CELIAC INFORMATION

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A Summary of Celiac Disease and Gluten Intolerance by Scott Adams

• By Scott Adams
• Published 07/26/1996
• Celiac Disease

Scott Adams

In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed and living happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease, and since then it has become an invaluable resource to people worldwide who seek information about celiac disease and the gluten-free diet.


In 1998 I created The Gluten-Free Mall, Your Special Diet Superstore! which was also another Internet first—it was the first gluten-free food site to offer a shopping cart-style interface, and the ability for people to order gluten-free products manufactured by many different companies at a single Web site.

View all articles by Scott Adams

Celiac disease, also known as gluten intolerance, is a genetic disorder that affects at least 1 in 133¹ Americans. Symptoms of celiac disease can range from the classic features, such as diarrhea, weight loss, and malnutrition, to latent symptoms such as isolated nutrient deficiencies but no gastrointestinal symptoms. The disease mostly affects people of European (especially Northern European) descent, but recent studies show that it also affects Hispanic, Black and Asian populations as well¹. Those affected suffer damage to the villi (shortening and villous flattening) in the lamina propria and crypt regions of their intestines when they eat specific food-grain antigens (toxic amino acid sequences) that are found in wheat, rye, and barley³. Oats have traditionally been considered to be toxic to celiacs, but recent scientific studies have shown otherwise. This research is ongoing, however, and it may be too early to draw solid conclusions.

Because of the broad range of symptoms celiac disease presents, it can be difficult to diagnose. The symptoms can range from mild weakness, bone pain, and aphthous stomatitis to chronic diarrhea, abdominal bloating, and progressive weight loss.³ If a person with the disorder continues to eat gluten, studies have shown that he or she will increase their chances of gastrointestinal cancer by a factor of 40 to 100 times that of the normal population⁴. Further, gastrointestinal carcinoma or lymphoma develops in up to 15 percent of patients with untreated or refractory celiac disease³. It is therefore imperative that the disease is quickly and properly diagnosed so it can be treated as soon as possible.

Based on the figure mentioned above we can extrapolate the total number of people in the United States with celiac disease: 2.18 million (based on the total population: 290,356,028⁵). It is very important that doctors understand just how many people have this disease so that routine testing for it is done to bring the diagnosis rate in line with the diseases epidemiology. Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis.

The only acceptable treatment for celiac disease is strict adherence to a 100% gluten-free diet for life. An adherence to a gluten-free diet can prevent almost all complications caused by the disease³. A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. This site is designed to help people with celiac disease get diagnosed, and make life easier after their diagnosis. Those who are interested can read the story of my diagnosis.

1. Alessio Fasano, MD, et. al., Arch Intern Med. 2003;163:286-292.
2. Gastroenterology, April, 1996 First Epidemiological Study of Gluten Intolerance in the United States. By Karoly Horvath, MD, Ph.D., et. al..
3. New England Journal of Medicine, May 2, 1996 -- Volume 334, Number 18, The Many Faces of Celiac Disease by Charles H. Halsted, MD
4. Goggins, et. al. Celiac Disease and Other Nutrient Related Injuries to the Gastrointestinal Tract The American Journal of Gastroenterology. Vol. 89, No. 8, pages S2 - S13, 1994.
5. United States Census Bureau, February 27, 2003.

Information on this site has been compiled from a variety of sources, including medical journals, books, doctors, scientists and the Celiac Listserv News Group. I would like to especially thank the latter for providing an invaluable source information for celiacs, doctors and researchers.




NATIONAL DIGESTIVE DISEASES INFORMATION CLEARINGHOUSE(NDDIC)

This website has information and answers to the many questions about celiac disease.

What is celiac disease?

What are the symptoms of celiac disease?

Why are celiac disease symptoms so varied?

What other health problems do people with celiac disease have?

How common is celiac disease?

How is celiac disease diagnosed?

How is celiac disease treated?

The Gluten-free Diet: Some Examples

Points to Remember

Hope through Research

For More Information

CANADIAN CELIAC ASSOCIATION

This website has extensive information about celiac disease and links to more education.
Following is an example of some of the information on the website.

In The Kitchen

How to Adapt Recipes
Some of the guidelines for gluten-free cooking are:

1. Focus only on the items in the recipe that need to be adapted. Choose a recipe with very little flour or gluten-containing items. Sometimes the flour can be omitted. (Breading or flouring meats can easily be omitted for most recipes.) Concentrate on the major flavours. Serve simple fruit and vegetables while gaining skills. Think "omit" or "substitute" while reviewing a recipe. Perhaps mark problem ingredients in a recipe.
2. Avoid recipes that rely on convenience foods. Go back to the "from scratch" recipes the convenience food replaces. Learn to make the basic sauces and gravies often used in casseroles and soups.
3. Look in a gluten-free cookbook for a similar recipe. Compare proportions, they are the key. Flour and other ingredients that act as thickeners are compared to the amount of liquids in the recipe. Keep proportions nearly the same for your recipe. Given the same amount of liquid, it takes less starch to thicken than flour (cornstarch vs. corn flour).
4. Use commercial or home-made gluten-free substitutes. For example, gluten-free macaroni, bread and corn tortillas.
5. Don't make anything more complicated than it already is. But do take family health concerns, likes, dislikes and food dollars available into consideration.
6. Before you begin baking, read about the unique taste and texture properties of each flour and starch alternatives
7. a combination of gluten-free flours and starches makes a better product than single flours. A variety of gluten-free all-purpose baking flour mixes can be substituted for wheat flour and are available form many gluten-free companies.

From Science Daily Genetic Connections of Celiac Disease & Crohn's Disease