Celiac disease

Overview

Celiac disease is an inherited autoimmune disorder that affects the digestive process in the small intestine. When affected people eat gluten – a protein found in wheat, rye and barley – their immune system responds by attacking and damaging the small intestine. This damage affects the absorption of nutrients from the gut.

When undiagnosed and untreated, celiac disease can cause a number of health problems. These include nutritional deficiencies, headaches, mood changes, osteoporosis, infertility and anemia, as well as growth delays in children. Celiac can also lead to the development of other autoimmune disorders, neurological conditions and (in rare cases) certain cancers.

Prevalence

Celiac disease affects at least 3 million Americans, or about 1% of the population. In people with symptoms associated with the condition, testing will show 1 in 56 to have it. For those with a first-degree relative (parent, child or sibling) with celiac disease, the incidence is 1 in 22. For those with a second-degree relative (aunt, uncle or cousin) with celiac disease, it's 1 in 39.

Signs & symptoms

Celiac disease can cause a range of symptoms, including:

• Abdominal pain
• Anemia
• Bloating and gas
• Constipation
• Depression and irritability
• Diarrhea
• Discolored teeth
• Fatigue
• Failure to thrive, delayed growth or poor weight gain
• Headaches
• Infertility
• Itchy rash
• Joint pain
• Pale mouth sores
• Thin bones
• Tingling and numbness
• Weight loss

Treatment

The only treatment for celiac disease is strict, lifelong adherence to a gluten-free diet. This means avoiding the following foods:

• Wheat
• Barley
• Rye
• Durum*
• Einkorn*
• Farro*
• Khorasan wheat (Kamut)*
• Spelt*
• Triticale*

*Types of wheat

Starchy foods that are safe for people with celiac disease include:

• Amaranth
• Buckwheat
• Corn
• Cornmeal
• Gluten-free flours (which may be made with rice, soy, potato or nuts)
• Millet
• Polenta
• Potatoes
• Quinoa
• Rice
• Sorghum
• Sweet potatoes
• Tapioca
• Teff

Packaged foods labeled "gluten-free" are safe to eat. Find out more about gluten-free labeling from the U.S. Food and Drug Administration.

Parents – and kids able to understand – should be aware that many processed foods are hidden sources of gluten. When these ingredients are listed, the product may be contaminated with gluten. The ingredients include:

• Amaranth
• Brown rice syrup
• Cornmeal
• Dextrin
• Hydrolyzed plant protein
• Hydrolyzed vegetable protein
• Malt vinegar
• Millet
• Modified food starch
• Polenta
• Potatoes
• Soy sauce or soy sauce solids
• Tapioca
• Teff
• Textured vegetable protein
• Vegetable gum

Some of these ingredients are naturally free of gluten, but they still carry a risk of cross-contamination.

Some nonfood items also may contain gluten, such as:

• Certain vitamins
• Certain medications
• Lipstick
• Play-Doh
• Stamp and envelope glue

While at school, kids and staff should take appropriate precautions, such as reading labels carefully, washing hands properly, avoiding cross-contamination in the cafeteria or during food preparation, and washing desks and tables with appropriate substances.