Celiac Disease

Imagine what it would be like if eating pizza, pasta, most breads, cookies, cakes, candy bars, canned soup, or luncheon meats or drinking a beer left you with cramps, diarrhea, anemia, and even osteoporosis. For many people with celiac disease, that is a reality.
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Celiac disease, also called celiac sprue, is a hereditary disease that occurs when a protein called gluten found in wheat, barley, rye, and possibly oats generates an immune reaction in the small intestine of genetically susceptible people. As a result, tiny hair-like projections in the small intestine, called villi, shrink and sometimes disappear. The villi then are not able to absorb nutrients from food, and the result is abnormally colored, foul-smelling stools and weight loss. This malabsorption also can deprive the brain, nervous system, bones, liver, and other organs of nourishment and cause vitamin and mineral deficiencies that may lead to other medical problems.

About 1 in 500 people in the United States has celiac disease—about 500,000 Americans. Some speculate that celiac disease has affected humans since they first switched from a foraging diet of meat and nuts to a cultivated diet that included high-protein grasses such as wheat. Physicians have gained an understanding of the disease and how to treat it in only the past 50 years. Today, people with celiac disease are able to lead nearly normal, healthy lives.

A gluten-free diet—a lifelong and complete avoidance of wheat, rye, barley, and oats and any foods that contain them— is the only way to treat this disease. Following such a diet is not as easy as it seems because many processed foods and medications contain gluten.

Once gluten is removed from the diet, the digestive tract begins healing within several days. Significant healing and regrowth of the villi may take several months in young people and as long as 2 to 3 years in older persons. Foods allowed in a gluten-free diet include fresh meats, fish, poultry, milk and unprocessed cheeses, dried beans, plain fresh or frozen fruits and vegetables, and gluten-free grains such as corn and rice.

Identifying gluten-free foods can be difficult. People with celiac disease should discuss their food selections with their physician and a registered dietitian. A dietitian also can advise how best to improve the nutritional quality of a diet.
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Food manufacturers can be contacted to find out whether a product contains gluten. Celiac disease support groups and Internet sites also may have information on the ingredients found in food products.