including bone or joint pain
- Osteoporosis or bone loss
- Unexplained anemia
- Recurring bloating, abdominal pain or gas
- Depression or anxiety
- Tingling or numbness in their hands and feet
- Missed or cessation of menstrual periods
- Unexplained weight loss or weight gain
- Canker sores in the mouth
- Infertility or spontaneous abortion (miscarriage)
- Vitamin K deficiency
- Dermatitis herpetiformis, an itchy skin rash
- Behavior changes including depression or irritability
- Tooth discoloration or loss of enamel which protects the teeth
Not all people with Celiac disease experience these symptoms. This doesn’t mean the disease isn’t wreaking havoc in their body, however. In fact, people with undiagnosed Celiac disease still experience the long-term complications associated with malnutrition. They may become anemic, develop osteoporosis, experience miscarriages, or develop life threatening diseases such as liver disease or cancer of the intestines.
People with family members who have been diagnosed with Type 1 Diabetes, Chronic Fatigue Syndrome, Fibromyalgia, Irritable Bowel Syndrome, Thyroid Disease, Peripheral Neuropathy and Systemic Lupus Erythematosus may be more likely to develop Celiac disease. The disease is also less commonly associated with the following diseases: Rheumatoid Arthritis, Chronic Active Hepatitis, Addison’s disease, Sjogren’s syndrome, Alopecia Areata, Scleroderma, and Down syndrome.
How Common is Celiac Disease?
Celiac disease can be found in people all over the world. There aren’t certain areas which are more likely to have people affected. There is an estimate of approximately 1 out of 133 people in the United States who are affected by this disease, which equals about 2 million people. Reports of people with Celiac disease are not known in less-developed nations although it is expected the numbers are comparable.
Can Celiac disease be Prevented?
Although research continues into the development of Celiac disease, doctors don’t know if there is a specific way to prevent the disease. Some scientists, however, believe extended exclusive breastfeeding and delaying the introduction of gluten-containing foods might be the best way to avoid development of this disease.
By withholding foods containing gluten until well after four months of age, a mother is giving her child’s digestive system time to mature before introducing it to gluten. Scientists surmise that allowing the digestive system to develop fully before allowing a child to eat gluten, they may be less likely to develop Celiac disease later in life. No definitive prevention is known at this time.
How is Celiac Disease Diagnosed?
One of the problems doctors face when someone comes to them for help is that many diseases have similar symptoms. This is definitely the case with Celiac disease. Since Celiac disease can be misdiagnosed as a number of conditions including iron-deficiency anemia, irritable bowel syndrome, diverticulitis, chronic fatigue syndrome or intestinal infections. In the past the disease has been either under diagnosed or misdiagnosed but newer tests is making this less likely to happen.
While the person continues to eat a diet containing gluten products such as bread and pasta, a doctor will take blood tests looking for a higher than normal level of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). These antibodies react and work against the body’s cells or tissues. These blood tests may be repeated if the first blood test comes back negative but Celiac disease is still suspected.
An intestinal biopsy will be performed if the blood tests come back positive for Celiac disease. This biopsy will confirm the diagnosis by removing a small piece of the intestine to check for damage to the villi. The sample is obtained by using an endoscope which is a thin, long tube which is placed in the mouth, run through the stomach, and into the small intestines. The sample is removed and brought out through the endoscope.
If someone in your family has been diagnosed with Celiac disease the likelihood of others in the family having it increase. Therefore, doctors may screen for the presence of the auto-antibodies in the blood. The possibility of someone being diagnosed with Celiac disease is four to twelve percent higher if a first-degree relative has been diagnosed.
What is the Treatment for Celiac Disease?
People who have been diagnosed with Celiac disease often wonder how they can treat their disease. It would be great if there were a simple pill those with Celiac disease could take to alleviate their suffering and reverse any damage. At this present time, however, the only course of treatment is to avoid gluten by following a life-long gluten-free diet.
A gluten-free diet will relieve symptoms in most people with Celiac disease. However, a small number of patients won’t improve with this type of diet because they suffer from refractory sprue.
Patients with this diagnosis may not have been diagnosed in time and the damage to the lining of the small intestines is damaged too much to heal any longer. Another possibility is that the person also has an allergy or intolerance to another substance such as eggs, soy or milk.
Currently there are clinical trials being conducted to develop a medication for those with Celiac disease to take. Other research is attempting to develop an enzyme to break down the protein within gluten that causes the intolerance and damage to intestinal villi. Scientists in the United Kingdom have been prescribing a medicine which does this for those with severe symptoms.
What is a Gluten-Free Diet?
Since a gluten-free diet is seemingly the only treatment for Celiac disease, you may want to know what a gluten-free diet is. Basically all gluten is removed from the diet which will allow the small intestine to heal. Your doctor may also recommend specific nutritional supplements to take along with your new diet.
Changing over from a gluten-rich to a gluten-free diet is not going to be easy. However, the prospects of developing osteoporosis, malnutrition and worse could encourage you to stick to this new diet. You’ll likely feel like you’re entire lifestyle has to change, but soon you’ll be in the habit of reading labels and learning which foods you can eat and which ones to avoid.
Here is a list of ingredients which have been known to cause problems for people with Celiac disease:
- Starch (often unidentified)
- Binders and fillers
- Excipients and extenders
If you have doubts about whether or not gluten in included in any food product don’t hesitate to contact the manufacturer. They will be able to tell you whether or not gluten is included in their foods. Since more people are being diagnosed with Celiac disease, you can also look for foods which are made specifically for people with gluten intolerance and are labeled “gluten-free.”
Your doctor may recommend you visit a professional dietician if you’re newly diagnosed with Celiac disease or gluten intolerance. The dietician will teach you to properly read the labels for the foods you eat and identify any foods which may contain gluten. This knowledge will help you to be able to make informed choices in regard to the food you purchase at a grocery store or when you go out to eat.
Once you remove all gluten from your diet, it’s possible for the small intestine to begin healing in as little as three months in children. Expect healing to begin after several years in adults. Remain off gluten for the rest of your life and you can expect a full reversal of the condition. Adding or failing to remove all gluten from the diet, however, can leave you with little to no benefit.
In some rare instances, people who have been diagnosed with Celiac disease will continue to have problems. The intestinal injury continues despite having removed gluten from their diet. These people are said to have Refractory Celiac disease. These people will require nutrients to be added intravenously until appropriate medications can be developed.
Video: Dr. Tom O'Bryan answers questions on the safety, nutritional benefit, and gluten content of millet, oats, quinoa, ancient wheat (frankenwheat), sprouted grains, chia seeds, and amaranth.
The Benefits of a Gluten Free Diet
With the increasing awareness of celiac disease, more individuals are getting tested and discovering that their near constant stomach and bowel issues are a result of an extreme gluten intolerance.
Some individuals who don’t have celiac disease find that they feel better, and their digestive tract works better, when they cut gluten from their diet. It’s becoming easier for people who wish to follow a gluten-free diet to do so.
Major food companies are introducing more gluten-free products and identify existing products that are gluten free. Even some restaurants are taking care to identify gluten free choices on their menus.
Help for those Suffering from Celiac Disease or Gluten Sensitivity
A gluten-free diet can obviously be a great and immediate benefit to anyone who has celiac disease or gluten sensitivity.
By removing gluten from the diet, affected individuals can experience relief from the sometimes overwhelming intestinal pains that gluten brings about, and they’ll better be able to absorb the essential nutrients from other food they eat.
But a gluten-free diet, if done correctly, can provide additional benefits to individuals who are not gluten sensitive.
Better Glycemic Response and Energy Levels
Because the vast majority of gluten in our diet comes from processed white flour, the biggest impact of a gluten-free diet is to remove white flour from our meals.
In terms of glycemic index and insulin response, white flour is quite similar to sugar, so removing white flour can lead to more stable blood sugar levels and energy levels that stay more even throughout the day.
Help Against Insulin Resistance
Too many blood sugar spikes (due in large part from too much refined white flour in the diet) can lead the body to adapt by forming an increased level of insulin resistance.
It’s generally thought that when an individual creates insulin resistance within their own body, they’ll be at a much greater risk of developing high blood pressure and diabetes. Following a gluten-free diet will remove refined white flour, which can be one of the main contributors to this condition.
More Whole Foods
It’s often the case that wheat-based products dominate too much of our meals, and displace other, more healthful, dietary choices.
Sandwich bread, doughnuts, muffins, pizza crust, hamburger rolls, and pasta are likely to be in many people’s diet every single day, and perhaps even at every meal. And too much white flour or gluten can take the place of other things.
When products containing gluten are removed from the diet, a healthy eater can replace them with a greater number vegetables and fruits, as well as alternative grains (such as quinoa, for example) that can provide additional dietary benefits.
Individuals with celiac disease or gluten sensitivities will likely want to learn more and adopt a gluten-free diet as soon as possible, but even people without those conditions may wish to investigate more to see how it can benefit them.
The Realities of Going Gluten-Free
As stated before, gluten is a protein found in wheat, rye and barley. Some foods which are thought to be safe for those with gluten intolerance to eat may also cause problems because they are processed on the same machinery as gluten-filled foods. If you’re one who loves bread, grains, cereal, pasta and processed foods, these will have to be given up or alternative foods found.
What is left to eat on a gluten-free diet if you can’t eat processed foods or those made with barley, rye or wheat? You’ll be amazed that the diet of someone with Celiac disease can still be well- balanced. Rather than reaching for breads made from wheat, try potato bread. You can also eat rice, soy, amaranth, quinoa, buckwheat or bean flour.
Look for products which are specifically labeled “gluten-free” on them. Many companies are beginning to realize the vast number of people who need this type of product and they’re finally offering them. You can also purchase organic foods or order foods from specialty foods companies which can be found online.
Someone with Celiac disease can also eat meat and fish which are not breaded, rice grains, fruits and vegetables. As long as the foods do not contain gluten, they’re safe to eat. Do you love oatmeal? You can eat small amounts of oats as long as they haven’t been processed with wheat gluten or on the same machines. Talking with your doctor and dietician will let you know if and how much oat products you can consume.
While you don’t have to wear a sign stating you’ve been diagnosed with Celiac disease, it is important to let the people in your life know. This means your family and friends you spend a good amount of time with. You may also want to inform your boss at work so they’ll be aware should there be an occasion to have food.
Find a support group for those suffering from Celiac disease. These people who have been living the gluten-free life will be able to give you advice to help you and your family to learn to live with the disease, as well. Don’t be afraid to ask a waiter how a meal is prepared if you’re unsure. If they can’t answer your questions, it is well within your rights to ask to speak with the chef.
Most people probably only think of gluten being a part of foods. It can also be an additive in medications, lipstick and play dough. Be sure to read the labels to avoid as much gluten as possible.
If you’re having problems making heads or tails out of the labels on foods, don’t despair. The Food Allergen Labeling and Consumer Protection Act (FALCPA) is working toward getting all food properly labeled. Beginning in 2006, FALCPA worked toward getting all food labels to clearly identify which foods contained wheat or other food allergens. Because of this act, you can look on food and other labels and supposedly know which ones contain gluten and which ones don’t.
For those with loved ones who have been diagnosed with Celiac disease, there is plenty you can do to help them. Begin with learning as much as you can about this disease and what foods they can and can’t eat on a gluten-free diet. You may have to learn to read labels, as well, but the health of your loved one is that important.
Can recipes with gluten be modified for those with Celiac disease?
Luckily for people with Celiac disease, most foods containing gluten can be modified to meet a gluten-free diet. Look for cooking and baking ingredients which are specifically marked “gluten- free.” If you can find these in your local markets, you can modify nearly every recipe you can think of.
Gluten-free flours are used one-to-one when compared with normal wheat, barley or rye flours. There are some companies which specialize in gluten-free products and they are easy to find on the internet by doing a search for “gluten-free flour.” Of course, these companies offer other gluten-free products besides just flour, but flour is a common ingredient in many recipes so you’ll most likely want to get some.
You can also find gluten-free cookbooks if you’re looking for a particular recipe. The cookbook authors will have made any substitutions for you so it will make cooking gluten-free recipes much easier. And the easier it is find a recipe and make it, the more likely you’ll be to continue following that specialized diet.
The dietician you first see when you’re initially diagnosed with Celiac disease will also be able to give you ideas on how to modify recipes to make them appropriate for you. They may also provide you with recipes or sources to find the products you need. A qualified dietician can be a wealth of information if you take the time to speak with them about your condition.
What Else Can You Do?
Even though it may be more difficult for the entire family, you could begin to eat a gluten-free diet with the person who has been diagnosed. If you can’t completely switch over your entire family’s diet, you can do the following:
- Be careful not to prepare foods containing gluten in the same area as those without it. You may want to prepare gluten-free foods on one side of the kitchen and foods with gluten on the other side. The goal is to totally avoid contaminating the gluten-free foods with any type of gluten.
- When preparing food for someone on a gluten-free diet, start with a clean surface. Use clean pots, pans, bowls and utensils. You probably don’t have to use an entirely different set of dishes for gluten-free cooking unless someone has severe Celiac disease.
- Prepare gluten-free meals separately from those containing gluten. This will ensure there is no cross-contamination.
- Eat foods as close to natural or raw as possible. The fewer ingredients a food has the lower the chance of contamination.
- Look for hidden sources of gluten including: H.V.P – or hydrolyzed vegetable protein, H.P.P – hydrolyzed plant protein, malt or malt flavoring, modified wheat starch or other starches.
- Gluten can also be found in bouillon cubes, sliced luncheon meats, Worcestershire sauce, baking powder, salad dressing, soups or gravy bases, seasonings and soy sauce.
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