Do you have celiac disease?
Celiac Disease

Celiac disease is also known as gluten sensitive enteropathy is an autoimmune condition where the body mounts an immune response against the protein, gluten. Glutens are primarily found in wheat, and most people relate this condition to eating wheat products. The proteins are, however, found in barley, rye and other cereal grains, which can be a problem as well. These molecules provoke an immune response with antibodies attacking the lining of the small intestine.

Symptoms

There can be a wide range of symptoms. The symptoms can include abdominal pain, diarrhea, weight loss, thinning of the bones and anemia. Some people can have very severe reactions to any exposure to gluten but others may be completely without symptoms. There is evidence that this is one of the most common immune disorders and can affect many other parts of the body, including cardiac, neurologic and endocrine systems.

Who's At Risk?

There's a high prevalence of celiac disease with the estimates being 1 in every 133 people having the disease. Here's the potential risk for different groups:

Group/ Prevalence

First-degree relatives (mother, father, sister, brother)/ 1 in 22

Second-degree relatives (grandparents, aunts, uncles)/ 1 in 39

Symptomatic patients/ 1 in 56

Not-at-risk individuals (overall prevalence)/ 1 in 133

Diagnosis

Doctors evaluate patients for celiac disease in a variety of ways. The definitive diagnosis is made by biopsy of the small intestine with the aid of endoscopy (a fiber optic telescope). There are also blood tests to help guide whether such invasive screening is indicated. Often the bloods tests can be negative and a biopsy of the small intestine is always required to make a definitive diagnosis. The diagnosis is also confirmed by removing all gluten containing foods from the diet. If the small intestine repairs itself, it is clear that a person has celiac disease. Physicians will sometimes re-challenge patients who have improved on the diet to help verify celiac disease.

Celiac disease is associated with HLA-DQ2 gene, and to a lesser extent, HLA-DQ8 gene. Interestingly, Type 1 diabetes is associated with the same DQ molecules, but in the opposite order. There are genetic tests for these genes and a mouth swab or blood test are both options. The test is negative more in men (especially older men) and the definitive diagnosis remains biopsy.

What You Can Do

Strictly following a gluten-free diet is the only treatment for this condition. This means avoiding all products that contain wheat, barley or rye. There is research that shows oat products to be safe for those with gluten sensitivity, but some may still have difficulty, as there may be some issue with contamination of oat products by gluten containing foods: they are often made in the same factories. As a result many people are best off to avoid oat products, at least during the early period of treatment.

Adherence to a gluten-free diet is a challenge for many as there so many foods that contain gluten, especially wheat flour. Often the gluten is hidden in foods that might not obviously contain wheat, barley or rye.

Substituting with foods made from corn, rice, buckwheat and quinoa is one strategy. The less processed the food the safer. This is a basic tenet of Dr. Gourmet recipes and applies to healthy eating in general. The closer the food is to its natural state, the healthier it is regardless of dietary restrictions. Fresher is just better, not only for health, but also for taste. Fresh food satisfies the body, senses and is a huge step toward taking control.

15 gluten-free items that are familiar choices: