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Celiac disease - nutritional considerations

Gluten-free diet; Gluten sensitive enteropathy - diet; Celiac sprue - diet

 

Celiac disease is an immune disorder passed down through families.

Gluten is a protein found in wheat, barley, rye, or sometimes oats. It may also be found in some medicines. When a person with celiac disease eats or drinks anything containing gluten, the immune system responds by damaging the lining of the intestinal tract. This affects the body's ability to absorb nutrients.

Carefully following a gluten-free diet helps prevent symptoms of the disease.

Food Sources

 

To follow a gluten-free diet means, you need to avoid all foods, drinks, and medicines made with gluten. This means not eating anything made with barley, rye, and wheat. All items made with all-purpose, white, or wheat flour are prohibited.

FOODS YOU CAN EAT

  • Beans
  • Cereals made without wheat or barley malt
  • Corn
  • Fruits and vegetables
  • Meat, poultry, and fish (not breaded or made with regular gravies)
  • Milk-based items
  • Gluten-free oats
  • Potatoes
  • Rice

Obvious sources of gluten include:

  • Breaded foods
  • Breads, bagels, croissants, buns
  • Cakes, donuts, and pies
  • Cereals (most)
  • Crackers and many snacks bought at the store, such as potato chips and tortilla chips
  • Gravy
  • Pancakes and waffles
  • Pasta and pizza
  • Soups (most)
  • Stuffing

Less obvious foods that must be eliminated include:

  • Beer
  • Candies (some)
  • Cold cuts, hot dogs, salami or sausage
  • Communion breads
  • Croutons
  • Marinades, sauces, soy and teriyaki sauces
  • Salad dressings (some)
  • Self-basting turkey

There is a risk for cross-contamination. Items that are naturally gluten-free may become contaminated if they are made on the same production line, or moved together in the same place, as foods containing gluten.

Eating at restaurants, work, school, and social gatherings can be challenging. Call ahead and plan. Due to the widespread use of wheat and barley in foods, it is important to read labels before buying food or eating.

Despite its challenges, maintaining a healthy, balanced diet is possible with education and planning.

 

Recommendations

 

Talk to a registered dietitian who specializes in celiac disease and the gluten-free diet to help you plan your diet.

You may also want to join a local support group. These groups can help people with celiac disease share practical advice on ingredients, baking, and ways to cope with this life-altering, lifelong disease.

Your doctor might have you take multivitamin and mineral or individual nutrient supplement to correct or prevent a deficiency.

 

 

References

Rubio-Tapia A, Hill ID, Kelly CP, et al. American College of Gastroenterology Guideline: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108:656-676. PMID: 23609613 www.ncbi.nlm.nih.gov/pubmed/23609613.

Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 140.

 
  • Celiac sprue - foods to avoid

    Celiac sprue - foods to avoid - illustration

    Celiac disease causes inflammation in the small intestine and damage in the lining. This prevents the body from properly absorbing the nutrients in food. The damage to the lining of the intestine comes from a reaction to eating gluten, which is found in wheat, rye, barley, and possibly oats, and in food made from these ingredients. The inability to absorb nutrients can lead to weight loss, fatigue, malnourishment, and other health problems. Gluten may be found in many foods, especially processed foods and baked goods. Breads, cakes, desserts, alcoholic beverages (except wine), cereals, and pastas may all contain gluten. Eating a gluten-free diet heals the intestines and prevents further damage.

    Celiac sprue - foods to avoid

    illustration

    • Celiac sprue - foods to avoid

      Celiac sprue - foods to avoid - illustration

      Celiac disease causes inflammation in the small intestine and damage in the lining. This prevents the body from properly absorbing the nutrients in food. The damage to the lining of the intestine comes from a reaction to eating gluten, which is found in wheat, rye, barley, and possibly oats, and in food made from these ingredients. The inability to absorb nutrients can lead to weight loss, fatigue, malnourishment, and other health problems. Gluten may be found in many foods, especially processed foods and baked goods. Breads, cakes, desserts, alcoholic beverages (except wine), cereals, and pastas may all contain gluten. Eating a gluten-free diet heals the intestines and prevents further damage.

      Celiac sprue - foods to avoid

      illustration

    A Closer Look

     

    Talking to your MD

     

      Self Care

       

        Tests for Celiac disease - nutritional considerations

         

           

          Review Date: 10/27/2015

          Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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