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.

Some people experience no symptoms at all, while others may present a variety of signs and symptoms. Examples include:

*This list contains just a few of the 200-plus symptoms associated with celiac disease.

Celiac disease is more than just a gluten sensitivity. It's important to consult your health care provider to determine whether you should be tested.

Causes and triggers

The exact causes of celiac disease are unclear. It's believed to be linked to the following factors:

• Heredity
• Environmental factors such as stress and repeated gastrointestinal infections
• Immune dysfunction

In all cases, it is triggered or aggravated by the consumption of gluten.

Additional factors that increase the risk of celiac disease include, among others, having type 1 diabetes, Down syndrome, or certain thyroid diseases, and having a family history of celiac disease.

Treatment

While there is no cure for celiac disease, it is possible to limit damage to the intestinal wall by adopting a gluten-free diet. Avoiding gluten helps the small intestine heal and potentially regain its ability to absorb nutrients. Symptoms may also improve or even disappear. Note that individuals with celiac disease must follow a gluten-free diet for their entire life.

Key facts:

• Gluten is a protein found in certain grains.
  • It's important to avoid eating these grains, as well as any by-products and foods containing them.
• Eliminating gluten from your diet may reduce your fibre intake, which may lead to constipation.
  • That's why it's important to add gluten-free grains and cereals to your diet and to drink plenty of water.
• Gluten-free foods sometimes have more sugar and fat and fewer vitamins, minerals, and protein than their gluten-containing counterparts.
  • It's best to choose enriched gluten-free foods that are minimally processed.

The chart below could help you make more informed choices.

These ingredients are found in many prepared foods, including bread, pizza, pastries, cereal, sauces, and condiments.

Some foods are naturally gluten-free and therefore safe to eat:

• Meat, poultry, and fish (avoid breading and marinades)
• Well-rinsed legumes (beans, chickpeas, lentils)
• Fruits and vegetables
• Milk, cheese, and yogurt* (check for added ingredients)
• Eggs
• Soy or almond beverages and tofu
• Nuts and seeds (look for "gluten-free" on the label)
• Vegetable oils and margarine

*Intolerance to lactose (a sugar found mainly in dairy products) can sometimes occur in individuals with celiac disease. In such cases, it may be recommended to choose lactose-free foods such as plant-based beverages (soy, almonds), yogurts and cheeses made with soy or coconut milk, and lactose-free milk.

A dietitian can help you achieve a balanced gluten-free diet and recommend which ingredients to avoid and which to look for. Your health care provider can also suggest vitamins and minerals that will help you maintain an optimal nutritional profile. Keep in mind that medications and supplements can also contain gluten.

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