A Closer Look at Celiac Disease: Facts, Foods, and Tips for Living Gluten-Free

written by Skye Sherman - Jul 8, 2024

Photo Credit: by amandeep hospital, flickr.com
Photo Credit: by amandeep hospital, flickr.com

Celiac disease, also known as coeliac disease, is often misunderstood and sometimes misdiagnosed, but it’s a serious autoimmune disorder that affects millions of people worldwide.

You may have grown annoyed by all the new gluten-free labels you see on food products and menus, but going gluten-free is not just a trend or a dietary preference for celiac sufferers. Instead, it’s a lifelong condition that requires strict adherence to a gluten-free diet.

And it’s nothing new, as South China Morning Post shares: “We can thank the second-century Greek doctor and writer Aretaeus of Cappadocia, considered to be second only to the father of medicine himself, Hippocrates, for its name. Aretaeus described the earliest account of a clinical presentation of the disease, which he called koiliakos after the Greek word koelia (for abdomen). He wrote: ‘If the stomach be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs.’”

This article delves into the intricacies of coeliac disease, explaining how it’s different from gluten intolerance, and offers practical advice for those living with celiac disease.

Understanding coeliac disease

Coeliac disease is an autoimmune disorder where the ingestion of gluten — a protein found in wheat, barley, and rye — triggers an immune response that damages the small intestine. This damage impairs nutrient absorption, leading to various health problems.

People typically get it due to genetic variations that are often inherited from a parent, but the good news is that even though it is a hereditary disorder, not everybody with a genetic predisposition to it develops it.

Nature Reviews explains, “It is a chronic inflammatory state that improves when gluten-containing foods are excluded from the diet. The disease primarily affects the small bowel; however, the clinical manifestations are broad, comprising both intestinal and extra-intestinal symptoms.”

Unlike gluten intolerance or gluten sensitivity, coeliac disease is diagnosed through blood tests and an intestinal biopsy. It’s estimated that 1 in 100 people worldwide have coeliac disease, though many remain undiagnosed. It is not the only bowel disease, but it is a serious one.

Symptoms and diagnosis of celiac disease

The symptoms of coeliac disease can vary widely, which is why it can be so difficult to diagnose, but generally it causes malnutrition and can lead to many other illnesses and autoimmune conditions, including osteoporosis, arthritis, liver disease, type 1 diabetes, and multiple sclerosis.

Common symptoms include:

* Digestive issues like chronic diarrhea, constipation, bloating, and gas

* Fatigue, or persistent tiredness despite adequate rest

* Anemia, often due to iron deficiency

* Weight loss, especially unexplained or sometimes rapid weight loss

* Skin rash, especially dermatitis herpetiformis, a blistering skin condition

* Neurological symptoms like headaches, numbness, and tingling in the hands and feet

* Bone and joint pain caused by nutritional deficiencies

It’s also important to note that celiac disease “is more frequently diagnosed in women than in men (ratio 2:1), and it is one of the most common causes of chronic malabsorption, with a worldwide prevalence of around 1%,” according to Nature Reviews.

MSN also shares some interesting facts about celiac disease prevalence: “Coeliac disease can affect you at any age, although the most common age to be diagnosed is between your 30s and 50s. It affects both sexes, but women are more likely to be diagnosed with coeliac disease than men. You’re also more likely to have coeliac disease if someone else in your family has it.”

In children, symptoms may also include delayed growth, dental enamel defects, and behavioral issues. If left untreated, coeliac disease can lead to serious complications, such as osteoporosis, infertility, neurological conditions, and even certain cancers.

Coeliac disease vs. gluten intolerance

It's crucial to distinguish between coeliac disease and gluten intolerance, also called non-coeliac gluten sensitivity. While both conditions involve adverse reactions to gluten, they differ significantly in their underlying mechanisms and severity.

Gluten intolerance does not involve an autoimmune response or damage to the small intestine. Symptoms of gluten intolerance can include bloating, abdominal pain, and fatigue, but they do not cause long-term harm to the body like coeliac disease does.

Diagnosis of gluten intolerance is typically based on symptom relief following the removal of gluten from the diet, whereas coeliac disease requires invasive medical testing for confirmation.

Also, it’s important to note that cutting out gluten may not be right for everyone. As South China Morning Post explains, “Avoiding gluten if you have not been diagnosed as coeliac or gluten intolerant may be bad for you; it has been shown to help prevent heart disease and more.”

Foods to avoid and safe alternatives

For those with coeliac disease, strict adherence to a gluten-free diet is the only treatment; they must avoid contact with gluten at all costs. This involves avoiding all foods containing wheat, barley, and rye, as well as any products that may even be contaminated with gluten.

Common foods to avoid include:

* Bread, pasta, and cereals, unless labeled gluten-free

* Baked goods, including cakes, cookies, and pastries

* Processed foods like soups, sauces, and dressings that could contain hidden gluten

* Beer and malt beverages, due to their barley content

Safe alternatives include naturally gluten-free foods such as fruits, vegetables, meat, poultry, fish, beans, legumes, nuts, and most dairy products. Additionally, there are many gluten-free grains and starches available, such as rice, corn, quinoa, and gluten-free oats.

Even more gluten-free products are hitting the shelves every day, so adhering to a gluten-free diet doesn’t have to feel so limiting.

Does celiac ever go away? Unfortunately, at this point in scientific advancement, celiac disease cannot be cured. However, symptoms can go away and the villi in the intestines can heal by following a lifelong gluten-free diet.

In some cases, a doctor may prescribe an immunosuppressant like Imuran or an anti-inflammatory medication like Entocort EC to manage the disease. Talk to your physician about whether these prescription drugs may be right for you.

Tips for living with coeliac disease

Managing coeliac disease goes beyond just dietary changes. Here are some practical tips for living a healthy, gluten-free life:

1. Learn to read food labels and understand which ingredients contain gluten. Familiarize yourself with gluten-free certification symbols.

2. When dining out or traveling, research gluten-free options and communicate your dietary needs to restaurant staff. Many restaurants now offer gluten-free menus.

3. Use separate kitchen utensils, toasters, and cutting boards to prevent gluten cross-contamination in your home.

4. Connecting with others who have coeliac disease can provide valuable support and resources. Online communities and local support groups can be helpful.

5. Working with a dietitian who specializes in coeliac disease can help you ensure your diet is balanced and nutritious.

Impact on children and pregnancy

For children with coeliac disease, early diagnosis and strict adherence to a gluten-free diet are crucial for normal growth and development. For this reason, parents should work closely with pediatricians and dietitians to monitor their child’s health and nutritional status, and not ignore any warning signs.

Coeliac disease can also impact pregnancy. Untreated coeliac disease has been associated with increased risks of miscarriage, preterm birth, and low birth weight. Women with coeliac disease should maintain a strict gluten-free diet before and during pregnancy and work closely with their healthcare providers to manage their condition.

For more information, support, and resources, consider visiting coeliac disease organizations and online communities dedicated to helping individuals manage this condition.



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While the above article is based on thorough research, we do not claim to offer a substitute for medical advice from a qualified healthcare provider. The article was written for information and educational purposes only. We aim to provide helpful information to our readers, but cannot provide a treatment, diagnosis, or consultation of any sort, and we are in no way indicating that any particular drug is safe or appropriate for you and your individual needs. To receive professional medical attention, you must see a doctor.