Q&A on Living Healthier with Celiac Disease
BY ALAN ATTRIDGE
Celiac Disease (CD) is a life-long intolerance to gluten, a protein found in all forms of wheat (including durum, semolina, and spelt), rye, oats, barley, and related grain hybrids such as triticale and kamut.
When people with CD consume gluten, the absorptive villi in the small intestine are damaged (also called a toxic reaction), preventing the assimilation of many important nutrients. The long-term effect of untreated CD can be life threatening. Genes are involved in the regulation of the immune system to gluten proteins. It is unknown what activates genes to respond to these proteins. There are many theories, however, as to why certain individuals may develop a disease, allergy, or intolerance to foods or chemicals (drugs). Some say these issues are genetic-related, while others believe that our bodies have become desensitized from consuming excessive amounts of particular types of foods (in CD's case, wheat), chemicals, or drugs. The majority of diseases (other than cancers) that require a change in diet are autoimmune, digestive, or neurological in nature.
Alan Attridge, shares his knowledge of the disease, as well as some personal and expert insight on how to live a healthier life with CD:
HOW MANY PEOPLE HAVE CD?
Recent research indicates that CD is the most common chronic intestinal inflammatory disease in the U.S. Some studies show that at least 1 in every 133 persons in this country (1:266 worldwide) is affected; other studies say it may be more.
WHAT ARE TYPICAL SYMPTOMS OF CD?
They can vary from person to person and range from asymptomatic to mild to severe. Symptoms can include abdominal pain; weight loss; iron deficiency/anemia; folate/vitamin B12 deficiency; bloating/ flatulence/cramping; chronic diarrhea, constipation, nausea, and/or vomiting; skin rashes; lactose intolerance; chronic fatigue and weakness; mouth ulcers; bone/joint pain; and irritability/depression. Because these symptoms overlap with those of many other conditions, CD is commonly misdiagnosed as Irritable Bowel Syndrome, lactose intolerance, Inflammatory Bowel Disease, chronic colic, and stress to name a few.
WHAT RESULTS FROM HAVING CD?
Nutrient deficiencies, which can cause and promote the following: Anemia, nervous system disorders, osteoporosis, lymphomas, gastro-intestinal (GI) malignancies, lactose intolerance, and other autoimmune disorders, like Lupus, Dermatitis Herpetiformis, and thyroid disease. Also, because of CD's frequent confusion with other conditions, the consequence of delayed diagnosis (which is an average of 11 years) may result in extensive damage to the digestive tract.
HOW CAN CD BE ACCURATELY DIAGNOSED?
To properly diagnose CD, a person must be consuming gluten prior to a test, which checks for specific antibodies in the blood. Recommended blood tests are: Anti-Gliadin (AGA) IgA, (AGA) IgG, Anti-Endomysial (EMA) IgA, Anti-tissue transglutaminase (tTG), and total serum IgA. If you have a positive antibody test, a bowel biopsy (gold standard) is required to confirm the diagnosis and to assess the degree of mucosal damage.
WHAT MANAGEMENT OPTIONS ARE AVAILABLE?
A life-long gluten-free (GF) diet is currently the only way to manage CD. The good news is that a completely GF diet will heal the intestinal lining (mucosal surface of the small intestine), allowing most people to live a normal, healthy life as long as their diet remains GF. Because a small amount of gluten can cause symptoms to reoccur, processed foods with additives or preservatives made from derivatives of gluten pose a problem.
WHICH GRAINS/FOODS ARE SAFE TO EAT?
Amaranth, arrowroot, flax, beans, quinoa, corn, buckwheat, sorghum, soy, rice, potato, tapioca, and millet.
WHAT SHOULD BE KEPT IN MIND WHEN SHOPPING FOR GF FOODS?
As statistics show, there are many people with food sensitivities, diseases, or allergies who must refrain from foods with certain ingredients. Most major food manufacturers, however, have had little reason to eliminate ingredients or food components that they believe serve the needs of the very few. Many processed foods do not list ingredients or binding agents, yet most binding agents use wheat. For years, consumers have made repeated requests of manufacturers to produce foods that are safe, and there are only a few that offer truly appealing products and "taste great."
With companies providing both healthful and great tasting foods, those with food allergies, intolerances, and sensitivities like CD and those seeking better choices, can eat pleasurable, tasty food without compromising their health.