Reduce Grains -Celiac

[Guest guest]

Hi All,

 

My biggest health concern (and breakthrough) turned out to be Celiac or

Gluten Intolerance, which can simply be explained as an " allergy to

wheat " .

 

Depression and migraines that did not respond to any medications, bloating

and gas, and a persistant herpes-like rash were my seemingly unrelated

symptoms, all of which have gone away since I gave up gluten. Gluten

intolerance has also been implicated in pschizophrenia and autism. It can

cause diahrea, wasting and weight loss, or constipation, bloating and

weight gain. No wonder it's called the " Great Pretender " ! One in 133 have

it, so if you have a lot of mysterious and seemingly unrelated symptoms,

try giving up wheat, barley and rye, and see what happens!

 

http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

 

What is celiac disease?

Celiac disease is a digestive disease that damages the small intestine and

interferes with absorption of nutrients from food. People who have celiac

disease cannot tolerate a protein called gluten, found in wheat, rye, and

barley. Gluten is found mainly in foods, but is also found in products we

use every day, such as stamp and envelope adhesive, medicines, and

vitamins.

 

 

Intestine

 

Villi on the lining of the small intestine help absorb nutrients.

 

When people with celiac disease eat foods or use products containing

gluten, their immune system responds by damaging the small intestine. The

tiny, fingerlike protrusions lining the small intestine are damaged or

destroyed. Called villi, they normally allow nutrients from food to be

absorbed into the bloodstream. Without healthy villi, a person becomes

malnourished, regardless of the quantity of food eaten.

 

Because the body's own immune system causes the damage, celiac disease is

considered an autoimmune disorder. However, it is also classified as a

disease of malabsorption because nutrients are not absorbed. Celiac

disease is also known as celiac sprue, nontropical sprue, and

gluten-sensitive enteropathy.

 

Celiac disease is a genetic disease, meaning it runs in families.

Sometimes the disease is triggered-or becomes active for the first

time-after surgery, pregnancy, childbirth, viral infection, or severe

emotional stress.

 

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What are the symptoms of celiac disease?

Celiac disease affects people differently. Symptoms may occur in the

digestive system, or in other parts of the body. For example, one person

might have diarrhea and abdominal pain, while another person may be

irritable or depressed. In fact, irritability is one of the most common

symptoms in children.

 

Symptoms of celiac disease may include one or more of the following:

 

gas

recurring abdominal bloating and pain

chronic diarrhea

pale, foul-smelling, or fatty stool

weight loss / weight gain

fatigue

unexplained anemia (a low count of red blood cells causing fatigue)

bone or joint pain

osteoporosis, osteopenia

behavioral changes

tingling numbness in the legs (from nerve damage)

muscle cramps

seizures

missed menstrual periods (often because of excessive weight loss)

infertility, recurrent miscarriage

delayed growth

failure to thrive in infants

pale sores inside the mouth, called aphthous ulcers

tooth discoloration or loss of enamel

itchy skin rash called dermatitis herpetiformis

A person with celiac disease may have no symptoms. People without symptoms

are still at risk for the complications of celiac disease, including

malnutrition. The longer a person goes undiagnosed and untreated, the

greater the chance of developing malnutrition and other complications.

Anemia, delayed growth, and weight loss are signs of malnutrition: The

body is just not getting enough nutrients. Malnutrition is a serious

problem for children because they need adequate nutrition to develop

properly. (See Complications.)

 

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Why are celiac symptoms so varied?

Researchers are studying the reasons celiac disease affects people

differently. Some people develop symptoms as children, others as adults.

Some people with celiac disease may not have symptoms, while others may

not know their symptoms are from celiac disease. The undamaged part of

their small intestine may not be able to absorb enough nutrients to

prevent symptoms.

 

The length of time a person is breastfed, the age a person started eating

gluten-containing foods, and the amount of gluten containing foods one

eats are three factors thought to play a role in when and how celiac

appears. Some studies have shown, for example, that the longer a person

was breastfed, the later the symptoms of celiac disease appear and the

more uncommon the symptoms.

 

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How is celiac disease diagnosed?

Recognizing celiac disease can be difficult because some of its symptoms

are similar to those of other diseases. In fact, sometimes celiac disease

is confused with irritable bowel syndrome, iron-deficiency anemia caused

by menstrual blood loss, Crohn's disease, diverticulitis, intestinal

infections, and chronic fatigue syndrome. As a result, celiac disease is

commonly under diagnosed or misdiagnosed.

 

Recently, researchers discovered that people with celiac disease have

higher than normal levels of certain autoantibodies in their blood.

Antibodies are protective proteins produced by the immune system in

response to substances that the body perceives to be threatening.

Autoantibodies are proteins that react against the body's own molecules or

tissues. To diagnose celiac disease, physicians will usually test blood to

measure levels of

 

Immunoglobulin A (IgA)

anti-tissue transglutaminase (tTGA)

IgA anti-endomysium antibodies (AEA)

 

Before being tested, one should continue to eat a regular diet that

includes foods with gluten, such as breads and pastas. If a person stops

eating foods with gluten before being tested, the results may be negative

for celiac disease even if celiac disease is actually present.

 

If the tests and symptoms suggest celiac disease, the doctor will perform

a small bowel biopsy. During the biopsy, the doctor removes a tiny piece

of tissue from the small intestine to check for damage to the villi. To

obtain the tissue sample, the doctor eases a long, thin tube called an

endoscope through the mouth and stomach into the small intestine. Using

instruments passed through the endoscope, the doctor then takes the

sample.

 

Screening

 

Screening for celiac disease involves testing for the presence of

antibodies in the blood in people without symptoms. Americans are not

routinely screened for celiac disease. Testing for celiac-related

antibodies in children less than 5 years old may not be reliable. However,

since celiac disease is hereditary, family members, particularly

first-degree relatives-meaning parents, siblings, or children of people

who have been diagnosed-may wish to be tested for the disease. About 5 to

15 percent of an affected person's first-degree relatives will also have

the disease. About 3 to 8 percent of people with type 1 diabetes will have

biopsy-confirmed celiac disease and 5 to 10 percent of people with Down

syndrome will be diagnosed with celiac disease.

 

The Web contains information about celiac disease, some of which is not

accurate. The best people for advice about diagnosing and treating celiac

disease are one's doctor and dietitian.

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What is the treatment?

The only treatment for celiac disease is to follow a gluten-free diet.

When a person is first diagnosed with celiac disease, the doctor usually

will ask the person to work with a dietitian on a gluten-free diet plan. A

dietitian is a health care professional who specializes in food and

nutrition. Someone with celiac disease can learn from a dietitian how to

read ingredient lists and identify foods that contain gluten in order to

make informed decisions at the grocery store and when eating out.

 

For most people, following this diet will stop symptoms, heal existing

intestinal damage, and prevent further damage. Improvements begin within

days of starting the diet. The small intestine is usually completely

healed in 3 to 6 months in children and younger adults and within 2 years

for older adults. Healed means a person now has villi that can absorb

nutrients from food into the bloodstream.

 

In order to stay well, people with celiac disease must avoid gluten for

the rest of their lives. Eating any gluten, no matter how small an amount,

can damage the small intestine. The damage will occur in anyone with the

disease, including people without noticeable symptoms. Depending on a

person's age at diagnosis, some problems will not improve, such as delayed

growth and tooth discoloration.

 

Some people with celiac disease show no improvement on the gluten-free

diet. The condition is called unresponsive celiac disease. The most common

reason for poor response is that small amounts of gluten are still present

in the diet. Advice from a dietitian who is skilled in educating patients

about the gluten-free diet is essential to achieve best results.

 

Rarely, the intestinal injury will continue despite a strictly gluten-free

diet. People in this situation have severely damaged intestines that

cannot heal. Because their intestines are not absorbing enough nutrients,

they may need to directly receive nutrients into their bloodstream through

a vein (intravenously). People with this condition may need to be

evaluated for complications of the disease. Researchers are now evaluating

drug treatments for unresponsive celiac disease.

 

The Gluten-Free Diet

 

A gluten-free diet means not eating foods that contain wheat (including

spelt, triticale, and kamut), rye, and barley. The foods and products made

from these grains are also not allowed. In other words, a person with

celiac disease should not eat most grain, pasta, cereal, and many

processed foods. Despite these restrictions, people with celiac disease

can eat a well balanced diet with a variety of foods, including

gluten-free bread and pasta. For example, people with celiac disease can

use potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead

of wheat flour. They can buy gluten-free bread, pasta, and other products

from stores that carry organic foods, or order products from special food

companies. Gluten-free products are increasingly available from regular

stores.

 

Checking labels for " gluten free " is important since many corn and rice

products are produced in factories that also manufacture wheat products.

Hidden sources of gluten include additives such as modified food starch,

preservatives, and stabilizers. Wheat and wheat products are often used as

thickeners, stabilizers, and texture enhancers in foods.

 

" Plain " meat, fish, rice, fruits, and vegetables do not contain gluten, so

people with celiac disease can eat as much of these foods as they like.

Recommending that people with celiac disease avoid oats is controversial

because some people have been able to eat oats without having symptoms.

Scientists are currently studying whether people with celiac disease can

tolerate oats. Until the studies are complete, people with celiac disease

should follow their physician's or dietitian's advice about eating oats.

Examples of foods that are safe to eat and those that are not are provided

in the table below.

 

The gluten-free diet is challenging. It requires a completely new approach

to eating that affects a person's entire life. Newly diagnosed people and

their families may find support groups to be particularly helpful as they

learn to adjust to a new way of life. People with celiac disease have to

be extremely careful about what they buy for lunch at school or work, what

they purchase at the grocery store, what they eat at restaurants or

parties, or what they grab for a snack. Eating out can be a challenge. If

a person with celiac disease is in doubt about a menu item, ask the waiter

or chef about ingredients and preparation, or if a gluten-free menu is

available.

 

Gluten is also used in some medications. One should check with the

pharmacist to learn whether medications used contain gluten. Since gluten

is also sometimes used as an additive in unexpected products, it is

important to read all labels. If the ingredients are not listed on the

product label, the manufacturer of the product should provide the list

upon request. With practice, screening for gluten becomes second nature.

 

The Gluten-Free Diet: Some Examples

 

Following are examples of foods that are allowed and those that should be

avoided when eating a gluten-free diet. This list is not complete, so

people with celiac disease should discuss gluten-free food choices with a

dietitian or physician who specializes in celiac disease. People with

celiac disease should always read food ingredient lists carefully to make

sure that the food does not contain gluten.

 

Food Categories Foods Recommended Foods To Omit Tips

Breads, cereals, rice, and pasta: 6 to 11 servings each day

Serving size = 1 slice bread, 1 cup ready-to-eat cereal, ½ cup cooked

cereal, rice, or pasta; ½ bun, bagel, or English muffin Bread made from

corn, rice, soy, arrowroot corn, or potato starch; pea, potato, or

whole-bean flour; or tapioca, sago, rice bran, cornmeal, buckwheat,

millet, flax, teff, sorghum, amaranth, quinoa

 

Hot cereals made from soy, hominy, hominy grits, brown rice, white rice,

buckwheat groats, millet, cornmeal, quinoa flakes

 

Puffed corn, rice, or millet, other rice and corn made with allowed

ingredients

 

Rice, rice noodles, pastas made from allowed ingredients

 

Some rice crackers and cakes, popped corn cakes made from allowed

ingredients Breads or baked products containing wheat, rye, triticale,

barley, oats, wheat germ, bran; graham, gluten, or durum flour; wheat

starch, oat bran, bulgur, farina, wheat-based semolina, spelt, kamut

 

Cereals made from wheat, rye, triticale, barley, and oats; or made with

malt extract, malt flavorings

 

Pastas made from ingredients above

 

Most crackers Use corn, rice, soy, arrowroot, tapioca, and potato flours

or a mixture of them instead of wheat flours in recipes.

 

Experiment with gluten-free products. Look for gluten-free products at the

supermarket, health food store, or directly from the manufacturer.

Food Categories Foods Recommended Foods To Omit Tips

Vegetables: 3 to 5 servings each day (includes starchy vegetables)

Serving size = 1 cup raw leafy, ½ cup cooked or chopped, ¾ cup juice All

plain, fresh, frozen, or canned vegetables made with allowed ingredients

Any creamed or breaded vegetables (unless allowed ingredients are used);

and canned baked beans

 

Some french fries Buy plain, frozen, or canned vegetables seasoned with

herbs, spices, or sauces made with allowed ingredients.

Food Categories Foods Recommended Foods To Omit Tips

Fruits: 2 to 4 servings each day

Serving size = 1 medium size, ½ cup canned, ¾ cup juice, ¼ cup dried All

fruits and fruit juices Some commercial fruit pie fillings, dried fruit

Food Categories Foods Recommended Foods To Omit Tips

Milk, yogurt, and cheese: 2 to 3 servings each day

Serving size = 1 cup milk or yogurt, 1 ½ oz natural cheese, 2 oz processed

cheese All milk and milk products except those made with gluten additives

 

Aged cheese Malted milk

 

Some milk drinks, flavored or frozen yogurt Contact the food manufacturer

for product information if the ingredients are not listed on the label.

Food Categories Foods Recommended Foods To Omit Tips

Meats, poultry, fish, dry beans and peas, eggs, and nuts:

2 to 3 servings or total of 6 oz daily

Serving size = 2 to 3 oz cooked; count 1 egg, ½ cup cooked beans, 2 Tbsp

peanut butter, or ¼ cup nuts as 1 oz of meat All meat, poultry, fish,

shellfish, eggs

 

Dry peas and beans, nuts, peanut butter, soybeans

 

Cold cuts, frankfurters, sausage without fillers Any prepared with wheat,

rye, oats, barley, gluten stabilizers, fillers including some

frankfurters, cold cuts, sandwich spreads, sausages, canned meats

 

Self-basting turkey

 

Some egg substitutes When dining out, select meat, poultry, or fish made

without breading, gravies, or sauces.

Food Categories Foods Recommended Foods To Omit Tips

Fats, snacks, sweets, condiments, and beverages

Butter, margarine, salad dressings, sauces, soups, desserts made with

allowed ingredients

 

Sugar, honey, jelly, jam, hard candy, plain chocolate, coconut, molasses,

marshmallows, meringues

 

Pure instant or ground coffee, tea, carbonated drinks, wine (made in

United States), rum, alcohol distilled from cereals such as gin, vodka,

whiskey

 

Most seasonings and flavorings Commercial salad dressings, prepared soups,

condiments, sauces, seasonings prepared with ingredients listed above

 

Hot cocoa mixes, nondairy cream substitutes, flavored instant coffee,

herbal tea

 

Beer, ale, malted beverages

 

Licorice Store all gluten-free products in your refrigerator or freezer

because they do not contain preservatives.

 

Avoid sauces, gravies, canned fish, products with hydrolyzed vegetable

protein or hydrolyzed plant protein (HVP/HPP) made from wheat protein, and

anything with questionable ingredients.

 

2001, the American Dietetic Association. " Patient Education Materials:

Supplement to the Manual of Clinical Dietetics. " 3rd ed. Used with

permission.

 

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What are the complications of celiac disease?

Damage to the small intestine and the resulting nutrient absorption

problems put a person with celiac disease at risk for malnutrition and

anemia as well as several diseases and health problems.

 

Lymphoma and adenocarcinoma are cancers that can develop in the intestine.

Osteoporosis is a condition in which the bones become weak, brittle, and

prone to breaking. Poor calcium absorption contributes to osteoporosis.

Miscarriage and congenital malformation of the baby, such as neural tube

defects, are risks for pregnant women with untreated celiac disease

because of nutrient absorption problems.

Short stature refers to being significantly under-the-average height.

Short stature results when childhood celiac disease prevents nutrient

absorption during the years when nutrition is critical to a child's normal

growth and development. Children who are diagnosed and treated before

their growth stops may have a catch-up period.

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How common is celiac disease?

Data on the prevalence of celiac disease is spotty. In Italy, about 1 in

250 people and in Ireland about 1 in 300 people have celiac disease.

Recent studies have shown that it may be more common in Africa, South

America, and Asia than previously believed.

 

Until recently, celiac disease was thought to be uncommon in the United

States. However, studies have shown that celiac disease is very common.

Recent findings estimate about 2 million people in the United States have

celiac disease, or about 1 in 133 people. Among people who have a

first-degree relative diagnosed with celiac disease, as many as 1 in 22

people may have the disease.

 

Celiac disease could be under diagnosed in the United States for a number

of reasons including:

 

Celiac symptoms can be attributed to other problems.

Many doctors are not knowledgeable about the disease.

Only a small number of U.S. laboratories are experienced and skilled in

testing for celiac disease.

More research is needed to learn the true prevalence of celiac disease

among Americans.

 

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Points to Remember

People with celiac disease cannot tolerate gluten, a protein in wheat,

rye, barley, and possibly oats.

Celiac disease damages the small intestine and interferes with nutrient

absorption.

Without treatment, people with celiac disease can develop complications

like cancer, osteoporosis, anemia, and seizures.

A person with celiac disease may or may not have symptoms.

Diagnosis involves blood tests and a biopsy of the small intestine.

Since celiac disease is hereditary, family members of a person with celiac

disease may wish to be tested.

Celiac disease is treated by eliminating all gluten from the diet. The

gluten-free diet is a lifetime requirement.

A dietitian can teach a person with celiac disease food selection, label

reading, and other strategies to help manage the disease.

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Diseases Linked to Celiac Disease

People with celiac disease tend to have other autoimmune diseases. The

connection between celiac disease and these diseases may be genetic. These

diseases include

 

thyroid disease

systemic lupus erythematosus

type 1 diabetes

liver disease

collagen vascular disease

rheumatoid arthritis

Sjögren's syndrome

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Dermatitis Herpetiformis

Dermatitis herpetiformis (DH) is a severe itchy, blistering manifestation

of celiac disease. The rash usually occurs on the elbows, knees, and

buttocks. Not all people with celiac disease develop dermatitis

herpetiformis. Unlike other forms of celiac disease, the range of

intestinal abnormalities in DH is highly variable, from minimal to severe.

Only about 20 percent of people with DH have intestinal symptoms of celiac

disease.

 

To diagnose DH, the doctor will test the person's blood for autoantibodies

related to celiac disease and will biopsy the person's skin. If the

antibody tests are positive and the skin biopsy has the typical findings

of DH, patients do not need to have an intestinal biopsy. Both the skin

disease and the intestinal disease respond to gluten-free diet and recur

if gluten is added back into diet. In addition, the rash symptoms can be

controlled with medications such as dapsone

(4',4'diamino-diphenylsuphone). However, dapsone does not treat the

intestinal condition and people with DH should also maintain a gluten-free

diet.

 

 

 

--

Brightest Blessings,

Jane Ma'ati Smith

Wejee's Eclectic Grimoire

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