Celiac Disease (Celiac Sprue)

Celiac disease is an inherited autoimmune disease that causes the body's immune system to respond to the protein gluten by damaging the lining of the small intestine. Gluten is found in wheat, rye and barley and a few other grains.

The normal intestinal lining is covered with tiny, finger-like structures called villi that help the intestine absorb food. In celiac disease, the villi are flattened instead of being long and narrow, which decreases the intestine's ability to absorb nutrients. As a result, stomach pain and diarrhea may develop along with anemia, malnutrition, infertility, a certain skin rash and other health problems. It may also affect several other organ systems.

Celiac disease is also called celiac sprue, sprue, nontropical sprue and gluten-sensitive enteropathy.

Causes

The exact cause of celiac disease is unknown. Once thought rare, celiac disease recently has been estimated to affect one of every 133 Americans. However, only a small fraction of people living with celiac disease in the United States has been diagnosed at this time.

Those with a family member with celiac disease are at greater risk for developing the disease. The disorder is most common in Caucasians and those of European ancestry. The disease can develop at any point in life, from infancy to late adulthood.

Symptoms

The symptoms of celiac disease can vary significantly from person to person and include:

  • Slowed growth
  • Weight loss
  • Gas
  • Diarrhea (rarely, constipation)
  • Stomach pain
  • Feeling very tired or low mood
  • Irritability
  • A very itchy skin rash with blisters

Most people with celiac disease have one or more symptoms, but not all have digestive problems. Some people with the disease don't have any symptoms. Having one or more of these symptoms does not mean a person has celiac disease because many other disorders include these symptoms.

Exams and Tests

If your pediatric GI specialist thinks your child has celiac disease, he or she will probably do a blood test. People with celiac disease have higher than normal levels of certain antibodies in their blood. Antibodies are produced by the body in response to substances that the body thinks are a danger. If the blood work results show increased antibodies, your child's doctor will then perform an endoscopy procedure to get biopsies (tissue samples) of the intestine to prove the diagnosis. Your child will need to follow a regular diet that includes gluten before and during testing to ensure accurate results.

Since the disease runs in families, immediate family members of patients with celiac disease need to have blood tests done.

Treatment

The only treatment for celiac disease is to avoid eating foods that contain gluten. Even tiny amounts of gluten can damage the intestine. A dietitian can work with you to help you learn how to select gluten-free foods. You will learn to check labels of foods and other items for gluten. The small intestine will heal once gluten is eliminated from the diet, though celiac disease is a life-long condition.

What to Eat If You Have Celiac Disease

The following chart lists examples of foods you can eat and foods you should stay away from if you have celiac disease. This list is not complete. A dietitian can help you learn what other foods you can and can't eat when following a gluten-free diet.

Allowed Foods

Amaranth Potatoes
Arrowroot Quinoa
Buckwheat Rice
Cassava Sago
Corn Seeds
Flax Soy
Indian rice grass Sorghum
Job's tears Tapioca
Legumes Wild Rice
Millet Yucca
Nuts  

Foods to Avoid

Wheat Barley
  • Including einkorn, emmer, spelt, kamut, wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein

Rye

Triticale (a cross between wheat and rye)

Other Wheat Products to Avoid

Bromated flour Phosphated flour
Durum flour Plain flour
Enriched flour Self-rising flour
Farina Semolina
Graham flour White flour

Processed Foods that May Contain Wheat, Barley or Rye*

Bouillon cubes Matzo
Chips/potato chips Sauces
Candy Seasoned tortilla chips
Cold cuts, hot dogs, salami, sausage Self-basting turkey
Communion wafer Soups
French fries Soy sauce
Gravy Vegetables in sauce
Imitation fish  
* Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer.

From the following resource: Thompson T. Celiac Disease Nutrition Guide, 2nd ed. Chicago: American Dietetic Association; 2006. © American Dietetic Association. Adapted with permission. For a complete copy of the Celiac Disease Nutrition Guide, please visit eatright.org.

Points to Remember

  • People with celiac disease shouldn't eat foods or use items with gluten in them.
  • Celiac disease harms the small intestine.
  • People with untreated celiac disease can't get needed nutrients.
  • Without treatment, people with celiac disease can develop other health problems.
  • Celiac disease is diagnosed by blood tests and a biopsy of the small intestine.
  • A gluten-free diet should be followed for life.
  • A dietitian can help people choose the right foods.

For More Information

Celiac Disease Awareness Campaign
National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892–3570
Phone: 1.800.891.5389
Fax: 703.738.4929
Email: celiac@info.niddk.nih.gov
Internet: celiac.nih.gov

American Celiac Society
P.O. Box 23455
New Orleans, LA 70183–0455
Phone: 504.737.3293
Email: info@americanceliacsociety.org
Internet: americanceliacsociety.org

American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, IL 60606–6995
Phone: 1.800.877.1600
Email: knowledge@eatright.org
Internet: eatright.org

Celiac Disease Foundation
13251 Ventura Boulevard, #1
Studio City, CA 91604
Phone: 818.990.2354
Fax: 818.990.2379
Email: cdf@celiac.org
Internet: celiac.org

Celiac Sprue Association/USA Inc.
P.O. Box 31700
Omaha, NE 68131.0700
Phone: 1.877.CSA.4CSA (272.4272)
Fax: 402.558.1347
Email: celiacs@csaceliacs.org
Internet: csaceliacs.org

Gluten Intolerance Group of North America
31214 124th Avenue SE
Auburn, WA 98092
Phone: 253.833.6655
Fax: 253.833.6675
Email: info@gluten.net
Internet: gluten.net

National Foundation for Celiac Awareness
P.O. Box 544
Ambler, PA 19002
Phone: 215.325.1306
Email: info@celiaccentral.org
Internet: celiaccentral.org

Gluten-Free Indy Celiac Support Group
Internet: www.glutenfreeindy.com

 
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