Coeliac Disease or Celiac Disease explained, what to eat and some things to look out for, including food labels.
These two names are both used to describe the same illness. Which is used tends to vary from country to country and person to person.
It is generally believed that Coeliac is the correct name, but it is pronounced Celiac, but do not worry which you use, everyone will understand you.
Celiac is not a food allergy, or intolerance. It is an autoimmune disease, (sometimes called a digestive disease), involving the small intestine and it limits the bodies ability to absorb nutrients from food. It is principally a gluten intolerance, even if that is not the medical term.
If a Celiac eats gluten their body responds badly, and does damage to “Villi”. (Villi are like little sticks in the small intestine through which nutrients from food pass into the bloodstream.) If your Villi are not working properly, your body will lack essential nutrients and you risk becoming under-nourished. If you are Celiac your immune system will also have a reaction to gluten that is not normal, and this may cause other health issues.
Celiac disease is genetic, but can also start after pregnancy, an infection or stress.
What is gluten?
Gluten is a protein in wheat, rye, and barley.
Gluten is not a substance the body needs and it provides no necessary nutrients. Leaving gluten out of your diet does absolutely no harm. In fact a gluten free diet would benefit everyone.
The problem arises from the fiber, vitamins, and minerals provided by grain, as these need to be found in other food stuffs to ensure your bodies needs are met. This can be provided by quinoa, millet, and rice, as an example.
Symptoms of Celiac disease
Like any illness, the symptoms of Celiac disease vary in different people, but some common ones are;
- abdominal bloating and pain
- chronic diarrhea or constipation
- unexplained weight loss
While the above symptoms are usually strong in children, they can be less obvious in adults. Here are some more possible indicators of Celiac disease in adults;
- arthritis or pain in the bones or joints, even osteoporosis
- tingling or numbness in hands and feet
- unexplained fatigue, depression or anxiety
- an itchy skin rash
- sores inside the mouth
Having none of these symptoms, does not mean you are not a Celiac, just as having all of them, does not mean you are. Not everyone who suffers from Celiac disease have obvious indicators, so if in doubt, ask your doctor to run some simple blood tests. (If you are having tests done it is important to keep eating gluten before the tests, as your reaction to this substance is measured.)
The longer the disease is left untreated the more risk of, “hard to get rid of complications”.
Treatment of Celiac disease
The only treatment for this disease is a gluten free diet. This means learning to recognize “hidden gluten”, (as mentioned below), as well as the obvious sources.
Following this diet will not only stop the symptoms, but also allow the body to heal the damage done during the time when gluten was consumed.
If benefits do not happen on a gluten free diet, this means “hidden gluten” is still being consumed and you need to take a more careful look at your diet.
Substitutes for foods containing gluten
There are many types of gluten free bread, biscuits and cakes, as well as pasta and just about every food stuff containing gluten. Buying potato, rice, soy or bean flour instead of wheat flour, and making your own cookies, bread, pizzas etc. is another alternative – and is healthier on all levels.
Food Labeling for people with Celiac disease
How food labeling works, or doesn’t, could be a big problem for Celiac sufferers. The rules governing how foods are labeled are not as clear as they could be.
The international standards for food labeling does not apply to, "foods which in their normal form do not contain gluten".
This means that a product like ice-cream, which is principally made from dairy products, could say “gluten free”, as milk does not normally contain gluten. However, a stabilizing agent used in the preparation of ice-cream often does. This means ice-cream could contain gluten, but not say this on the label. This “hidden” gluten is a big problem for Celiac. It can also be found in some ketchup, gravy, salad cream, meat seasoning and many other products.
Remember the words “gluten free” on a label need only refer to foods which normally contain gluten and not to others.
Things many people do not think of;
- If a product is safe for a Celiac to eat in the “normal” size, it is not necessarily so in a lager or smaller size. Some manufacturers change their ingredients slightly in different sized products.
- Make sure food handlers change their gloves before serving you, as they may have touched a product containing gluten bifore serving you.
- Some sweet or candy manufacturers use flour to stop sweets sticking to the conveyor belt.
- Watch out for medicines, vitamins, and lip balms, lipstick, as these may contain gluten.
Foods to aviod if you are a Celiac:
Bear in mind, things may have different names, one example of this is pasta, normally made from wheat, this is sometimes called “Durham Pasta”, but Durham is a type of wheat.
Make a list of everyday foods containing gluten, but remember, there are many alternatives to buy that are gluten free. You can also buy gluten free flour and make your own bread and biscuits. There is no need to live without these products.
Apart from the usual list of wheat, barley and rye and all their derivatives, there are some other food stuffs to look out for.
Wheat – therefore most bread and bread rolls, rye bread and pumpernickel bread, crisp breads, scones, pancakes, pizza, some noodles etc.
Flour – therefore cakes, pastry or pie crust, muffins, biscuits or cookies etc. Also crumble toppings, sponge puddings, cakes.
Pasta - macaroni, spaghetti, lasagna etc. (there are many varieties of gluten free pasta available to buy)
Yorkshire pudding, Stuffing,
Pretzels, Couscous, Any food in breadcrumbs, bread crumbed ham
Barley water drinks, Malted drinks.
Muesli, most breakfast cereals, (there are gluten free cereals to buy), All Bran
Malt – malt extract as an additive, malt vinegar and malt or barley drinks.
Bran, whole-meal flour and semolina.
Hydrolyzed Wheat Gluten, Hydrolyzed Wheat Starch, Textured Vegetable Protein, thickening, rusk or spelt.
Foods you need to be careful of;
Each make differs and some of these may contain gluten while others don’t. Check with the manufacturer. Manufacturers change ingredients and method, so what was safe last month may not be safe next month, so check.
Beer - Artificial Color - Suet - Alcohol and Spirits - baking powder - Emulsifiers - Edible Coatings - Caramel Color - Dry Roasted Nuts - Caramel Flavoring - Flavoring - Dextrins - Clarifying Agents - Gravy - Dextrimaltose - Coloring - Non-dairy Creamer - Glucose Syrup - Ground Spices - Modified Starch - Hydrolyzed Protein - Vegetable Protein - Seasonings - Natural Flavouring - Soy Sauce - Stabilizers - Natural Flavours - vitamins - Vegetable Broth - Vegetable Starch - Stock Cubes - Starch
Gluten free foods
Apart from the expected meat, fish, fruit and vegetables here are a few others;
Yeast - Black treacle or molasses - Jam - Cream of tartar - Popcorn (check coating) - Marmalade - Honey - Nuts - cheese (not cheese spreads) - Xanthan gum (replaces "elastic" quality of gluten) - Vegetable oils, sunflower oil, olive oil - Dried beans, peas and pulses - Tea (check herb teas first) - Rice, ground, long or short grain - Corn tacos - Cider vinegar - Golden syrup - Bicarbonate of soda - Tamari soy sauce - Rice flour - Jelly (jello) - Dried peppercorns - Rice cakes/crackers - Marmite (only from UK) - Wine vinegar - Millet - Corn Tortillas - Tapioca - ornflour (from maize) - Flax seed - Distilled vinegar - brown rice syrup - cold cuts, hot dogs, salami, sausage (check) - seasoned tortilla chips - Candy/sweets, (check) - sauces - chips/potato chips
Oats are generally thought to be gluten free, but, as they are usually contaminated with gluten from wheat, rye or barley, they are a risk to Celiacs. This contamination can happen either as they are growing – most farms grow multiple cereals and the wind can blow particles of one cereal onto another, or during processing – most machines process different types of cereals and particles of one type can be left behind to mix with another type.
Many medicines, both over-the-counter and prescription can contain gluten. Some form of starch is often added to give shape and fill out pills, tablets and capsules and this may be from wheat.
There is a “dot com” web site for checking which medicines are gluten free, (gluten free drugs), but this list is not complete, so do check with your pharmacist.
Research on Celiac disease is ongoing, both for diagnosing and treating. Experts are looking at a drug that will “detoxify the gluten” before it can enter the small intestine, but as yet there is nothing conclusive.
As with many allergies or food related problems, you are better relying on your own findings rather than trusting labels. Contact manufacturers or Celiac specialists, web sites or any trusted source before consuming – and check regularly in case of changes to production.
Do not be afraid of ridicule for asking about a dish on a menu or a staff member to change their gloves. This is your health.
A change in diet may be a bit difficult initially, but in the long term you will feel health benefits.
Photo courtesy of:MorgueFile