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                     The Celiac ActionLine, Fact Sheet

    What Is Celiac Disease?

    This disorder can be called  celiac disease, celiac sprue,  coeliac
    disease, or  gluten  sensitive  enteropathy.    Previously  it  was
    incorrectly thought of as a childhood disease.

    The small  intestinal  lining  of persons  with  this  disorder  is
    damaged by a protein fraction of gluten called gliadin.  Gliadin is
    present in wheat, oats, rye, and barley.  Since the function of the
    small intestine is  digestion and absorption  of nutrients,  water,
    and bile salts,  damage can have  far-reaching effects.   Follow-up
    with hundreds  of  patients  indicate that  healing  of  the  small
    intestine will  only  occur when  the  offending grains  have  been
    removed from the diet.  Additional grains which may cause  problems
    include soy.

    Celiac disease is an inherited  illness with the genes  responsible
    for it being present throughout life.  The onset of the disease has
    no age  restriction  but  there  are  many  hypotheses  related  to
    possible causative factors.  In some adults, symptoms leading to  a
    diagnosis of  Celiac disease  have been  observed to  appear  after
    severe emotional  stress, a  pregnancy, an  operation, or  a  viral
    infection.

    Other related  immune system  disorders  and sequela  to  long-term
    malabsorption may  be present.   Two  of  the most  common  related
    immune disorders seen in those with celiac disease are the  gluten-
    sensitive  skin  disorder  dermatitis  herpetiformis  and   insulin
    dependent diabetes  mellitus (type  I),   Other  related  disorders
    include:  Grave's  Disease, Addison  Disease, Scleroderma;  Chronic
    Active Hepatitis, Myasthenia Gravis; Systemic Lupus  Erythematosus,
    Sjogren's Syndrome.

    If  left   untreated,   the  disease   can   be   life-threatening.
    Malabsorption, osteoporosis, central and peripheral nervous  system
    disease, pancreatic disease, internal hemorrhaging, organ disorders
    (gall bladder, liver, and spleen), and gynecological disorders  are
    a few of the common maladies.  The risk of certain types of  cancer
    is fifty to seventy times greater for an untreated celiac than  for
    the normal population.

    How is Celiac Disease Diagnosed?

    Celiac disease can only be diagnosed by a biopsy of the jejunum  of
    the small  intestine.    Additionally, there  must  be  a  clinical
    response to the gluten-free diet.

    Treatment

    There is no cure  for celiac disease.   A celiac  must adhere to  a
    very strict diet.   There are no drugs  that can reduce or  prevent
    the damage to  the villi, although  steroids may  be prescribed  to
    establish initial control.

    The gluten-free diet is simple -  - removal of all forms of  wheat,
    rye, oats, barley, and  oats from the diet.   However, the diet  is
    complicated by modern food technology.  In the American diet hidden
    forms of these grains appear in the most unlikely foods.

    A celiac  must  become a  label  sleuth  and read  every  food  and
    pharmaceutical label for obvious and hidden sources of gluten.

    Some of the common hidden sources of gluten are labeled as:

      hydrolyzed vegetable protein (HVP)
      texturized vegetable protein (TVP)
      hydrolyzed plant protein (HPP)
      natural flavoring, (grain) vinegars, fillers, malt, modified
      food starch, starch, gum, alcohol, mono & diglycerides,
      maltodextrin, caramel, and most soy sauces.

    With appropriate substitutions, the  diet can be quite  acceptable.
    Combinations of rice, corn, soy, potato, tapioca flours are used to
    make gourmet breads, cakes, cookies, pastas and pizzas.

    Inadvertent reintroduction of gluten into the diet of a celiac will
    destroy the villi and the previous  conditions will return.   After
    removal of offending  items from the diet, the villi will return to
    normal and  within one  to two  weeks the  body will  rebuild  it's
    stores of essential minerals and nutrients.

    Support Groups

    The life of  a celiac is  enhanced through attendance  at a  celiac
    support group  meeting.   Meetings  are  designed to  increase  the
    celiac's quality of life through a series of programs of awareness,
    education, and advocacy.

    Support groups play  the important  role of  helping identify  what
    foods are free from  gluten, how to  adjust recipes, and  continual
    updates on where to locate foods  that are free from the  offending
    grains.