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BODY PARTS MARCH 2013

Did you know that one in one hundred and thirty-three people suffer from celiac disease? We just went through a bit of a scare with one of our own family members on this growing problem with people in our society. Because of this, I decided to write this months Body Parts article about information surrounding this disease.


Celiac disease 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.


The 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. The disorder is most common in Caucasians and persons of European ancestry. Women are affected more often than men.


The symptoms of celiac disease can be different from person to person. This is part of the reason why the diagnosis is not always made right away. For example, one person may have constipation, a second may have diarrhea, and a third may have no problem with stools.


Gastrointestinal symptoms include:

Abdominal pain

Bloating

Gas or indigestion

Constipation

Decreased appetite (may also be increased or unchanged)

Diarrhea, either constant or off and on

Lactose intolerance

Nausea and vomiting

Stools that float, are foul smelling, bloody, or “fatty”

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:

Bruising easily

Depression or anxiety

Fatigue

Growth delay in children

Hair loss

Itchy skin

Missed menstrual periods

Mouth ulcers

Muscle cramps and joint pain

Nosebleeds

Seizures

Tingling 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

Diarrhea

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


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.


You must read food and medication labels carefully to look for hidden sources of these grains and ingredients related to them. Because wheat and barley grains are common in the American diet, sticking with this diet is challenging. With education and planning, you will heal.

You should NOT begin the gluten-free diet before you are diagnosed. Starting the diet will affect testing for the disease.


The health care provider may prescribe vitamin and mineral supplements to correct nutritional deficiencies. Occasionally, corticosteroids (such as prednisone) may also be prescribed for short-term use or if you have sprue that does not respond to treatment. Following a well-balanced, gluten-free diet is generally the only treatment you need to stay well.


When you are diagnosed, get help from a registered dietitian who specializes in celiac disease and the gluten-free diet. A support group may also help you cope with the disease and diet.


What can you eat that is gluten free? There are actually lots of options.


To start, unprocessed fruit, vegetables, meat, poultry, seafood, dairy, and oils are all naturally gluten free. So are beans, legumes, rice, and sweeteners like honey and sugar. In general, you will notice that all of these foods do not need ingredient labels, or have ingredients lists with only one item.


When these basic foods are processed into other products, you need to start looking at the ingredient lists to make sure that all of the ingredients in the product are gluten free. When you take a naturally gluten-free potato and fry it and add spices, you need to read the label to make sure that all the ingredients added are gluten free. When you grind meats and add spices and stuff it into casing to make sausage, you need to do the same thing – read the label to make sure the final product is gluten free.


The challenge comes when it comes to grains and baking products because wheat is the primary starch used in so many baked goods. There are a lot of different products that can be used when you create gluten-free baked goods, however.


Here are some of them:

Arrowroot flour

Baking soda

Bean flour

Buckwheat

Chick pea flour

Corn flour

Cornmeal

Cornstarch

Cream of tartar

Dal or Dahl (Legume from India)

Flax

Gelatin

Green pea flour

Legume ~ Seeds of plants which include:

*Chick peas

*Lentils

*Peanuts

*Peas

*Soya


Oats, unless they are specially grown, harvested, and processed, contain barley and wheat. Only pure and uncontaminated oats are acceptable for people with celiac disease


** Distilled vinegar, including white, apple cider, sherry, fruit, balsamic, palm, cane, and honey vinegars are all gluten free**


Malt vinegar is NOT gluten free. Beer vinegar is NOT gluten free. Rice vinegar may or may not be gluten free. It may contain wheat – read the label.


Source: Adapted with permission from Gluten-Free Diet: A Comprehensive Resource Guide 2008 by Shelley Case, Dietitian and www.ncbi.nlm.nih.gov