A Gluten-Free Diet can End Painful Symptoms of Celiac Disease
Question:
My 3-year-old daughter was recently diagnosed with celiac disease. I have similar symptoms but my blood test came back negative. Can you tell me more about what our diagnoses mean? What is the best way to manage her diet, and our family’s diet, to prevent further reactions?
Answer:
Celiac disease is an inherited autoimmune disorder affecting the small intestine. When people with celiac disease consume gluten, it causes an inflammatory reaction that damages the lining, or mucosa, of the intestine, inhibiting absorption of necessary nutrients from food. Consequently, people with celiac disease can become malnourished. The resulting inflammation of the intestinal lining causes abdominal pain and other symptoms that you may have experienced.
In people with celiac disease, the immune system views gluten as a foreign substance and reacts against it, causing inflammation. Gluten - a protein in wheat, barley, and rye - is found in a wide variety of food. It is also a binding agent in dough and other batter, and is used in processed food. While found predominately in foods, it also may be found in products such as stamp and envelope adhesive, medicines, and vitamins.
Symptoms of celiac disease include bloating, abdominal cramps, abdominal swelling, nausea, vomiting, diarrhea or constipation, chronic fatigue, weakness, loss of appetite, and severe weight loss. In young children, these symptoms, as well as stunted growth, poor muscle tone, and irritability, can occur when children begin eating cereals. Many people with the disorder also experience dermatitis herpetiformis, a skin reaction to gluten in which clusters of intensely itchy blisters form around the knees, elbows, buttocks, back, and scalp.
When people experience these symptoms, they should consult their physician. A doctor can perform a simple blood test to detect an elevated level of autoantibodies that are characteristic for celiac disease. Before being tested, people should continue to eat a regular diet that includes foods with gluten, such as breads and pastas. If a person stops eating foods with gluten before being tested, the results may be negative for celiac disease even if celiac disease is actually present. If results are positive, a minimally invasive biopsy of the lining of your small intestine to confirm the diagnosis of celiac disease is warranted.
Even if the blood test is negative for celiac disease, gluten could still be the problem. Doctors now recognize that many individuals have non-celiac gluten sensitivity or intolerance. These people experience many of the same symptoms as people with celiac disease and also benefit from a gluten-free diet.
Although there is no cure for celiac disease, it can be managed by eliminating all gluten from your diet. Strict adherence to this diet typically produces a complete relief of symptoms. People often report positive effects within 48 hours, and damage to the intestine is usually repaired within months.
Gluten is found in breads, breading, batter, cereals, pasta, crackers, cookies, pies, and gravies. It also is used in many processed foods that you need to be equally wary of: some candy bars, canned soup, packaged meat, energy bars, ketchup, mustard, ice cream, instant coffee, and pastas. The only way to be completely sure that the product you are buying is gluten-free is to carefully read the ingredient label. If you still have questions, contact the food manufacturer.
Fortunately, there are many gluten-free foods that may appeal to young children: cheese, nachos, Chex Mix, popcorn, fruit rolls, applesauce, pudding, Jello, and yogurt are all appropriate for people with celiac disease and gluten intolerance. Be sure to communicate with your child’s teachers and other parents your child may visit about celiac disease so they are aware of the foods that are off-limits. You also may want to pack lunches or special snacks when your child goes to school or has play-dates.
A dietician can be an invaluable resource in helping you and your daughter adapt to a gluten-free lifestyle. They can teach you how to properly read food labels, direct you to gluten-free recipes and cookbooks, coach you on ordering in restaurants, and provide you with information for contacting food manufacturing companies. Most recommend diets high in meat, salads, vegetables, potatoes, corn, rice, fruits, and breads and cereals made from alternative flours such as rice or soy.
One tool that is particularly helpful is downloadable software of mainstream gluten-free product listings. You can install the software on your home computer to create grocery lists or on your pocket PC so you can search for approved brands while you are in the supermarket. Clan Thompson SmartLists and GlutenGuard both make these products in the $70-$100 range.
The Web is a great resource for parents making the switch to a gluten-free diet. You can find cookbooks, recipes, specialty product companies, and gluten-free product listings online. A list of restaurants in your area that provide gluten-free menu items is also available, courtesy of the Gluten Intolerance Group.