Coeliac disease--also called celiac, celiac sprue and non-tropical sprue--is a condition in which the immune system damages or destroys villi, tiny projections in the small intestine that help absorb nutrients from food, in response to any gluten, a person consumes, according to the National Digestive Diseases Clearinghouse (NDDIC). Damaged villi can't absorb nutrients effectively, and abdominal pain, diarrhea and complications such as malnutrition can occur. While no cure exists, eliminating gluten from the diet is key to managing the disease and reversing symptoms, according to the Clearinghouse.
Gluten
Avoiding gluten is critical in coeliac to help prevent symptoms and future complications--small amounts of gluten can cause problems, so it's important to know what foods to avoid. Grains such as wheat, barley and rye are all high in the protein gluten and must be avoided in a coeliac diet, as well as any foods made from these grains, such as cookies, graham flour or pasta, according to the Mayo Clinic.
Gluten containing grains can pop up as additives in foods, vitamins, medications and even cosmetics. Look out for foods that contain malt flavoring or modified food starch in their ingredient list. Be aware that gluten-containing ingredients may even appear in lipstick as binding agents, according to the Mayo Clinic.
Alternatives
Eliminating foods containing gluten may seem daunting. Consulting with a dietitian can help when planning to eat gluten-free, however, many healthy foods don't contain gluten including meat, fish and poultry (as long as they are not breaded or prepared with gluten containing marinades), fruits, vegetables and most dairy products, notes the Mayo Clinic.
Grains that don't contain gluten exist, such as buckwheat, rice, quinoa and amaranth and flours can be made from these grains as well as from potato or tapioca, and be used to bake or create gluten-free foods, plus many ready to eat gluten-free products are on the market, according to the Mayo Clinic.
Considerations
When planning to eat gluten free, cross contamination of gluten-free grains with gluten, during processing or harvesting, is a real possibility so check products labels to make sure they clearly state the product is gluten free or manufactured in a gluten-free facility, according to the Mayo Clinic. The Mayo Clinic adds that using the same utensil or bowl to prepare gluten containing and gluten free meals can cross contaminate as well.
Oats may be a grain that does not affect people with coeliac disease; however, oats are often contaminated with wheat and, even without any wheat gluten contamination, it's still debatable in the scientific community as to whether people with coeliac disease can safely consume oats, according to the Mayo Clinic.
Deficiencies
Iron, folate and calcium malabsorption is common in coeliac disease as these nutrients are absorbed at the start of the small intestine, and malabsorption of fat soluble vitamins A, D, E and K can occur as the disease moves down the small intestine, resulting in nutrient deficiencies that may require supplementation with gluten-free vitamins, according to researcher Mary M. Niewinski, MS, RD at the Department of Pediatrics/Genetics at the University of Illinois at Chicago Medical Center.
Lactose intolerance (difficulty digesting the milk sugar lactose) may also occur in ceoliac disease, and the diet may need to be adjusted, such as consuming non-dairy food sources of calcium and vitamin D, notes Niewinski.
Diagnosis and Diet
No single test exists to confirm or rule out coeliac disease. A blood test looking for elevated levels of certain antibodies--anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA)--can be the initial step in diagnosing the disease, before a biopsy of the small intestine is performed to check for changes in the villi; however, it's critical that gluten is not excluded from the diet when these tests are performed to avoid a negative test even though the disease may be present, according to Niewinski.
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