What is Celiac Disease?

Celiac Disease is a genetically linked autoimmune disease that affects about 1 in 133 people and which can develop at any age.

Individuals with Celiac Disease must avoid gluten at all costs.  Inside the small intestines, nutrients from food get absorbed through millions of tiny finger-like structures called villi. When a person with Celiac Disease eats food that contains gluten, their immune system responds by damaging and flattening the villi.

Damaged villi cannot fully absorb the nutrients needed to stay healthy, resulting in various health problems such as gas, bloating, diarrhea, skin rash, anemia, joint pain, depression, delayed growth, fatigue, osteoporosis, infertility and even cancer.  There are some people who have no symptoms at all. Often, since the symptoms are so varied, Celiac Disease may be misdiagnosed as other conditions.

Eating as little as 1/8th of a teaspoon of a gluten-containing item, is enough to cause damage to the villi in a person with Celiac Disease even if the person does not detect any symptoms. To date, there is no cure for Celiac disease and there are no medicines to treat it. The ONLY treatment for Celiac Disease is to follow a strict, gluten-free diet for life.

Are these villi permanently damaged in someone with Celiac Disease and how long does it take for the villi to return to normal?

The villi are not permanently damaged. The intestine is an organ, which renews itself every three days. Therefore, if the damage is exclusively due to Celiac Disease, the villi will be reformed once on a gluten-free diet. The time for the villa to return to normal varies between individuals.


What are the symptoms of Celiac Disease?

There are over 300 symptoms of Celiac Disease, the most common of which are diarrhea, abdominal pain, bloating, fatigue, mouth sores, skin rash, anemia, osteoporosis, headaches, weight loss, or short stature.  Some people with Celiac Disease may be very sick while others may have no symptoms. A detailed infographic created by www.GlutenDude.com can be found at the bottom of this page, where you will find a list of possible Celiac Disease Symptoms.


And what are the symptoms in babies?

Babies who were introduced to wheat, barley or rye in the first 3 months had five times the risk of developing Celiac Disease over those exposed at 4 to 6 months. Symptoms in babies include muscle wasting in the arms and legs, bloated tummy, irritability and failure to gain weight or lose weight after previously growing fine.


Then what is Gluten Sensitivity/Intolerance?

Gluten Sensitivity is a general term that means someone feels sick when they eat gluten.  People who report Gluten Sensitivity may or may not have Celiac Disease. The difference between Celiac Disease and Gluten Intolerance is that the latter causes an inflammation, whilst the former causes damage.


Is Celiac Disease a food allergy?

Celiac Disease is not caused by food allergies. Food allergies, including wheat allergy, are conditions that people can grow out of.  This is not the case with Celiac Disease.  As stated previously, it is an autoimmune disease triggered by gluten.  A person is born with the Genes HLA-DQ2 and HLA-DQ8 that puts them at risk of developing Celiac Disease.  Some even have these genes and have nothing wrong.  If on the other hand, these genes are not present, it’s almost impossible for someone to ever have Celiac Disease.

The symptoms of wheat allergy may be similar to those of Celiac Disease, so it can be hard for someone to tell the difference without medical testing.  A consultation with an allergist may be helpful if you suspect you have wheat allergy.


How is Celiac Disease diagnosed?

A blood test can check for specific antibodies that are seen in Celiac Disease.  A positive Celiac Disease blood test is not enough to diagnose someone with Celiac Disease.  A biopsy to look for intestinal damage is needed before beginning a gluten-free diet to diagnose the disease.


Is it necessary to have an intestinal biopsy to confirm the diagnosis of celiac disease?

An intestinal biopsy is the gold standard for the diagnosis of Celiac Disease, and therefore is considered essential.


Why do I have to be eating gluten to be tested?

The blood tests look for antibodies that your body produces when you eat gluten so if you are not eating gluten you will not be producing antibodies and so the result will come back negative.  It is recommended that you eat some gluten in more than one meal every day for at least six weeks before testing.


Can you still be a Celiac even if tests prove negative?

A person can test negative for Celiac Disease but still get the disease later on in life when it might be “triggered” off after pregnancy, childbirth, viral infection, or severe emotional stress.


How is Lactose Intolerance related to Celiac Disease?

Lactose intolerance is frequently a side effect of Celiac Disease.  Celiacs can become Lactose Intolerant after the villi become damaged, and are no longer capable of catching and breaking down the lactose molecule. The problem usually disappears when Celiacs remove gluten from their diet, which allows the damaged villi to grow back, which may take from six months up to two years.


So what is and where do you find Gluten?

Gluten is a protein substance found in wheat, rye and barley.  You will find Gluten in most bread, pasta, breakfast cereal, and baking mixes. It may also be present in foods and beverages such as bouillon, candy, imitation meat or fish, soy sauce, soup, sauce, seasoned potato chips, seasoned rice mixes, malt vinegar, gravy, beer, flavored tea or flavored coffee.


If nearly everything contains Gluten, what can I eat?

It can be overwhelming to think of the foods you cannot eat on a gluten-free diet. But do not focus on what you cannot eat … just focus on what you can!  You will be amazed at the many foods that are naturally gluten-free and what you can create with them!

  • Fresh, fruits & vegetables
  • Fresh meat, poultry, fish, eggs, nuts, peas, and beans
  • Plain milk and cheeses
  • Varieties of Rice and certain grains (check these out under ‘Gluten Free Flours & Mixes’)

You can start out by trying out simple recipes at first. Then you can start experimenting with different  gluten free flours until you gain some confidence and you will soon see that it is not that different or that hard.  You can start now … just go to our recipe section and have a browse through.


What about oats, some say it is best not to eat them, is that true?

Many recent studies indicate that the protein found in oats may not be harmful to most people with Celiac Disease. However, there is concern that the oats may be contaminated with wheat during the milling and processing.  Check the labeling to ensure they are really gluten free.  Also, do consult your dietitian before adding oats to you or your child’s diet.


Does gluten-free food have to be prepared separately?

Yes, gluten-free foods should be prepared separately from regular foods. Cross-contamination can occur from something as simple as using the same utensils and can trigger a reaction from people with Celiac Disease.


Does everyone in the house need to eat gluten free?

Every family approaches this differently. It is not necessary for the entire family to eat gluten-free foods although it would make things easier. You have to be very careful for cross-contamination of gluten into gluten-free foods that can occur during food preparation.

Tips to avoid cross-contamination:

  • Store gluten-free foods in separate containers, especially butter/margarine, peanut butter, jelly and mayonnaise as dipping the knife back into the container after using on regular bread puts gluten into the whole container.
  • Wash all dishes and pots thoroughly that were previously used for gluten containing foods.
  • Use a separate toaster for gluten-free breads.
  • Use separate utensils if preparing gluten-containing and gluten-free foods at the same time, such as two pots of pasta.  A separate colander is necessary.
  • Gluten-free foods should be served in separate bowls, with clean utensils.


Is the gluten-free diet nutritionally adequate?

When making the change to a gluten free diet, it can be challenging to obtain adequate nutrition while not compromising on taste.  What makes it even more difficult is that many gluten free products on the market are low in nutrition and high in sugar and starches and inflammatory ingredients.  Research has indicated that individuals on a gluten free diet are prone to deficiencies in minerals, B vitamins and fibre.  Fortunately there is a wide selection of grains available that are gluten free and packed with nutrients! Your appointed dietician will be able to help and guide you.


What happens if I eat gluten by mistake?

The effect of eating gluten varies from person to person and may last from a few hours to a few days. Symptoms of eating gluten, or being ‘glutened’, include headaches, diarrhoea, stomach pains and lethargy.  The reaction is not the same as an allergic reaction and does not cause anaphylactic shock.


Surely a breadcrumb would not hurt me?

Cross-Contamination should be avoided at all costs as even just a bread crumb is enough to inflict intestinal damage on somebody who has Celiac Disease.


Should members of my family be tested too?

Genetically, there is a 10% incidence in first order relatives and 71% in identical twins. It is critical that they get tested for Celiac Disease, even if they are not experiencing any symptoms.


Since I am Celiac, can I still donate blood?

Yes, a person with Celiac Disease can donate blood.


Can I still drink wine, alcohol and beer?

Yes, wine is made from grapes, even rum, tequila and sake are safe as they do not come from toxic grains. Some Vodkas too, but please do your research before consuming brands.  Grain alcohols are one of those controversial products and so may be suspect, like whiskey, bourbon and gin as they are made with rye and barley. Conversely, beer is made from grains and cannot be consumed by a Celiac, even rice beers as they use malt.  However Gluten Free Beer in now available.


Can I still dine out at Restaurants?

When booking any restaurant, check with them whether they have a Gluten Free Menu.  Some establishments already cater for Celiacs.  However there are still many who do not offer this option and unfortunately a few who are not even aware about this Disease.  In this case, the best thing would be to pick very simple  dishes on their menu which look safe.  When ordering, do explain to your server that you are Celiac which means you cannot eat any wheat at all and you have to be careful about cross contamination.  You need to also ask questions about how your food will be prepared.  Always avoid dishes with any sauces or anything that might be fried like french fries as they might be coated in flour to make them crispier or fried in contaminated oil.  Never assume, always ask. 










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