Gluten-free answer for those with celiac disease
Q: My 40-year-old grandson has just been diagnosed with celiac disease after months of feeling poorly and being underweight. What’s next? Where can he go for guidance and what should he do?
Let’s begin with the basics: Celiac disease is an inflammatory reaction within the small intestine. The reaction is caused by gluten, a protein found in wheat, rye, spelt and barley, and occurs in people genetically prone to the disease.
In years past, celiac disease was diagnosed only in people with the classic, or severe, form of the disease, which damages the fingerlike projections of the small intestine that help absorb nutrients. When those projections are damaged, the body is unable to absorb fats, leading to increased abdominal gas; stools that are bulky, foulsmelling and float; and poor absorption of vitamins and nutrients.
Your grandson probably suffered for months prior to his diagnosis because his symptoms were mild. In less-debilitating forms of the illness, symptoms can be either misdiagnosed or not severe enough to push someone to seek medical attention.
Regardless of severity, however, celiac disease can be addressed. The cornerstone of treatment is removing gluten from the diet. That means avoiding wheat, rye and barley, which are in a surprising number of foods — not just breads, pastas, crackers and snacks, but also sauces, vinegars, salad dressings, marinades, seasonings, soup stocks, soy sauces, and even beers, ales and lagers. For that reason, anyone with celiac disease should carefully read the labels of all prepared foods and condiments that they consume.
On the plus side, many condiments and beers are increasingly available without gluten, as are breads and pastas. The latter foods are made with quinoa, tapioca, rice, soybeans or buckwheat, all of which are safe to eat.
In 70 percent of patients with celiac disease, following a gluten-free diet leads to a reduction in symptoms within two weeks, and levels of inflammatory antibodies decline substantially after six weeks.
Among people who continue to have symptoms, 90 percent either don’t adhere properly to a gluten-free diet, or they consume foods they mistakenly believe are gluten-free. For those who are strict about a glutenfree diet but still have severe symptoms, oral steroids or other medications to suppress the immune system can relieve symptoms.
Your grandson is probably already seeing a gastroenterologist who is monitoring his symptoms and evaluating him for nutritional deficiencies, but he also should consult a nutritionist to review the types of foods and drinks he is consuming. With a glutenfree diet, he should be feeling better soon.
is written by Robert Ashley, M.D., Eve GlAzier, M.D., And ElizAbeth Ko, M.D. Send questions to Askthedoctors@ mednet.uclA.edu, or write: Ask the Doctors, c/o MediA RelAtions, UCLA HeAlth, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.