What Is Celiac Disease?

A whole wheat muffin with a pad of butter. Fresh rye bread just out of the oven. A big bowl of oatmeal with maple syrup. Mmmmmm. Are you hungry yet? If you have celiac disease, these foods may smell delicious, but you better not take a bite.

“Celiac disease is a genetically linked disease of the autoimmune system in which people cannot eat certain grain-based products that contain gluten, a protein found in wheat, barley, rye and some oats,” said Carol Walsh, a registered dietitian with .  “It is not a simple food allergy or intolerance to food. If a person with celiac disease eats foods that contain gluten, an immune response kicks in that causes damage to the small intestine. When this happens, the small intestine cannot properly absorb nutrients that the body needs, leading to malnutrition and other health problems.”

Celiac disease runs in families and affects approximately 2 million American adults and children. Most people don’t know they have the disease because symptoms are often similar to other conditions. The average length of time between the onset of symptoms and diagnosis is about 10 years in the United States.

“Signs of celiac disease may include abdominal pain and bloating, diarrhea, joint pain, fatigue, constipation, mouth sores, tooth enamel defects and weight loss,” said Walsh.

Long-term effects of the disease can cause anemia, infertility and brittle bones. The amount of damage to the small intestine and length of time that nutrient absorption has been abnormal tend to impact the type and severity of symptoms. If not treated, celiac disease can increase the risk of cancer, miscarriage, osteopenia and osteoporosis.

People may develop celiac disease if three conditions are met: they carry the genes for the disease; they experience some type of environmental, emotional or physical event that triggers the immune system to respond to gluten; and they eat a diet that contains gluten. Celiac disease can be diagnosed based on results from a blood test and biopsy of the small intestine.

While the disease cannot be cured and lasts a lifetime, damage to the small intestine is reversible. The only treatment for celiac disease is strict adherence to a gluten-free diet. This requires staying away from all items that contain gluten, including wheat, barley, rye, and many types of flour, such as self-rising, enriched and plain flour.  

Certain processed foods that may contain wheat, barley or rye that also should be avoided include chips, French fries, candy, hot dogs, cereals, salami, soups, soy sauce and matzo. Fortunately, most of these foods can be found in gluten-free versions. Other foods that are safe to eat include corn, legumes, flax, soy, tapioca, nuts, potatoes, rice and seeds.

“Since gluten also may be found in some medicines, it is important to talk with a doctor or pharmacist before taking new medications,” said Walsh.  

A dietitian can teach people with celiac disease how to check food labels and other items for gluten. For more information about celiac disease, talk with your doctor or visit the Academy of Nutrition and Dietetics website at www.eatright.org for a complete copy of the Celiac Disease Nutrition Guide.