Celiac Disease

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Provided Courtesy of Nutrition411.com
Celiac Disease
Review Date 3/14 G-0605
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• 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.

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What is Celiac Disease?

• Characterized by four factors
• Genetic susceptibility
• Exposure to gluten
• Environmental trigger
• Autoimmune response

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What is Celiac Disease? (contd)

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

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Result of Celiac Disease

• 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

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Symptoms

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

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Symptoms (contd)

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

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Diagnosis

• Serum antibody test
• Dietary changes alter results, so schedule
  evaluation before gluten is eliminated from the
  diet
• Biopsy of lining of intestine to confirm
  diagnosis

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Associated Conditions

• 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

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Associated Conditions (contd)

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

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Malnutrition

• Vitamins A, D, E, and K
• Vitamin B12
• Folate
• Iron
• Most severe for childrenmay result in failure to
  thrive

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Calcium and Vitamin D

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

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Additional Medical Consequences

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

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Treatment

• Avoid ingesting gluten for a lifetime
• See a registered dietitian, registered dietitian
  nutritionist, 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

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Ingredients to Avoid

• Grainsbarley, 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

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Living With a Gluten Restriction

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

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Read Labels Before Purchasing These Foods

• Medications
• Pasta
• Pies
• Sauces
• Snack foods

• Bread
• Cakes
• Cereals
• Cookies
• Crackers
• Gravies

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Cosmetics

• Gluten-containing cosmetics and skin care
  products are OK to use
• Gluten-free toothpastes and mouthwashes often are
  recommended, as are 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

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Choose

• Quinoa
• Potatoes
• Rice
• Tapioca

• Amaranth
• Arrowroot
• Buckwheat
• Corn
• Nut flours

For a complete list of allowed foods, contact a
registered dietitian or registered dietitian
nutritionist. Call manufacturers if you have any
questions about possible cross-contamination
during processing or packaging.
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Managing Celiac Disease

• Meet with a registered dietitian or registered
  dietitian nutritionist at least annually
• Remain diligent about checking ingredients and
  safe preparation methods

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Managing Celiac Disease (contd)

• Vitamin and mineral supplementation?
• Not necessary for general wellness if celiac
  disease patient is eating a healthful diet
• Supplementation of B vitamins, magnesium, and a
  few others still too questionable to make
  definitive recommendations

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Managing Celiac Disease (contd)

• Seek reliable sources of information
• Nutrition411.com
• Celiac Disease Foundation (www.celiac.org)

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References and Resources

• Decher N, Krenitsky JS. Medical nutrition therapy
  for lower gastrointestinal tract disorders. In
  Mahan LK, Escott-Stump S, Raymond JL. Krauses
  Food and the Nutrition Care Process. 13th ed. St
  Louis, MO Elsevier Saunders 2012618-624.
• Jonega JV. The Health Professionals Guide to
  Food Allergies and Intolerances. Chicago IL
  Academy of Nutrition and Dietetics 2013.