What is Celiac Sprue (Gluten Sensitivity)?Celiac sprue, or gluten-sensitive enteropathy, is an auto-immune disease of the intestines, which is caused by gluten, a protein found in various cereal grains. Therefore, a person with celiac disease should follow a gluten-free diet.
Where is Gluten Found?The principle sources of gluten in the diet include wheat, rye, and barley. Oats may be tolerated in small amounts by some patients with celiac sprue, although those with severe disease typically do not.
Dairy foods may not be tolerated when someone with celiac disease has active symptoms, since lactose intolerance frequently develops. However, this is due to the lactose sugar in the dairy foods, rather than the proteins, which can cause milk allergy.
What Common Foods are Gluten-Free?Foods such as soybean flour, tapioca flour, rice, corn, buckwheat and potatoes are usually safe for people with celiac disease. See below for more information regarding a gluten-free diet.
Why Follow a Gluten Free Diet?
- Even if there are no obvious symptoms, celiac sprue can cause serious vitamin and nutritional deficiencies, since the intestines may not be able to absorb important nutrients if gluten is being eaten.
- Rates of certain cancers of the gastrointestinal tract are much higher in people with celiac sprue, and there is evidence that this risk is decreased with a gluten-free diet.
- People with active celiac disease are at increased risk for other auto-immune conditions, (such as diabetes mellitus type 1, Graves’ disease and Hashimoto’s thyroiditis) especially those with continued gluten exposure.
- Mothers with untreated celiac disease are at increased risk for having a low birth weight baby.
How to Follow a Gluten-Free Diet?First, reading all labels on prepared foods is important. Do not eat any foods that contain the following:
- Hydrolyzed vegetable protein
- Flour or cereal products
- Vegetable protein
- Malt and malt flavorings
- Starches (unless specified as corn starch, which does not contain gluten)
- Various flavorings, which can be derived from cereals containing gluten
- Vegetable gum
- Emulsifiers, stabilizers derived from cereals containing gluten
Next, especially when eating at a restaurant, avoid the following:
- Breaded foods
- Creamed foods
- Meatloaf and gravies
The following are good choices for a gluten-free diet:
- Broiled or roasted meats (beef, poultry, fish)
- Plain vegetables
- Plain salads
- Potatoes (white, sweet, yams)
- Breads and baked goods made from alternative flours (rice, soy, tapioca, arrowroot, potato)
- Breakfast cereals containing only rice, corn, grits or hominy (Such as puffed rice). Some people with celiac disease may tolerate oats as well.
Are There Other Recommendations Regarding Nutrition?It is a good idea to see a dietician or nutritionist on a regular basis to ensure that your gluten-free diet is well balanced and meeting nutritional needs. Your doctor may also prescribe various vitamin supplements to make up for any nutritional deficiencies.
Since bone loss is a common problem in people with celiac sprue (due in part to vitamin D deficiency), frequent monitoring with bone density scans is recommended.
Consider buying a cookbook with gluten-free recipe ideas, and visit various sites specializes in the support of people with celiac disease:
- 1. Lakness J. Allergy Elimination Diets. In: Lawlor GJ, Fischer TJ, Adelman DC, eds. Manual of Allergy and Immunology. 3rd ed. Boston: Little, Brown and Co;1995:553-55.
- 2. Ciclitira PJ. Management of Celiac Disease. UpToDate. Available at www.uptodate.com. Accessed February 8, 2005.
DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.