<<Disclaimer: Verify this information before applying it to your situation.>> 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.