Gluten free diet - Celiac
Disease - Wheat Intolerance
sprue; nontropical sprue; gluten enteropathy; celiac sprue
A disease in which the lining of the small intestine is damaged in response to ingestion
of gluten and similar proteins, which are found in wheat, rye, oats, barley, and other
grains including hybrid grains such as triticale.
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Causes, incidence, and risk factors
The exact cause of celiac disease is unknown. There is evidence that the disorder is
inherited (its incidence is much higher in siblings). The disorder may be caused by an
abnormal immune response to proteins found in grains, particularly gluten and the related
protein gliadin. The intestines contain projections (called villi) which normally absorb
nutrients. Celiac disease causes the villi to become flattened and lose the ability to
absorb nutrients. Weight loss, anemia, and vitamin deficiencies may occur as a result of
the malabsorption (inadequate absorption of nutrients from the intestinal tract).
Symptoms appear in babies within 6 months of introducing food containing gluten in the
diet. The disease also affects children and adults approximately 1 out of 25,000 people.
Risk factors are a genetic or familial tendency toward the disease. The disorder is most
common in Caucasians of northern and southern European ancestry, and approximately 70% of
reported cases occur in women.
Diseases that can be associated with celiac disease include lactose intolerance,
dermatitis herpetiformis (a burning, itching, blistering rash), insulin dependent diabetes
mellitus (IDDM), systemic lupus erythematosus, thyroid disease, and autoimmune disorders.
Because the exact cause is unknown, there is no way known to prevent the development of
celiac disease. However, awareness of risk factors (such as a family member with the
disorder) may increase the chance of early diagnosis and treatment.
|IN INFANTS AND CHILDREN
growth, slow (child 0 to 5 years old)
stools, clay colored
decreased appetite (anorexia)
stools - foul smelling
muscles in arms and legs are thin and wasted
|abnormal appearance of the teeth
breathlessness (due to anemia)
Additional symptoms that may be associated with this disease:
nosebleed - symptom
stools - floating
Signs and Tests
Typically, most persons with celiac disease will have symptoms of malabsorption. However,
some will have bone disease, anemia, or other conditions without diarrhea. Compression
fractures of the back, kyphoscoliosis (see scoliosis), or other signs of bone disease may
be present. Steatorrhea ("fatty" diarrhea, stools may also be foul smelling and
unusual colored) is often present.
Dental examination may show changes in the teeth. In fact, some cases of celiac disease
are suspected by the dentist because of the changes in the enamel of the teeth, which
include symmetrical (the same on both sides) changes in the tooth color and surface
A CBC often indicates anemia. An EGD (endoscopy) and small bowel biopsy, particularly
biopsy of the jejunum (the part of the small intestine most often affected), will show an
abnormal intestinal lining. Serial biopsies may be performed before and after a
gluten-free diet. Improvement of the findings of biopsy (or improvement of symptoms) after
a gluten- and gliadin-free diet is considered highly indicative of celiac disease.
A life long gluten-free diet is required. This allows the intestinal villi to heal. Foods
that contain wheat, rye, oats, and barley must be eliminated from the diet. Food and drug
labels should be read carefully to look for "hidden" sources of gluten. This
often includes the words "vegetable protein" or "plant protein" (such
as tvp--textured vegetable protein). Other "hidden" sources of gluten include
grain derivatives such as malt, modified food starch, soy sauce (some types), grain
vinegar (or "distilled vinegar"), and some binders, fillers, and flavorings.
Vitamin and mineral supplements may be needed to correct nutritional deficiencies.
Sometimes, corticosteroids (such as prednisone) may also be required.
The stress of a chronic disorder can sometimes be helped by joining a support group where
members share common experiences and problems. See celiac disease - support group.
Untreated, the disorder can cause life threatening complications. Symptoms usually
disappear within several weeks after the person begins a gluten-free diet. The gluten-free
diet must be followed continuously or the symptoms will return.
Vitamin and mineral deficiencies such as rickets and osteomalacia are common
complications. Other complications include pancreas disorders, damage to the nerves,
infertility, miscarriage, and other disorders. People with celiac disease may be at a
greater risk for lymphoma and intestinal cancers.
Calling your health care provider
Call for an appointment with your health care provider if symptoms develop that are
suggestive of celiac disease.
An appointment with a nutritionist or registered dietician may be helpful in determining
dietary guidelines. Many communities have support groups such as the Celiac Disease
Foundation; these groups are also a good source of information about dietary guidelines.
Imagine a world where wheat and anything made
of rye, oats, or barley were off-limits, then further imagine being deprived of favorite
recipes from lasagna and pizza to crusty oven-fresh bread and apple pie. That's what faces
people with an autoimmune system refusing to tolerate these food products. Hagman
emphasizes speed of preparation and low-fat/low-cholesterol recipes. Her more than 175
dishes don't venture too far from the traditional fare; nor will her ingredient
substitutes cause much consternation or surprise among home chefs. The only serious
omission is the absence of nutritional analyses for any of the recipes. Barbara
Jacobs Copyright© 1996, American Library Association. All rights reserved
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however, if you'd prefer to deal with Amazon in Europe - click
gluten free diet cookbooks here - Candida diet here
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I am NOT a medical professional.
I am a CFS - EBV sufferer who is relaying some of his experiences and
None of the information on these pages is to be construed as medical advice.
Please see a doctor for such advice.
Due to the nature of my illness, I am unable to work for a
regular employer in my former occupation as a journalist, and have started this Website, it's mirror
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