The best possible diet plans for patients with Celiac Disease

People who have celiac disease cannot tolerate a protein called gluten, found in wheat, rye, and barley. Although gluten is mainly found in foods, it can also be found in other products we use every day such as stamps and envelope adhesive, medicines, and vitamins.

The big problem is that the decreased absorption of nutrients can cause vitamin deficiencies that can deprive a patient’s brain, peripheral nervous system, bones, liver and other organs of vital nourishment, which can lead to other illnesses. This disease is also called celiac sprue, nontropical sprue and gluten-sensitive enteropathy.

Mechanism and causes

The exact cause of celiac disease is unknown but the experts agree that it is often inherited. If someone in your immediate family has it, there is a 10 to 20 percent chance that you have it too. About 3 to 8 percent of people with type 1 diabetes will have biopsy-confirmed celiac disease as well as 5 to 10 percent of people with Down syndrome.

It can occur at any age, although symptoms don't appear until gluten is introduced into the diet.

Many times, for unclear reasons, the disease emerges after some form of trauma such as:

• an infection,
• a physical injury,
• pregnancy,
• severe stress or
• surgery

The disease is considered to have immunological nature. The main characteristic is that, when people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging the small intestine. This results in forming of tiny lesions to the small, fingerlike protrusions lining the small intestine called villi. These formations normally allow nutrients from food to be absorbed into the bloodstream. Because the body's own immune system causes the damage, celiac disease is considered an autoimmune disorder.

Symptoms of celiac disease

Different patients have different symptoms. Another problem is that symptoms may occur in the digestive system, or in other parts of the body. 

Symptoms of celiac disease may include one or more of the following:

• gas
• recurring abdominal bloating and pain
• chronic diarrhea
• pale, foul-smelling, or fatty stool
• weight loss / weight gain
• fatigue
• unexplained anemia (a low count of red blood cells causing fatigue)
• bone or joint pain
• osteoporosis, osteopenia
• behavioral changes
• tingling numbness in the legs (from nerve damage)
• muscle cramps
• seizures
• missed menstrual periods (often because of the excessive weight loss)
• infertility, recurrent miscarriage
• delayed growth
• failure to thrive in infants
• pale sores inside the mouth
• tooth discoloration or loss of enamel
• rash called dermatitis herpetiformis - itchy, blistering skin disease that also stems from gluten intolerance.

A person with celiac disease may have no symptoms. Patients must understand that the longer a person goes undiagnosed and untreated, the greater the chance of developing malnutrition and other complications.

The most common symptoms of malnutrition are

• anemia,
• delayed growth, and
• weight loss.

Many Celiac sufferers who struggle with malabsorption are deficient in the following nutrients:

• Essential Fatty Acids
• Iron
• Vitamin D
• Vitamin K
• Calcium
• Magnesium
• Folic Acid

Risk factors

Although celiac disease can affect anyone, it tends to be more common in people of European descent and people with disorders caused by other autoimmune disorders such as:

• Lupus erythematosus
• Type 1 diabetes
• Rheumatoid arthritis
• Autoimmune thyroid disease
• Liver disease
• Collagen vascular disease
• Sjögren's syndrome

Diagnosis

Diagnosis of celiac disease is often very complicated because some of the symptoms are similar to those of other diseases. It is very often confused with:

• irritable bowel syndrome,
• iron-deficiency anemia caused by menstrual blood loss,
• Crohn's disease,
• diverticulitis,
• intestinal infections, and
• chronic fatigue syndrome.

Some researches done in the past have proven that people with celiac disease have levels of certain autoantibodies in their blood higher than normal. Autoantibodies are proteins that react against the body's own molecules or tissues. That’s why, to diagnose this disease, physicians will usually test blood to measure the levels of:

• Immunoglobulin A
• anti-tissue transglutaminase  
• IgA anti-muscles antibodies 

If the test results and symptoms are unclear, the doctor will perform a small bowel biopsy. To take the tissue sample, the doctor eases a long, thin tube called an endoscope through the mouth and stomach into the small intestine.

Screening is also a possible which in case of the celiac disease involves testing for the presence of antibodies in the blood in people without symptoms.

Treatment - Gluten free diet

The only treatment for celiac disease is to follow a gluten-free diet. This lifelong diet can be difficult and socially troublesome, especially in young patients, but it is crucial in order to avoid serious health consequences. Vitamin and mineral supplements may be prescribed to correct the nutritional deficiencies. Occasionally, corticosteroids (such as Prednisone) may also be prescribed for short-term use or if the patient has refractory sprue. Following a well-balanced, gluten-free diet is generally the only treatment required for staying well. That’s why, after diagnosis, the first person that patient should talk with is a dietitian or a nutritionist. The patient will then learn from a dietitian how to read ingredient lists and identify foods that contain gluten.

The patients must know that, no matter how snall the amount of gluten is, it can damage the small intestine perhaps even without any noticeable symptoms.
A gluten-free diet means avoiding food that contains wheat including spelt, triticale, and kamut, rye, and barley. Many people are afraid that there are too many restrictions included in a gluten-free diet, but the fact is that the diet is not that restrictive and people with celiac disease can lead a nice life. For example, they can use potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour.

Meat, fish, rice, fruits, and vegetables do not contain gluten, so people with celiac disease can eat as much of these foods as they like.
Patient must know that the gluten can also be found in some medications, so, they must avoid using them. Another common problem among people with Celiac disease is a deficiency in digestive enzymes.

This means that the intestinal systems of celiac patients often do not produce an adequate digestive secretion.

The most common gluten-free diet samples

Breads, cereals, rice, and pasta: 6 to 11 servings each day

Bread should be made from corn, rice, soy, arrowroot corn, or potato starch; pea, potato, or whole-bean flour; tapioca, sago, rice bran, cornmeal, buckwheat, millet, flax, sorghum, amaranth or quinoa. Hot cereals can also be beneficial. They should be made from soy, hominy, hominy grits, brown rice, white rice, buckwheat, millet, cornmeal. Quinoa flakes are also recommended. Puffed corn, rice, or millet, or other rice and corn made with allowed ingredients.

Vegetables: 3 to 5 servings each day (including starchy vegetables)
It is proven that all plain, fresh, frozen, or canned vegetables made with the allowed ingredients can be very beneficial to mucous lining of the stomach and the intestines.

Fruits: 2 to 4 servings each day

Milk, yogurt, and cheese: 2 to 3 servings each day

Meats, fish, dry beans and peas, eggs, and nuts:2 to 3 servings or total of 6 oz daily

All meat, poultry, fish, shellfish, eggs can be used as well as the dry peas and beans, nuts, peanut butter, soybeans, cold cuts, frankfurters, sausage without fillers etc.

Fats, snacks, sweets, condiments, and beverages

Butter, margarine, salad dressings, sauces, soups, desserts made from the allowed ingredients can be used on daily basis. Patients shouldn’t be afraid of sugar, honey, jelly, jam, hard candy, plain chocolate, coconut, molasses, Marshmallows, meringues. Even some alcohols can be used such as wine, rum, alcohol distilled from cereals such as gin, vodka, whiskey… Avoid sauces, gravies, canned fish, products with hydrolyzed vegetable protein or hydrolyzed plant protein made from wheat protein, and anything with questionable ingredients.

It is important to know that most foods made from grains contain gluten. Avoid these foods unless they're labeled as gluten-free or made with corn, rice, soy or other gluten-free grain:

• Breads
• Cereals
• Crackers
• Pasta
• Cookies
• Cakes and pies
• Gravies
• Sauces