Go gluten-free to relieve celiac disease
DEAR DOCTOR: My 40-year-old grandson has just been diagnosed with celiac disease after months of feeling poorly and being underweight. What’s next?
DEAR READER: 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. Symptoms vary depending upon the extent of inflammation.
In years past, celiac disease was diagnosed only in people with the classic, or severe, form of the disease, which damages the finger-like 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, foul-smelling and float; and poor absorption of vitamins and nutrients. The ultimate result can be anemia, weight loss, nerve dysfunction and osteoporosis. Today, we’ve realized that the prevalence of celiac disease is much greater
than initially thought because many patients have milder symptoms, such as fatigue and generally loose stools.
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.
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 fact, over the past 20 years, a whole industry has developed to cater to people who are intolerant to gluten, and many restaurants now provide gluten-free options as well.
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.