It finally happened. You had been wondering for a while, and now your doctor confirmed you have celiac disease. What do you do now? You may start by mourning the loss of your favorite baked goods, but soon it is time to build your new diet. The good news is, the road ahead may be tastier and easier than you think.
What is Celiac Disease?
In brief, celiac disease is a disorder of the immune system. If you have celiac disease, the lining of your small intestine becomes inflamed and irritated when exposed to gluten proteins. Sources of gluten are grains like wheat, barley and rye or triticale, which is a crossbred grain created by combining wheat and rye. The irritation caused by this autoimmune reaction can be very uncomfortable in its own right, with bloating and abdominal pain being the most prominent symptoms people report. But the real problem with celiac disease is the constant inflammation damages the body's ability to absorb nutrients.
Celiac disease is linked to the presence of certain genetic markers and identified by particular antibodies in the blood, but we still don’t know for certain what leads to the development of symptoms. Some people become intolerant to gluten during childhood. It is also common for people to develop symptoms of celiac disease during their 20s and 30s. While we don’t yet know every factor in disease formation, we do know that continued, long-term exposure to the wheat flour used in bread, pasta, cereals, and even the gluten in beer and other alcohols is a potential component in the formation of gluten intolerance.
Celiac disease is an official diagnosis that differs from non-celiac gluten sensitivity. You may have a gluten intolerance or wheat allergy that does not produce the intestinal damage and presence of some antibodies that are associated with celiac disease. Talking to your doctor is very important if you are going to confirm the source of your symptoms and rule out other conditions such as irritable bowel syndrome or an intolerance to dairy products.
A proper diagnosis is important because the damage done by celiac disease can be far more serious than feeling bloated after you eat certain foods. Like any other part of your body, your intestines don't work properly when inflammation is present. The lining of your small intestine contains millions of tiny protrusions called villi. These finger-like projections are responsible for absorbing nutrients from the food you eat. When your intestines become inflamed, the villi can no longer do their job properly. If the inflammation is severe enough and continues for a long period of time, the villi can become damaged, further impairing your ability to digest your food.
When your intestines stop absorbing nutrients from your food, your whole body suffers. Depending on when you become symptomatic, malabsorption of nutrients can lead to a wide variety of symptoms. In children, celiac disease is linked to reduced height, dental problems, and issues with bone formation. For people who encounter celiac disease later in life, iron deficiency and serious conditions like osteoporosis and unintended weight loss can become problems.
Preventing Small Intestinal Damage
For people with celiac disease, intestinal damage is caused by exposure to gluten proteins. One of the challenges for many people is that gluten sensitivity is built over time, and the continued exposure before you are diagnosed and your diet is modified only increases the damage to your small intestine.
If you have celiac disease, you are up against more than just an upset stomach or problems with your stool. The danger for people with severe celiac disease comes from malabsorption of nutrients in your food. As the lining of the intestine becomes inflamed, the villi can become damaged. These projections which are responsible for the absorption of nutrients from the food you eat line the intestine, and cannot do their job properly if the surrounding tissue is inflamed. This can lead to your body absorbing fewer nutrients than it should during digestion.
A Gluten-Free Diet Improves Nutrient Absorption
This malabsorption of nutrients caused by celiac disease can cause significant issues beyond just bloating and abdominal pain. Iron deficiency and other long-term nutrient deficiencies have been linked to celiac disease. This can be particularly dangerous for children, as vitamin and nutrient deficiencies during your formative years can stunt growth, cause dental issues and set the stage for other severe health problems later in life.
Thankfully, maintaining a gluten-free diet can eliminate the inflammation that plagues many people with celiac disease. By cutting out foods containing gluten, you can reduce the irritation that has reduced the efficiency of your intestines. As the lining of your intestine heals, your body will be able to return to normal levels of nutrient absorption during digestion.
Are Any Grains Gluten-Free?
The good news is, yes, there are many gluten-free grains! Many people believe eating only gluten-free products means giving up baked goods altogether. Thankfully this doesn’t have to be the case. You will have to make modifications to your diet, and some flaky pastries may be off-limits forever, but there are several alternative grains that can be substituted for wheat, barley or rye flour in a wide variety of baked goods. In fact, it is now quite common for gluten-free bread options to be found in many grocery stores.
The list of grains that you can eat if you have celiac disease is quite long. There are more, but a list of gluten-free grains and alternative flours includes:
- Buckwheat groats (also called kasha)
One of the most common mistakes people make when starting on a gluten-free diet is using ancient forms of wheat flour, thinking they do not contain gluten. Though very healthy and attractive options for people without wheat allergies, durum, kamut and semolina are all ancient forms of wheat and all contain gluten. Though the levels of gluten may vary, these types of wheat are still off-limits if you have celiac disease.
Knowing which gluten-free grains you can use is only part of the story. Though gluten-free products can be used to make cakes, bread, and pasta, substituting a grain like quinoa or potato starch flour for wheat flour often means you must modify your recipes and cooking techniques. Thankfully, there are many resources online and even support groups you can attend to learn how to work with theses alternative grains so you can keep enjoying your favorite foods.
When you are making the switch to consuming only gluten-free foods, it can be beneficial to consult a dietitian as well. While there are a host of resources online, talking to a medical professional who knows your symptoms and sensitivities can help point you in the right direction as you begin your new diet.
Is a Gluten-Free Diet Safe if I Have Celiac Disease?
If you have celiac disease, a gluten-free diet is the only safe and proven way to manage your symptoms. By eliminating gluten proteins from your diet, you will be able to prevent the immune system reaction and resulting inflammation that occurs when you eat foods containing gluten. Keeping to a strict gluten-free diet may not be as easy as it sounds, though.
Many foods, food stabilizers, additives and other products you might not suspect can contain gluten. This is one of the challenges of a gluten-free diet, and a potential concern if your gluten sensitivity is very severe. Some foods are clearly safe, like vegetables, fruits, and meat, but being vigilant in restaurants and grocery stores can keep you from getting a nasty surprise. Increasingly, many foods are labeled gluten-free as people become more aware of dietary restrictions such as celiac disease, lactose intolerance, or other food allergies.
When you are eating out, however, you don't have the chance to read the food labels on everything you eat. Two places gluten can be lurking are in salad dressings and sauces. You can start by avoiding the hamburger bun or tortilla to ensure you are going truly gluten-free, but you need to go the extra mile and ask restaurant staff about the food just to be safe. If you have a severe gluten intolerance, it pays to ensure any dressings, sauces or toppings do not contain gluten, or that salads are served without croutons. Happily, menus at many restaurants note which items are gluten-free, and restaurant staff is often trained to be aware of what items contain gluten. If you are ever in doubt, it is better to simply order an item you know to be safe.
In the home, maintaining a gluten-free diet is much easier. At first it may be intimidating, and there may be a few beloved treats you will have to give up, but in the long run, you will be healthier and happier for it. Going gluten-free at home is easier than ever, with resources available online about what products are safe for people with gluten intolerance. Your doctor or dietitian can also be great resources to find out more about how you can begin changing your diet to get the nutrients you need without the gluten.
Another thing to keep in mind when choosing gluten-free foods is that many healthy, nutritious foods are still very safe. You can still eat a balanced diet and may find that your eating habits even improve after eliminating certain baked goods from your diet. A few major categories of foods that are generally safe for most people with celiac disease include:
- Beans, legumes, and nuts
- Poultry and eggs
- Fish and seafood
Ask your Doctor About Celiac Disease
Consulting your physician to confirm your celiac disease diagnosis is crucial. Many people try to self-diagnose, but this can be dangerous. There are many diseases that share common symptoms with celiac disease, which makes getting an accurate diagnosis very important. It is even possible to have non-celiac gluten sensitivity, which is very similar to celiac disease, though individuals with this condition may lack the genetic markers and antibodies which are part of an official diagnosis of celiac disease.
When you have celiac disease, you should continue to seek medical advice even after your diagnosis. Consulting with your physician and possibly a dietitian is an important step in educating yourself about how to take control of your diet and take care of your body. While there are support groups and many resources online, it is important to have a medical professional who understands your body and your specific dietary needs. At Cary Gastroenterology, we understand the challenges of living with celiac disease, and we are here to help you make the most of life after your diagnosis.
If you suspect you may have celiac disease, or if you have already been diagnosed and are having trouble managing your symptoms, make an appointment today. We can help you establish a diet and a lifestyle that will help you reclaim your health and overcome the challenges of gluten sensitivity.