Frequently Asked Questions

Frequently Asked Questions About Celiac Disease

Q	What is gluten?
A	Gluten is a grain protein that is harmful to some people. It is found in wheat, rye, barley, spelt, kamut, and triticale. Scientists used to think oats also contained harmful gluten. But recent research indicates that is not the case. Oats in limited amounts may be safe, but concerns about cross contamination have kept oats off the gluten-free diet in the US.

What is gluten sensitivity?

Some individuals are “sensitive” to gluten and this sensitivity can result in their being diagnosed with “celiac disease.” (The terms gluten sensitivity, gluten-sensitive enteropathy, celiac sprue, celiac sprue disease, or non-tropical sprue are also used.) People with celiac disease have an adverse reaction to gluten. Whey they consume any gluten, which is found in many common foods, their immune system tries to “protect” their bodies as it might if they had consumed poison. But the immune response damages their small intestine, which leads to malabsorption of vital nutrients, such as iron, calcium, folic acid or fat-soluble vitamins including D,E, K and A. This can lead to illness that is sometimes serious.

Q	How is celiac disease cured?
A	By following a strict gluten-free diet. When celiac patients totally avoid glutenous grains, their immune system can no longer react to gluten. This gives their small intestine a chance to heal and more properly absorb nutrients. By following a lifelong, strict gluten-free diet the patient can maintain intestinal health.

Q	What are the main symptoms of celiac disease?
A	· Continued gastrointestinal distress including bloating, gas and diarrhea. · Weight loss · Constant fatigue and/or weakness · Depression that does not respond to medications. · Abdominal or bone pain · Unexplained anemia.

Q	Do children have the same symptoms?
A	They might. Other symptoms common in childhood are: · Failure to thrive · Short stature · A distended abdomen · Dental enamel defects · Unusual behavior changes.

Q	Who is at risk for celiac disease?
A	· Those suffering from any of the symptoms mentioned above or continued poor health for which no cause can be found. · Relatives of those already diagnosed with celiac disease. · Individuals with Type I Diabetes.

How is celiac disease diagnosed?

There are three parts to a diagnosis:
1. Your physician has to suspect that you have it! (Celiac disease was once considered a rare disease. However, recent studies show that as many as one in 133 Americans has celiac disease. Yet many physicians still think it is a rare disease. So they don’t suspect it and therefore don’t test for it.)
2. Once a physician (or a patient) suspects celiac disease, the patient should have special blood tests that measure antibodies to gluten.
3. If the blood tests are positive, the physician does a small bowel endoscopy with biopsy. The biopsy sample is examined under a microscope and if the pathologist identifies gluten-induced damage, a diagnosis of celiac disease is confirmed.

A valid diagnosis can relieve debilitating symptoms that may have existed for years and reduce or eliminate the long-term risks of undiagnosed celiac disease.

Q	What are those risks?
A	Osteoporosis due to calcium malabsorption, overall poor health, fertility problems and possibly birth defects or lymphoma of the small intestine. In small children, undiagnosed celiac disease can cause lack of proper development, short stature and unusual behavior.

Are there other forms of gluten sensitivity besides celiac disease?

Yes, there is a skin form called dermatitis herpetiformis (DH). In this case, the small intestine is usually damaged by gluten, but the antibodies related to gluten sensitivity are deposited in the skin and are expressed as an itchy, blistering rash. This rash tends to appear on the elbows, knees, buttocks, scalp or back. In its full blown state, DH may be easily diagnosed, but mild cases are frequently confused with other types of dermatitis. A special skin biopsy processed by immunoflourescence can help diagnose gluten sensitivity.

Q	Is gluten sensitivity the same as a wheat allergy?
A	No. Food allergies are generated through a different physiological process and usually produce different and more easily recognized symptoms. If you are allergic to wheat, you must avoid foods that contain wheat. If you are sensitive to gluten, you must avoid all grains that contain gluten, not just wheat.