Celiac Disease Awareness Month

by Paulette Avery, R.N., M.S.N., I.B.C.L.C.

October is Celiac Disease Awareness month. Celiac disease occurs in people who cannot tolerate a protein called gluten, which is found in wheat, barley, and rye. There seems to be a growing number of people with this disease, and more and more people are choosing to limit or eliminate gluten from their diets, so I'm focusing this month's column on the topic.

For those with the disease, eating gluten causes damage to the small intestine and also interferes with the absorption of nutrients from food. The disease occurs in both children and adults, is twice as common among females, and often affects multiple relatives, especially siblings. The disease affects more people of European descent than other groups, and is rarely diagnosed in people who are African, Chinese, or Japanese. The exact number of cases in the U.S. is unknown, but estimates range from one in 133 to one in 250 people with the disease.

Symptoms of celiac disease vary widely from stomach upset and diarrhea to irritability and depression. The wide range of possible symptoms include: gas, constipation, weight loss or gain, fatigue, bone or joint pain, missed menstrual periods, tooth discoloration or loss of enamel, and many others. Because there is such a range of symptoms, or no symptoms at all, getting a correct diagnosis may take some time. Diagnosis comes after testing blood for immunoglobulin A (IgA), anti-tissue transglutaminase (TGA), and IgA anti-endomysium antibodies (AEA). If symptoms and blood testing indicate celiac disease, the doctor will perform a small-bowel biopsy through an endoscope to check intestinal tissue for damage.'

Treatment depends on the elimination of gluten from the diet, a feat that is often more difficult than it may seem because so many foods contain hidden gluten. Reading labels carefully becomes important, because gluten-containing ingredients are often added to products that one might assume to be gluten-free, such as tomato soup, yogurt, and packaged shredded cheese. People newly diagnosed with the disease are usually referred to a dietitian to help them plan a new way of eating. To get some idea of how challenging it can be to eat gluten-free, begin thinking of all the foods, including most breads, baked goods, and pastas, that you could no longer eat because they contain wheat, rye, or barley.'

Fortunately, gluten-free products are becoming more and more common. You can find them now in many grocery stores. And as gluten-free products become more common, their quality is also improving. Fortunately, gluten-free baked goods as tasteless and dry as cardboard are being replaced by products with much improved texture and flavor.'

Many resources exist for people with celiac disease. For additional information and support, here are two places to begin:

Celiac Disease Foundation

Phone: 818-990-2354

Email: cdf\@celiac.org

Internet: www.celiac.org

American Dietetic Association

Phone: 1-800-877-1600 or 312-899-0040

Email: hotline\@eatright.org

Internet: www.eatright.org

Omission: I realized after submitting my last column on insomnia that I left out a very important component of my improved ability to sleep: my acupuncturist and Chinese herbalist, Francine Ball, who has worked hard to research and create an herbal tea that has helped me. Thanks, Francine!

Paulette Avery is a registered nurse and a freelance writer who specializes in health issues.