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Celiac Disease in Adults

Treating Celiac Disease

Celiac disease happens when your immune system attacks the protein gluten. Gluten is a protein found in many grains such as wheat, barley, and rye. Celiac disease affects villi (tiny, fingerlike stalks) in the small bowel (intestine). Normally, the villi make it possible for the small bowel to absorb nutrients from the food you eat. But celiac disease damages the villi. As a result, you can’t get the nutrients you need, even if you eat plenty of food. Celiac disease can’t be cured, but you can feel better and eliminate symptoms by following a gluten free lifestyle.  Celiac disease is treated by removing all sources of gluten in your diet and from the products that you use.  It is important to avoid gluten even if you are not feeling sick and to stay gluten-free even when you are having no symptoms.  Eating even a small amount of gluten can damage the intestine.  Once gluten is removed, symptoms likely go away in 3-4 weeks.

Causes of Celiac Disease

With celiac disease, villi that line the small bowel become damaged and cannot absorb nutrients properly.

Celiac disease is likely genetic. This means it can be passed down in families. If your doctor thinks that you have celiac disease, he or she may advise that other members of your family be checked for it as well.

Signs and Symptoms of Celiac Disease

The symptoms of celiac disease can vary for each person. Some people have no symptoms at all. If symptoms do occur, they can include:

  • Diarrhea, constipation, or both

  • Abdominal pain and cramping

  • Abdominal swelling or bloating

  • Weight loss

  • Bone or joint pain

  • Tiredness and loss of energy

  • Mood changes, irritability, and depression

  • Canker sores

  • Skin rash

  • Tooth enamel problems

Diagnosing Celiac Disease

Your doctor will ask about your symptoms and health history. You’ll also have a physical exam. Tests are then done to confirm the problem. These can include:

  • Blood tests. These help check for specific proteins in the blood that are present with celiac disease. They also check for anemia and help rule out other problems. The tests are done by taking a blood sample.

  • Upper endoscopy with biopsy. This is done to see inside the stomach and duodenum (first part of the small bowel). For the test, an endoscope is used. This is a thin, flexible tube with a tiny camera on the end. It’s inserted through the mouth and down into the stomach and duodenum. Tools are passed through the endoscope to remove tiny tissue samples (biopsy). The tissue samples are taken to a lab and looked at under a microscope. This is to check the tiny villi for damage. This test must be done while you are still eating food with gluten. This is the only way to see if the presence of gluten is damaging the villi.

  • Genetic tests. These check for problems with specific genes linked to celiac disease. They are done by taking a blood or saliva samples.

Sources of Gluten

Gluten is a protein found in wheat, barley, and rye and food made from these grains. The most common foods with gluten are those made with wheat flour. These include bread, pasta, crackers, cake, cookies, beer, many snack foods and cereal. Gluten is also often found in sauces, salad dressing, canned soup, cooking sprays, gravies, and most packaged foods. It is even found in some non-food products such as certain medications, make-up, lotions, cosmetics and many commonly used products.  You will need to read labels for gluten in everything you use. Your healthcare provider can refer you to a dietitian to counsel you about what you should avoid. The resources below will also give you lists of food and products that contain gluten.

What Can I Eat?

There are plenty of foods that are naturally gluten-free. You can also find gluten-free versions of bread, pasta, and other products normally made with wheat flour. Safe foods and ingredients include:

  • Fruits and vegetables

  • Fresh meats (beef, poultry, lamb, pork)

  • Seafood

  • Many dairy products

  • Eggs

  • Rice

  • Potatoes

  • Beans

  • Tofu

  • Corn

  • Amaranth

  • Buckwheat

  • Millet

  • Quinoa

What Foods Must Be Avoided?

  • Wheat

  • Forms of wheat:  Spelt, farina, semolina, wheat germ, and others)

  • Malt

  • Barley

  • Rye

  • Oats:  Need to be processed in a place that does not have wheat; check labels on oats for gluten-free

Avoiding Accidental Exposure to Gluten

A gluten-free diet can take some getting used to. Your food can’t come into contact with gluten. So all of your meals will have to be prepared with separate utensils. This includes knives, cutting boards, toasters, and storage containers. It also means being extra careful at restaurants, parties, and anywhere you aren’t preparing your food yourself. Gluten can also be found in a variety of non-food products. Accidental ingestion can occur with products such as shampoo, lotion, makeup, glue, and soap. Some medicines also contain gluten, so ask your healthcare provider or pharmacist what medications you can’t take. One way to help avoid accidental exposure is for the whole family to go gluten-free. This can save you time and energy, and reduce your risk of exposure to gluten. 

Living Gluten-Free Can Be Challenging

Adjusting to a gluten-free lifestyle can be challenging and can put a strain on yourself and your family. It takes time to learn about gluten-free products and can be expensive to purchase them.  Learning how to prepare some of your favorite foods with gluten-free replacements takes time and effort.  Parties, holidays, and special events involving food are difficult.  A celiac disease support group can help.  Support groups offer ideas and recipes for making the gluten-free lifestyle easier.

Follow-Up

You should be seen by your healthcare provider at least once a year for a celiac check-up.  A simple blood test can show if your celiac diseaseis under control.   The blood test will check for antibodies which are proteins made by your immune system in response to the presence of gluten.  If antibody levels are high, accidental exposure to gluten may be the cause.  In this case, your healthcare provider can discuss with you how to find the source of the gluten and get rid of it.  Your healthcare provider can also refer you to other support and advocacy groups to help you cope with your disease.

Learning More About Celiac Disease

The following resources can help you learn more about celiac disease and how to manage it.

  • Celiac Disease Foundation, www.celiac.org

  • Celiac Sprue Association, www.csaceliacs.org

  • Gluten Intolerance Group, www.gluten.net

  • Gluten-Free Medicationswww.glutenfreedrug.com

  • National Institute ofDiabetes and Digestive and Kidney Diseases,www2.niddk.nih.gov

© 2000-2017 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.