What is celiac disease?

Celiac disease is a problem some people have with foods that contain gluten. Gluten is a type of protein. It's found in the grains wheat, barley, rye, and triticale (a wheat-rye cross).

When you have this disease and you eat food with gluten in it, the gluten triggers an immune response that isn't normal. This damages the inside of your small intestine so that it can't do a good job of absorbing nutrients from your food.

Celiac disease can lead to anemia or osteoporosis.

In children, celiac disease can slow growth and weaken bones. If it isn't treated, your child can get very sick.

Symptoms of celiac disease include:

• Gas and bloating.
• Belly pain.
• Diarrhea or other changes in bowel movements.
• Weight loss.
• Feeling very tired.
• Weakness.
• Tingling, numbness, or pain in the hands or feet (neuropathy).

Symptoms may come and go. They may be very mild and go completely unnoticed. Or they may be severe symptoms that impact your daily life.

Your doctor will ask questions about your symptoms and do a physical exam.

You may have blood tests to see if you have certain antibodies that could mean you have the disease. Celiac disease triggers the immune system to produce these antibodies.

To find out for sure if you have celiac disease, you will probably have an endoscopy. In this test, a doctor uses a thin, lighted tube to look at the inside of your small intestine. Your doctor can also take small samples of tissue to be tested in a lab. This is called a biopsy.

If the biopsy shows signs of celiac disease (such as abnormal villi and inflammation in the small intestine), a gluten-free diet will be recommended.

A diagnosis of celiac disease is confirmed if the diet makes symptoms go away and if antibody tests become normal.

The treatment for celiac disease is to avoid all foods that have gluten. This is called a gluten-free diet. Eating even the smallest amount of gluten can cause symptoms such as weight loss and diarrhea.

A gluten-free diet means:

• Avoiding all foods with wheat, barley, rye, triticale (a wheat-rye cross), or oats. Oats may later be slowly brought back into the diet.
• Avoiding beer unless it's gluten-free. Beers with and without alcohol contain gluten unless the label specifically says they're gluten-free.

Gluten can also be in things you may not expect, like medicine, vitamins, and lipstick.

You may also be advised to avoid milk or milk products for a while until your intestine heals. Then you may be able to slowly reintroduce them.

If you have nutritional deficiencies, you may need other treatments. Treatments include vitamin, iron, and calcium supplements.

• Feed your child a gluten-free diet to prevent symptoms and damage to the small intestine. Even a small amount of gluten may cause damage.
  • Avoid all foods that contain wheat, rye, and barley. Foods that are often made with these grains include bread, bagels, pasta, pizza, malted breakfast cereals, and crackers.
  • Avoid oats, at least at first. Oats may cause symptoms in some people. It may be contaminated with wheat, barley, or rye from processing. But many people who have celiac disease can eat moderate amounts of oats without having symptoms. Health professionals vary in their long-term recommendations regarding eating foods with oats. But most agree it is safe to eat oats labeled as gluten-free.
• Your child may need to avoid milk and milk products for a while. Once your child stops eating any gluten, the intestine will begin to heal. Then it should be okay to drink milk and eat milk products.
• Read food labels carefully and look for hidden gluten, such as gluten in medicine and some food additives. If a label says "modified food starch," the product may contain gluten.
• Plan your child's diet around:
  • Eggs.
  • Dairy products, if your child can eat them. Cheese, yogurt, and other dairy products can be an important part of the diet.
  • Flours and foods made with amaranth, arrowroot, beans, buckwheat, corn, cornmeal, flax, millet, potatoes, gluten-free oat bran, quinoa, rice, sorghum, soybeans, tapioca, or teff.
  • Fresh, frozen, and canned meats, fruits, and vegetables. Watch for added gluten.
• Talk to your doctor or contact your local hospital or dietitian for information about support groups in your area. You may find a support group helpful for discovering ways to help you deal with celiac disease. Celiac disease support groups often share recipes and good food sources.
• Look for gluten-free foods. Many food stores, especially health food stores, offer specially marked gluten-free food.