Celiac disease

Overview

Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine. It's triggered when an affected person consumes gluten, a protein found in wheat, rye and barley, and the immune system responds by attacking and damaging the small intestine. This damage affects the absorption of nutrients in the gut.

Left undiagnosed and untreated, celiac disease can lead to the development of other autoimmune disorders, as well as osteoporosis, infertility, anemia, neurological conditions and, in rare cases, cancer.

Prevalence

Celiac disease affects at least 3 million Americans, or about 1 percent of the population. In people with symptoms linked to the condition, 1 in 56 will have it. For those with a first-degree relative (parent, child or sibling) with celiac disease, the prevalence is 1 in 22. For those with a second-degree relative (aunt, uncle or cousin) with celiac disease, it's 1 in 39.

Signs & symptoms

Celiac disease can cause a range of symptoms, including:

• Bloating and gas
• Diarrhea
• Constipation
• Fatigue
• Failure to thrive
• Anemia
• Weight loss
• Abdominal pain
• Itchy rash
• Tingling and numbness
• Pale mouth sores
• Joint pain
• Delayed growth
• Poor weight gain
• Thin bones
• Infertility
• Headaches
• Depression
• Irritability
• Discolored teeth

Treatment

The only treatment for celiac disease is to strictly follow a gluten-free diet for life. This entails avoiding the following foods:

• Wheat
• Barley
• Rye
• Durum*
• Einkorn*
• Farro*
• Kamut*
• Spelt*
• Triticale*

*Types of wheat

Patients and parents should be aware that there are many hidden sources of gluten in food. These include:

• Modified food starch
• Hydrolyzed vegetable protein
• Hydrolyzed plant protein
• Malt vinegar
• Soy sauce or soy sauce solids
• Brown rice syrup
• Dextrin
• Textured vegetable protein
• Vegetable gum
• Tapioca
• Potatoes
• Teff
• Cornmeal
• Polenta
• Amaranth
• Millet

Certain non-food items may also contain gluten, such as:

• Lipstick
• Certain vitamins
• Certain medications
• Stamp and envelope glue
• Play-Doh

Starchy foods that are safe to eat include:

• Quinoa
• Buckwheat
• Rice
• Corn
• Sorghum
• Millet
• Sweet potatoes
• Rice
• Gluten-free flours made of rice, soy, potato or nuts

Packaged foods that are labeled "gluten-free" are also safe to eat. A FAQ about gluten-free labeling is available on the FDA's website.

While at school, kids and staff should take appropriate precautions such as reading labels carefully, washing hands properly, avoiding cross contamination in the cafeteria or during food preparation, and washing desks and tables with appropriate chemicals and materials.