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May 6, 2024

Understanding Celiac Disease with Lisa Robinson-Mihiar, RDN

by Lisa Robinson-Mihiar, RDN

Celiac disease is a serious autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. For those with celiac disease, consuming gluten leads to damage in the small intestine, resulting in malabsorption of nutrients and a range of gastrointestinal symptoms. Let’s delve into what celiac disease is, how it’s diagnosed, and the dietary modifications necessary for managing the condition.

What is Celiac Disease?

Celiac disease is an autoimmune disorder where the body’s immune system reacts abnormally to gluten, leading to damage in the lining of the small intestine. This damage hampers the absorption of vital nutrients, causing various symptoms and potential complications. It affects about 1% of the population worldwide, though many cases remain undiagnosed.

How People Get Celiac Disease

The exact cause of celiac disease isn’t fully understood, but it’s believed to involve a combination of genetic and environmental factors. Individuals with specific genetic markers, such as the HLA-DQ2 and HLA-DQ8 genes, are more susceptible. Environmental triggers, such as introducing gluten into the diet, can then activate the immune response leading to the development of celiac disease.

Testing for Celiac Disease

Diagnosing celiac disease involves two steps:

1. Blood Tests: Initially, blood tests are conducted to check for specific antibodies like anti-tissue transglutaminase (tTG) and anti-endomysial antibodies (EMA). Elevated levels of these antibodies suggest an immune reaction to gluten.

2. Biopsy: If blood tests indicate a possibility of celiac disease, a biopsy of the small intestine is usually performed to confirm the diagnosis. During this procedure, a small tissue sample is taken from the intestine and examined for characteristic damage caused by celiac disease.

Dietary Modifications for Celiac Disease Management

The primary treatment for celiac disease is a strict gluten-free diet. This involves eliminating all sources of gluten from the diet, including wheat, barley, and rye. While this may seem straightforward, gluten can hide in various foods and products, so it’s crucial to become adept at reading labels and understanding potential sources of gluten contamination.

Here are key dietary modifications individuals with celiac disease need to make:

1. Gluten-Free Grains: Substitute wheat, barley, and rye with gluten-free alternatives like rice, corn, quinoa, millet, and gluten-free oats.

2. Fruits and Vegetables: Emphasize fresh fruits and vegetables, which are naturally gluten-free and provide essential nutrients.

3. Proteins: Opt for lean meats, poultry, fish, eggs, legumes, nuts, and seeds, ensuring they are prepared without any gluten-containing ingredients or coatings.

4. Dairy: Most dairy products are naturally gluten-free, but it’s essential to check for added ingredients or cross-contamination risks.

5. Processed Foods: Be cautious with processed foods, sauces, condiments, and snacks, as they may contain hidden sources of gluten. Choose certified gluten-free options whenever possible.

6. Gluten-Free Labeling: Look for products labeled as “gluten-free,” as they are specifically manufactured to meet gluten-free standards.

What About Gluten Intolerance?

In addition to celiac disease, another related condition is non-celiac gluten sensitivity, also known as gluten intolerance. Gluten intolerance has symptoms similar to those of celiac disease, but without the characteristic immune response or intestinal damage. Diagnosing gluten intolerance can be challenging because there are not specific biomarkers or diagnostic tests. Diagnosis often relies on excluding celiac disease and wheat allergy and noticing improvement in symptoms with a gluten-free diet. Symptoms of gluten intolerance, such as abdominal pain, bloating, diarrhea, fatigue, and headaches, are similar to those of celiac disease. However, gluten intolerance does not cause intestinal damage like celiac disease does. Management of gluten intolerance involves following a gluten-free diet, though individual tolerance levels may vary, with some able to tolerate small amounts of gluten while others require strict avoidance. Understanding the differences between celiac disease and gluten intolerance is essential for accurate diagnosis and appropriate management.

Celiac disease requires lifelong adherence to a strict gluten-free diet to manage symptoms effectively and prevent complications. Proper diagnosis through blood tests and biopsies is crucial, followed by diligent dietary modifications to eliminate gluten from the diet completely. By understanding celiac disease and making the necessary lifestyle adjustments, individuals can effectively manage their condition and lead healthy, fulfilling lives. If you suspect you have celiac disease or have been experiencing symptoms, consult with a healthcare professional for proper evaluation and guidance.

Do you need help with a gluten free diet? Avance Care has dietitians that can help support you in management of a modified diet. To get connected with our team, contact our nutrition coordinators at 919- 237-1337, option 4, or visit here to learn more.

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