Celiac Disease Articles

Cheat Sheet / Updated 03-27-2016

For people with celiac disease, consuming gluten — a protein found in wheat, rye, barley, and some other grains — leads to damage to the lining of the small intestine, resulting in the inability to properly absorb nutrients into the body. Left untreated or insufficiently treated, celiac disease can lead to damage to other organs. If properly treated, celiac disease typically leads to . . . nothing! These articles indicate who should be screened for celiac disease, highlight some of the disease’s most common symptoms, offer some valuable hints on shopping for food to ensure your diet is gluten-free, and provide tips on living healthfully with celiac disease.

Article / Updated 03-26-2016

If your doctor suspects that you have celiac disease or gluten intolerance, he or she may use blood tests — also called serological tests — to look for antibodies that the body produces when someone with a sensitivity or celiac disease eats gluten. You have to be eating gluten for an extended length of time before blood testing. If you don’t eat gluten, or haven’t eaten it for long enough, your body may not produce enough antibodies to show up on the tests, and the results will seem to show that you’re “normal” — or “negative” for gluten sensitivity or celiac disease. No one knows for sure exactly how much gluten you need to be eating, but if you eat the equivalent of about one or two pieces of gluten-containing bread a day for at least three months, you should have enough gluten in your system to provide a measurable response. If you have severe symptoms during that time, consult your physician to see whether you should continue to eat gluten. The most comprehensive panel of blood tests for gluten sensitivity and celiac disease includes five tests for antibodies: tTG (anti-tissue transglutaminase)-IgA: This test is very specific to celiac disease, meaning that if you have a positive tTG, it’s very likely that you have celiac disease and not another condition. EMA (anti-endomysial antibodies)-IgA: This test is also specific to celiac disease. When it’s positive, especially if tTG is positive too, it’s extremely likely that you have celiac disease. AGA (antigliadin antibodies)-IgA: The antigliadin tests are less specific for celiac disease, and these antibodies sometimes show up in other diseases (including gluten sensitivity). AGA-IgA is useful when testing young children, who don’t always produce enough tTG or EMA for diagnostic purposes. AGA-IgA is also useful for monitoring compliance on the gluten-free diet (if it’s still elevated after you’ve been gluten-free for several months, gluten may be sneaking into your diet). Some people feel that a positive AGA-IgA indicates gluten sensitivity. AGA (antigliadin antibodies)-IgG: This is another antigliadin test (like the preceding one) and is less specific to celiac disease, but it may be useful in detecting gluten sensitivity or leaky gut syndrome. Also, if the IgG levels are highly positive and all the other tests are negative, that may signal that the patient is IgA-deficient, in which case the results of the other tests are erroneous. Total serum IgA (total serum, immunoglobulin A): A significant portion of the population is IgA-deficient, meaning their IgA production is always lower than normal. Three of the four tests above are IgA-based (the only one that isn’t IgA-based is antigliadin IgG), so in someone who’s IgA-deficient, results of those three tests would be falsely low. By measuring total serum IgA, doctors can determine whether a patient is IgA-deficient and can compensate when reading the results of the three IgA-based tests. Any lab can draw the blood, as long as you have an order from a health care practitioner allowed to order blood draws. Celiac disease and gluten sensitivity can be triggered at any age, so just because you went to the doctor and tested negative once doesn’t mean you’re “out of the woods” forever.

Article / Updated 03-26-2016

Celiac disease and gluten sensitivity share some of the same symptoms. Although the actual damage occurs in the gastrointestinal tract, specifically in the small intestine, the symptoms manifest in many different ways and often show up throughout your entire body. Gluten sensitivity and celiac disease have hundreds of symptoms; the following lists don’t contain them all, but are a good sampling: Gastrointestinal symptoms: These are some of the “classic” — although not the most common — symptoms of celiac disease: Abdominal pain and distension Acid reflux Bloating Constipation Diarrhea Gas and flatulence Greasy, foul-smelling, floating stools Nausea Vomiting Weight loss or weight gain Nongastrointestinal symptoms: Interestingly, although gluten sensitivity and celiac disease affect the gut, most people’s symptoms are not gastrointestinal in nature. This partial list includes just some of the more than 250 symptoms not centered in the digestive tract. Fatigue and weakness (due to iron-deficiency anemia) Vitamin and/or mineral deficiencies Headaches (including migraines) Joint/bone pain Depression, irritability, listlessness, and mood disorders “Fuzzy brain” or an inability to concentrate Infertility Abnormal menstrual cycles Dental enamel deficiencies and irregularities Seizures Clumsiness (ataxia) Nerve damage (peripheral neuropathy) Respiratory problems Canker sores (apthus ulcers) Lactose intolerance Eczema/psoriasis Rosacea (a skin disorder) Acne Hashimoto’s disease, Sjögren’s syndrome, lupus erythematosus, and other autoimmune disorders Early onset osteoporosis Hair loss (alopecia) Bruising easily Low blood sugar (hypoglycemia) Muscle cramping Nosebleeds Swelling and inflammation Night blindness

Article / Updated 03-26-2016

The most widely accepted testing protocol for celiac disease (basically, the inability to digest gluten) includes a blood test followed by an intestinal biopsy, though there isn’t an exact science behind the diagnosis. You may be given the following tests in search of a diagnosis: Blood tests Biopsies Urine tests Stool tests Genetic tests The real diagnosis comes after the tests: with the results. Your test results are sometimes easy to interpret, and other times are impossible. For one thing, there are false negatives and occasionally false positives. False negatives can be due to several factors: Not eating enough gluten prior to testing can affect the amount of antibodies you produce. Testing that doesn’t include all five blood tests may leave an antibody unnoticed. About 5 to 10 percent of people don’t produce the antibodies that indicate celiac. Young children don’t always produce enough antibodies to show a response. A compromised immune system may weaken the antibody response. In the very initial stages of sensitivity or disease, you may not have produced enough antibodies or show other signs of the disease — yet. Some people test negative on some or all the tests, yet they find that they don’t feel right when they eat gluten. Perhaps you got false negatives — or maybe gluten just doesn’t sit right with you. Bottom line: If it makes you feel bad, don’t eat it!

Article / Updated 03-26-2016

If you have celiac disease, you need to maintain a gluten-free diet to stay healthy, but shopping for foods without gluten can be a challenge. Here are some tips to help you avoid gluten-containing foods and find gluten-free foods in your grocery store: Become a label-reader. In North America, it is the law that food that contains gluten must say so on the label. Choose naturally gluten-free foods. These include fruits, vegetables, legumes, nuts, meat, poultry, fish, seafood, dairy products and certain grains such as rice and (pure) oats. Look for foods that contain the following gluten-free grains: rice, corn, (pure) oats, soy, millet, teff, sorghum, buckwheat, quinoa, and amaranth. Be careful when buying prepared foods such as those that come in cans, boxes, jars and other packages. Make use of various on-line and published resources to assist you in finding and buying prepared and packaged foods that are gluten-free. Because they contain gluten, avoid the following products: Barley malt, malt extract, malt syrup, and malt vinegar Soya sauce (unless made from non-gluten-containing food sources) Modified food starch if it is derived from wheat Brewer’s yeast Products that do not specify their content Take your child along. If you are shopping for your child with celiac disease, if they are sufficiently mature, bring them with you (some of the time anyhow) as you shop, and make it into a gluten-free learning experience for them.

Article / Updated 03-26-2016

Although you may not have any of the symptoms of celiac disease, you may still have the condition and be endangering your health through the consumption of gluten. Some people without symptoms of celiac disease should consider being screened for the ailment, which usually involves blood tests and always involves taking a biopsy if the blood test is positive. Your doctor and you should discuss testing you for celiac disease if you have any of the following: A first degree relative (that is, a parent, sibling, or child) with celiac disease. Another disease that often occurs together with celiac disease and therefore puts you at increased risk of having celiac disease. An example is Type 1 diabetes. A health problem that can be caused by celiac disease. Examples are osteoporosis and iron deficiency.

Article / Updated 03-26-2016

If you or your child has celiac disease, you can still live healthy, active, full, rich and rewarding lives. Staying gluten-free is just one part of not just surviving but thriving with celiac disease. Follow these helpful tips and you’ll be well on your way to living successfully: Strive to be healthy. Commit to living gluten-free, eating nutritiously and exercising regularly. Keep informed about your disease. Keep tabs on good quality Web sites. Join a support group in your community (or online). Prepare for your child’s visit to friends. Let your child’s friend’s parents know that your child must not eat gluten and let them know what this means. Help out by sending gluten-free snacks with your child. Learn how to eat out without standing out. Call ahead before you go to a restaurant for dinner to let them know of your gluten-free eating needs and to make sure they can accommodate them. Show restaurant staff dining cards that contain information on gluten-free eating. Be prepared for questions about your celiac disease. Many people, either out of concern and caring, or sometimes out of simple curiosity, will ask you about your celiac disease, so be prepared to provide an answer you’re comfortable sharing. Prepare for travelling adventures. Where you go, your celiac disease goes with you, so think about how you will manage your gluten-free eating needs whether you’re travelling to the cottage, across the country, or across the globe. Deal with the slipups. At some point or another, and for a variety of reasons, you’re bound to consume some gluten. Don’t get discouraged; life happens. Just remind yourself that gluten isn’t plutonium; your misadventure won’t kill you; then jump right back on the gluten-free wagon.

Article / Updated 03-26-2016

Do you suspect that you or someone in your family has celiac disease and maybe you or they should give up gluten? Symptoms of undiagnosed or insufficiently treated celiac disease can vary greatly in their nature and number (including having no symptoms at all), but some symptoms are more common than others. If you have one or more of the following symptoms — especially if persisting and/or severe — speak to your doctor about the possibility you that have celiac disease: Gastrointestinal symptoms, especially Diarrhea Stools that are bulky, foul-smelling, and stick to the toilet bowl Abdominal bloating, especially after meals Indigestion, reflux, heartburn Unexplained or unexpected weight loss Small, intensely itchy, pinkish blisters on the elbows, knees, or buttocks (less often on the shoulders, scalp, face, and back). This may indicate a skin disease, very closely related to celiac disease, called dermatitis herpetiformis In a child, failure to grow and develop normally