Celiac DiseaseCeliac Disease

Provided Courtesy of Nutrition411.com

Review Date 11/14G-0605

This presentation provides general information about celiac disease. Consult with your health care professional if you have any questions or for additional information, because each case is unique.

• Characterized by four factors:– Genetic susceptibility– Exposure to gluten– Environmental “trigger”– Autoimmune response

What Is Celiac Disease?

• No classic profile for celiac disease exists, unlike hypertension, cancer, or other diseases that have biomarkers•Often mistaken for Crohn’s disease, parasites, skin disorders, or other conditions• Trauma or stress may serve as the trigger

What Is Celiac Disease? (cont’d)

• Intestinal villi (tiny “hairs” that help with nutrient absorption) are damaged by an inflammatory response to gluten•Malabsorption of nutrients results• Intestinal walls are more porous

Result of Celiac Disease

• Diarrhea• Stools that float because they contain unabsorbed fat•Weight loss• Fatigue• Anemia

Symptoms

• Vomiting• Poor appetite• Dermatitis herpetiformis (itchy skin rash)

Symptoms (cont’d)

• Serum antibody tests:– Dietary changes alter results, so schedule

evaluation before gluten is eliminated from the diet

• Biopsy of lining of intestine to confirm diagnosis

Diagnosis

• Iron deficiency anemia •Osteoporosis • Vitamin K deficiency associated with risk for hemorrhaging • Vitamin and mineral deficiencies • Central and peripheral nervous system disorders, usually because of unsuspected nutrient deficiencies

Associated Conditions

• Pancreatic insufficiency• Intestinal and other gastrointestinal (GI) cancers• Lactose intolerance• Neurological manifestations

Associated Conditions (cont’d)

• Vitamins A, D, E, and K• Vitamin B12

• Folate• Iron•Most severe for children—may result in failure to thrive

Malnutrition

•Osteomalacia, rickets, and kidney stones• Secondary lactose intolerance (usually reversible)

Calcium and Vitamin D

• Intestinal lymphoma and bowel cancer, if gluten-free diet is not followed• Seizures and peripheral neuropathy often manifest

Additional Medical Consequences

• Avoid ingesting gluten for a lifetime• See a registered dietitian (RD), registered dietitian nutritionist (RDN), or physician for vitamin supplementation recommendations•Once a gluten-free diet is implemented, absorption of all nutrients, vitamins, and minerals will return when GI tract is repaired

Treatment

• Grains—barley, wheat, triticale, rye, farina, graham, semolina, durum, bulgur, Kamut®, kasha, matzo meal, and spelt•Oats?– Many people with celiac disease have

celiac disease symptoms when they eat oats

– Possibly because many oats are processed on equipment that processes wheat

Ingredients to Avoid

• Reading labels and asking questions are the keys to successfully managing celiac disease

Living With a Gluten Restriction

• Bread • Cake• Cereal• Cookies• Crackers•Gravy

•Medication• Pasta• Pie• Sauce• Snack food

Read Labels Before Purchasing These Foods

•Gluten-containing cosmetics and skin care products are OK to use•Gluten-free toothpaste and mouthwash often are recommended, as are gluten-free lip products, because of ingestion• Some experts ask children to use gluten-free hand lotions, if they put their fingers in their mouth as a habit

Cosmetics

• Amaranth• Arrowroot• Buckwheat• Corn• Nut flours

• Potatoes•Quinoa• Rice• Tapioca

Choose

For a complete list of allowed foods, contact an RD or RDN. Call manufacturers if you have any questions about possible cross-contamination during processing or packaging.

•Meet with an RD or RDN at least annually• Remain diligent about checking ingredients and safe preparation methods

Managing Celiac Disease

• Vitamin and mineral supplementation?– Not necessary for general wellness if

individual with celiac disease is eating a healthful diet

– Supplementation of B vitamins, magnesium, and a few other vitamins and minerals still too questionable to make definitive recommendations

Managing Celiac Disease (cont’d)

• Seek reliable sources of information:– Nutrition411.com– Celiac Disease Foundation

(www.celiac.org)

Managing Celiac Disease (cont’d)

Decher N, Krenitsky JS. Medical nutrition therapy for lower gastrointestinal tract disorders. In: Mahan LK, Escott-Stump S, Raymond JL. Krause’s Food and the Nutrition Care Process. 13th ed. St Louis, MO: Elsevier Saunders; 2012:618-624.

Jonega JV. The Health Professional’s Guide to Food Allergies and Intolerances. Chicago IL: Academy of Nutrition and Dietetics; 2013.

References and Resources