Celiac Disease In Adults
Celiac disease is a condition in which the immune system responds abnormally to gluten, that leads to damage to the lining of the small intestine and malabsorption. Gluten is found in wheat, rye, barley, and a multitude of prepared foods. Celiac disease can occur in people of any age and it affects both genders.
Celiac Disease Symptoms
The symptoms of celiac disease vary from one person to another. In its mildest form, there may be no symptoms whatsoever. However, even if you have no symptoms, you may not be absorbing nutrients adequately, which can be detected with blood tests. As an example, you can develop a low blood count as a result of decreased iron absorption.
Symptoms of celiac disease, including diarrhea, weight loss, abdominal discomfort, excessive gas and/or bloating, constipation, and other signs and symptoms caused by vitamin and nutrient deficiencies.
Associated conditions with celiac disease, include:
- Osteopenia or osteoporosis
- Iron deficiency anemia
- Diabetes mellitus
- Thyroid problems
- A skin disease called dermatitis herpetiformis
- Nervous system disorders
- Liver disease
Diagnosis
Blood tests — A blood test can determine the blood level of antibodies that become elevated in people with celiac disease. Over 95 percent of people with untreated celiac disease have elevated antibody levels
Before having these tests, it is important to continue eating a normal diet, including foods that contain gluten. Avoiding or eliminating gluten could cause the antibody levels to fall to normal, delaying the diagnosis.
Esophagogastroduodenoscopy and small bowel biopsy — If your blood test is positive, the diagnosis must be confirmed by examining the intestinal lining with a biopsy and histology.
In people with celiac disease. Normally, the lining has distinct finger-like structures, which are called villi. The villi become flattened in people with celiac disease. Once you stop eating gluten, the villi can resume a normal growth pattern. Most patients begin to feel better within two weeks after stopping gluten.
One way to determine if the gluten-free diet is working is to monitor the levels of antibodies in your blood. If your levels decline on a gluten-free diet, this usually indicates that the diet has been effective.
Treatment
Gluten-free diet — The cornerstone of treatment for celiac disease is complete elimination of gluten from the diet for life. Gluten is the group of proteins found in wheat, rye, and barley that are toxic to those with celiac disease. Gluten is not only contained in these most commonly consumed grains, but is also hidden as an ingredient in a large number of prepared foods as well as medications and supplements.
Maintaining a gluten-free diet can be a challenging task that may require major lifestyle adjustments. Strict gluten avoidance is recommended since even small amounts can aggravate the disease.
- Avoid foods containing wheat, rye, barley, malt, brewer’s yeast, oats (unless uncontaminated, labeled gluten-free oats), and yeast extract and autolyzed yeast extract (unless the source is identified as gluten-free). “Malt” means “barley malt” unless another grain source is named, such as “corn malt.”
- Naturally gluten-free foods include rice, wild rice, corn, potato, fresh meat, fish or chicken are gluten free unless contaminated.
- If a food is regulated by the FDA and is not labeled gluten-free (such as prepared foods and condiments), read the ingredients list and “contains” statement carefully. The word “wheat” will be included if the product is FDA regulated and contains wheat protein. If you do notsee any of the following words on the label of an FDA-regulated food (wheat, rye, barley, malt, brewer’s yeast, oats, yeast extract, and autolyzed yeast extract) then the product is unlikely to include any gluten-containing ingredients.
- Unlike the FDA, there is no official standard for gluten-free labeling of USDA products. However, if an USDA regulated product has a gluten-free label, it should meet the same standard as FDA products.
- Distilled alcoholic beverages and vinegars, as well as wine, are gluten-free unless gluten-containing flavorings are added after production. However, malt beverages, including beer, are not considered gluten-free. There are specially produced beers that do not use malted barley that are labeled gluten-free and can be consumed on a gluten-free diet. Avoid beer that is labeled as gluten-removed or gluten-reduced. Please note that malt vinegar is not gluten-free.
- You may not tolerate dairy products initially while your intestines are healing. If you tolerated lactose before your diagnosis, you may be able to tolerate it again after the intestine heals. In the meantime, choose lactose-reduced or lactose-free products if your symptoms are worsened by dairy products.
- Discuss your need for calcium and vitamin D supplements with your healthcare provider or dietitian.
- A small percentage of people with celiac disease cannot tolerate gluten-free oats for several reasons. Pure oats are naturally GF, but most are grown in or near barley, rye, and wheat. They can also be processed on the same equipment which contaminates them and makes them unsafe to eat for someone with celiac disease
- All oats consumed, at the very least, must be labeled gluten-free or certified gluten-free.
Helpful links
Celiac Disease Foundation
www.Celiac.org
National Celiac Association
www.nationalceliac.org
Academy of Nutrition and Dietetics
www.eatright.org
Celiac Disease Symptoms, Testing & Diet
www.BeyondCeliac.org
