Celiac disease (CD) is not food allergy. Rather, it is a disease of the digestive system that results in damage to the small intestine by interfering with the absorption of nutrients. CD is unique in that one specific food component, gluten, has been identified as the main culprit. Gluten is the common name for proteins in specific grains that are harmful to persons with CD. These proteins are found in all forms of wheat (including durum, semolina, spelt, kamut, einkorn, and faro), and related grains, rye, barley, and tritcale. Damage to the surface of the small intestine is caused by an immunologically toxic reaction to the ingestion of gluten.
CD is often confused with food allergy because so many of the grains and wheats that can cause food allergies are the same ones that cause CD. A common symptom and side-effect of CD is Dermatitis Herpetiformis (DH), a severe, itchy skin rash (not a skin allergy) of small dark spots that develop in CD patients on their hands, arms and legs.
CD is genetically passed down from generation to generation. It is estimated that up to 1 in every 133 persons in the U.S. is affected. Family members can be tested for CD even if symptoms are not apparent. Patients with IgA deficiency should consult with an experienced pathologist to ensure proper diagnosis.
The only treatment for CD is life-long avoidance of foods with gluten. When gluten is removed from the diet, the small intestine will start to heal and overall health improved. Medication is normally not required. Consult your physician regarding specific nutritional supplementation to correct any deficiencies.
All patients should be monitored by their physician to ensure compliance with, and response to the gluten-free diet. Dietary compliance decreases the likelihood of osteoporosis, lymphoma and other associated illnesses.
Adapting to the gluten-free diet requires some lifestyle changes. It is crucial to read labels which are often imprecise, and learn to identify ingredients that may contain hidden gluten.
Be aware that hidden gluten can be found in some unlikely foods such as: cold cuts, soups, hard candies, soy sauce, many low or non-fat products, even licorice and jelly beans.
Common foods with gluten are:
- Brown rice syrup (frequently made from barley)
- Caramel color (infrequently made from barley)
- Dextrin (usually corn, but may be derived from wheat)
- Flour or cereal products
- Malt or malt flavoring (usually made from barley; okay if made from corn)
- Malt vinegar
- Modified food starch (from unspecified or forbidden source)
- Soy sauce or soy sauce solids (many soy sauces contain wheat)
SOURCE: This information should not substitute for seeking responsible, professional medical care. First created 1995; fully updated 1998; most recently updated 2005.
© Asthma and Allergy Foundation of America (AAFA) Editorial Board