Celiac Disease

Celiac disease is a medical condition whereby the immune system reacts abnormally to a protein called gluten, resulting in damage to the lining of the small intestine. The small intestine is responsible for absorbing nutrients from food. Damage to its lining may therefore lead to problems absorbing important nutrients.

Individuals with celiac disease may experience gastrointestinal symptoms such as:

  • Abdominal pain
  • Diarrhea
  • Bloating and gas
  • Constipation
  • Loss of appetite
  • Nausea and vomiting

Some people with celiac disease may not have any gastrointestinal symptoms, but may instead experience fatigue, anemia (low red blood cell counts), weight loss, skin problems, or delayed growth (in children).

Celiac disease is much more than just gluten sensitivity. Consulting a doctor is therefore important, as they are the only ones who can provide a medical diagnosis.

Causes and triggers

The exact cause of celiac disease is unclear. The development of the disease appears to be related to genetic (inherited) and environmental factors.

It is always triggered or worsened by the ingestion of gluten.

Additionally, celiac disease is more common in individuals with type 1 diabetes, Down syndrome, certain thyroid conditions, and those who have a family member with celiac disease, among others.

Treatment

There is no cure for celiac disease. However, minimizing damage to the intestinal wall, by following a gluten-free diet, is possible. It should be noted that individuals diagnosed with celiac disease must follow a strict gluten-free diet for life.

Gluten is found in certain cereals, which must be avoided. Since a low-fiber diet can cause constipation, it is important to add gluten-free cereals and grains to the new diet, and to drink water throughout the course of the day.

The chart below could help you make more informed choices.

 IngredientExamples
Avoid
  • Wheat
  • Flour
  • Graham
  • Malt
  • Barley
  • Rye
  • Triticale
  • Foods that are coated in flour, breaded, fried or contain breadcrumbs
  • Beer
  • Cookies, crackers
  • Certain spices and seasonings (e.g., ketchup, soy sauce, garlic powder)
  • Breakfast cereals and infant baby cereals
  • Malted barley
  • Malted milk powder
  • Pasta
  • Pastries
  • Semolina (e.g., couscous)
  • Malt vinegar
Usually gluten-free
  • Distilled spirits
  • Amaranth
  • Flax seed
  • Corn
  • Millet
  • Nuts
  • Potatoes
  • Quinoa
  • Rice
  • Buckwheat
  • Soy
  • Tapioca
  • Rum, tequila, vodka, whisky
  • Corn flour
  • Rice vermicelli
Gluten-free but may be contaminated
  • Oats (except gluten-free oats)
  • Legumes
  • Oatmeal
  • Beans
  • Chickpeas
  • Lentils

These ingredients are found in countless prepared foods such as bread, pizza, pastries, cereals, sauces and condiments. Medications and supplements can also contain ingredients derived from gluten. A dietician can help you develop a healthy, well-balanced gluten-free diet and recommend ingredients that can and cannot be part of your food plan. Your healthcare provider will also be able to suggest vitamins to help you maintain recommended nutrient levels.

While dairy products are gluten-free, some individuals experience a worsening of their symptoms with the ingestion of dairy. To allow the intestines time to heal, these individuals may have to avoid milk, cheese and other dairy products when first starting a gluten-free diet.

When should I see a healthcare professional?

To obtain an accurate diagnosis, a doctor must order tests. For these tests to be accurate, it is important for you to be on a gluten-containing diet prior to testing.

If you experience digestive discomfort or if you have diarrhea for more than two weeks, see a healthcare professional.

If your child is experiencing the following symptoms, see a healthcare professional:

  • Paleness
  • Irritability
  • Bloated stomach (potbelly)
  • Bulky and foul-smelling stools
  • Delayed growth
For more information:
Canadian Celiac Association
www.celiac.ca
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