In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease, and since then it has become an invaluable resource to people worldwide who seek information about celiac disease and the gluten-free diet.
In 1998 I created The Gluten-Free Mall, Your Special Diet Superstore! which was also another Internet first—it was the first gluten-free food site to offer a shopping cart-style interface, and the ability for people to order gluten-free products manufactured by many different companies at a single Web site.
I am also co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.
Avoiding gluten is crucial
A life-long diet free of gluten is the standard treatment for celiac disease. To manage the disease and prevent complications, its essential to avoid all foods that contain gluten. That means it is crucial to:
- Avoid all foods made with wheat, rye, or barley. Including types of wheat like durum, farina, graham flour, and semolina. Also, bulgur, kamut, kasha, matzo meal, spelt and triticale. Examples of products that commonly contain these include breads, breading, batter, cereals, cooking and baking mixes, pasta, crackers, cookies, cakes, pies and gravies, among others.
- Avoid oats, at least during initial treatment stages, as the effects of oats on celiac patients are not fully understood, and contamination with wheat in processing is common. So, its best to eliminate oats at least until symptoms subside and their reintroduction into the diet can be fairly monitored and evaluated.
- Avoid processed foods that may contain hidden gluten. Wheat is commonly
used in many processed foods that one might never suspect. A few examples
include:
- candy bars
- canned soup
- canned meat
- energy bars
- ketchup
- ice cream
- instant coffee
- lunch meat
- mustard
- pastas
- processed meat
- sausages
- Avoid capsules and tablets that contain wheat starch, which is a common used binding agent in their production. Gluten is also commonly found in many vitamins and cosmetics, such as lipstick.
- Avoid beer (wine, brandy, whiskey and other non-wheat or barley alcohols are okay).
- Eat a diet rich in fish, fresh meats, rice, corn, soybean, potato, poultry, fruits and vegetables.
- Avoid milk and other dairy products, as it is common for patients with untreated celiac disease to be lactose intolerant. Successful treatment often means dairy products can be slowly reintroduced into the diet over time.
- Identify gluten-free foods. Because a gluten-free diet needs to be strictly followed, and because food ingredients may vary from place to place and even over time for a given product, it is important to always read the label. Consider purchasing commercial listings of gluten-free foods and products. For specific advice on adopting, shaping and maintaining the gluten-free diet that is right for you, you may wish to consult a registered dietitian who is experienced in teaching the gluten-free diet.
- Always read labels, as ingredients often change over time and products that that were once gluten-free may be reformulated and now include gluten in some form. Products that are gluten-free in one country are sometimes not gluten-free in another.
Most patients who remove gluten from their diets find that their symptoms improve as inflammation of the small intestine begins to subside, usually within several weeks. Many patients who adopt a gluten-free diet report an improvement within 48 hours.
Results of a gluten-free diet can be especially dramatic in children with celiac disease. Not only does their diarrhea and abdominal distress usually subside but, frequently, their behavior and growth rate are often markedly improved.
A reappearance of intestinal villi nearly always follows an improvement in symptoms.
In younger people, the villi may complete healing and regrowth in several months, while in older people, the process may take as long as two to three years.
In cases where nutritional deficiencies are severe, celiac patients may require vitamin and mineral supplements to help bring about a healthier vitamin profile: folic acid and B12 for patients with anemia due to folate or B12 deficiency; vitamin K for patients with an abnormal ProTime; calcium and vitamin D supplements for patients with low blood calcium levels or with osteoporosis. For all such cases, individuals should consult their health professional.
Skin lesions common in patients with dermatitis herpetiformis often improve with adherence to a gluten-free diet.
For patients with celiac disease, the importance of maintaining a life-long diet free of gluten can hardly be over-stressed. Research indicates that only half of those patients who have had celiac disease for at least 20 years were following a strict gluten-free diet. Up to 30% of those patients showed evidence of bone loss and iron deficiency. These are but a few of the long-term consequences for celiac patients failing to follow a gluten-free diet.
health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.