Why can’t you eat gluten?
You’ve probably heard of a gluten free diet. For some people, it’s something to try because it’s the latest health craze. For others, it’s not just a diet, it’s a necessity. Individuals who have celiac disease must follow a gluten free diet in order to be healthy. What is celiac disease? How do you know if you have it? Why does a gluten free diet help?
Celiac disease is when your body’s immune system overreacts to gluten in the food you eat. Gluten is a protein found in wheat, barley and rye. The reaction damages the villi (tiny, hair-like projections) that are attached to the inner surface of your small intestines. The villi are important because they are responsible for absorbing vitamins, minerals and other nutrients from the food you eat. If they are damaged, your body can’t get enough nutrients. The exact cause of celiac disease is unknown. However, it does usually run in families, so there is a genetic component to it. If you have certain other conditions, you could be at risk for developing it. Some of these conditions are Type 1 diabetes, Down syndrome, Turner syndrome, autoimmune thyroid disorder, Addison’s disease or microscopic colitis.
The symptoms of celiac disease can vary significantly among individuals and between adults and children. Typically, adults can have diarrhea, fatigue, weight loss, bloating/gas, abdominal pain, nausea/vomiting and constipation. A good portion of adults with celiac disease don’t have any symptoms related to their digestive system, but have other symptoms instead. These symptoms include mouth ulcers, headaches, fatigue, itchy/blistery skin rash (dermatitis herpetiformis—usually appears on elbows, knees, torso, scalp or buttocks), numbness/tingling in hands/feet, balance issues, joint pain and cognitive impairment. Children are more likely to have digestive issues, such as nausea/vomiting, chronic diarrhea, constipation, gas, swollen belly and pale/foul-smelling stools. Since their bodies aren’t absorbing the need nutrients, children often exhibit irritability, short stature, damaged tooth enamel and delayed puberty.
If celiac disease isn’t treated, it can lead to severe complications. Due to the inability to absorb nutrients, it can cause malnutrition which can result in anemia and weight loss. Since the body isn’t taking in enough calcium or vitamin D, your bone health suffers. In children, it can cause their bones to soften (osteomalacia) and the loss of bone density (osteopenia/osteoporosis) in adults. Also, not having enough calcium or vitamin D can increase your chances of infertility and miscarriages. The damage to your small intestine can make it difficult for you to tolerate dairy products. Individuals with untreated celiac disease are also at greater risk for developing several different types of cancer.
Unfortunately, there isn’t a cure for celiac disease. The only thing you can do is manage it with a strict, lifelong gluten-free diet. Besides wheat, barley and rye, other foods that contain gluten are bulgur, durum, farina, malt, graham flour, semolina, spelt and triticale. Gluten is used in many different products and can be hidden in things, such as modified food starches/preservatives/food stabilizers, medications, vitamin/mineral supplements, herbal supplements, lipstick products, toothpaste, mouthwash, envelope/stamp glue and play dough. Since even trace amount of gluten can be damaging, so it’s essential to keep track of where you might come into contact with gluten. A good way to gain a better understanding of what foods you should avoid is to talk to a dietician.
For most individuals, a gluten-free diet is all you need to follow in order for your body to heal. For children, it can take 3 – 6 months, whereas, for adults, it could take up to several years. If lab work shows that you’re deficient in copper, folate, iron, vitamin B12, vitamin D, vitamin K or zinc, your doctor will recommend that you take vitamins and supplements to help replace them. If your digestive system is having difficulty absorbing these, your doctor will recommend that you receive injections to help your body get the nutrients it needs. Severe celiac disease cases are treated with steroids in order to control the inflammation.
Occasionally, people with celiac disease don’t respond to a gluten-free diet. This is known as nonresponsive celiac disease and can be the result of unknowingly ingesting gluten, bacterial overgrowth in your small intestines, microscopic colitis, irritable bowel syndrome, poor function of your pancreas or difficulty digesting sugar. If none of these things apply to you, you’ve been following a gluten-free diet for 6 – 12 months and are still having symptoms, then you many have refractory celiac disease. These usually results in severe damage to your small intestines and requires treatment at a specialized center because there aren’t any proven treatments yet. If you have dermatitis herpetiformis, it’s important to have a gluten-free diet and take a pill, dapsone, to help clear the rash up.
Since there isn’t a way to prevent developing celiac disease, the goal is to prevent damage from occurring and reducing symptoms. This means having a thorough understanding of what foods contain gluten. Always check the packaging of product for the words “gluten-free.” A dietician can provide a more in-depth list, but some common things to avoid include cereals, pasta, baked goods, beer, candies, gravies, processed meats, imitation meat/seafood, rice mixes, salad dressings, sauces (ex. soy sauce), seasoned snack food, soups and self-basting poultry. However, there are many foods that you can eat, such as eggs, fruits, lentils, nuts, potatoes, vegetables, fresh meats (shouldn’t be breaded, batter-coated or marinated) and wine/other distilled liquors. Also, there are several grains that gluten-free that you can eat, like corn, cornmeal, quinoa, rice, tapioca, wild rice, buckwheat, amaranth and gluten-free flours (ex. rice, soy, corn, potato or bean). Besides educating yourself about celiac disease and what you need to do to treat it, it’s important to talk to your family and friends, so they know what’s going on and be a support system. It can also be helpful to join a support group in order to talk to other individuals who are living with celiac disease.
If you have celiac disease, it can be challenging to manage your diet at first. However, once you get the hang of it, it becomes second nature and you can alleviate all the uncomfortable symptoms. If you have any questions or concerns about celiac disease, please speak with your doctor. If you would like more information, please visit the Celiac Disease Foundation at https://celiac.org/about-celiac-disease/what-is-celiac-disease/