Celiac Info (Gluten Intolerance)
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What is gluten intolerance?
How
serious is it?
Informational Links
So, what do you eat?
Where do you buy that stuff?
How can you go on vacations?
What
is it?
This
is a disease which affects people primarily of European descent; it's also
known as
celiac disease
and non-tropical
sprue. My first
diagnosis was given the technical name of gluten-sensitive
enteropathy. Many people
actually go undiagnosed; one in every 135 - 250 Americans suffer
from celiac disease. Although there is a wide range of symptoms, basically what
happens is the villi in the intestines shorten and flatten. The flattened villi mean vitamins and minerals are no longer absorbed and utilized by
the body. A general condition of overall malnutrition develops in
an untreated person, especially fat-soluble vitamins, B-complex vitamins
and zinc. It is also characterized by weight loss, anemia from lack
of iron, folic acid deficiency, listlessness, irritability (calcium metabolism
imbalance), and immature bone development from calcium deficiency.
Genetics
This is a genetic condition which is permanent and life long; it sometimes
is latent and emerges when one undergoes some type of trauma, which has
caused delay in the medical community's research into the genetic connection.
It is now known that it is not uncommon to find several people in the same
family with the condition, which makes it even more important to understand
that this is not a food allergy. About 10 percent of an affected person's
first-degree relatives (parents, siblings, or children) will also have the
disease. The longer a person goes undiagnosed and untreated, the greater
the chance of developing malnutrition and other complications.
Treatment
The only true treatment for gluten intolerance
is strict life long adherence to a gluten-free diet. A gluten-free
diet means avoiding all products that contain wheat, rye and barley, or
any of their derivatives (oats are a debated grain at the moment; the recommendation
is to avoid oats). This is complicated by the numerous sources
of gluten found in the ingredients of most processed foods. Something
as simple as canned soup, soy sauce or salad dressing would contain gluten.
How serious is it?
Diagnosis and Related Disorders
Left untreated,
this disease can cause permanent damage and life threatening
complications. Deterioration of the small intestine and problems
with nutrient absorption can put one at a greater risk for lymphoma and aden
carcinoma, which are types of cancer that can develop in the intestine. Osteoporosis is a condition in which bones become weak, brittle and prone to
breaking. Poor calcium absorption due to gluten intolerance
contributes to osteoporosis.
Relief from symptoms is usually achieved by strictly following a
gluten-free diet, which means complete avoidance of wheat, barley, rye,
oats, malt, MSG and other gluten-containing foods. However, a
definitive diagnosis can be done by blood tests and an intestinal biopsy. Again, remember you must stay on the gluten-free diet for life.
Other diseases or conditions that can be associated with this disease
include: dermatitis herpetiformis, systemic lupus, thyroid disease and
autoimmune disorders. People with celiac disease tend to have
other autoimmune diseases as well, including Type 1 diabetes, liver disease,
collagen vascular disease, rheumatoid arthritis and Sjogren's syndrome.
Dermatitis
Herpetiformis
I am one of the minority of people with DH, too. DH
is what we call dermatitis herpetiformis for short. DH is a severe itchy,
blistering skin disease caused by gluten intolerance. DH is related to
celiac disease/gluten intolerance since both are autoimmune disorders -- it
is also said that DH is a form of celiac disease by some. However, the
important part is control of DH is also by a gluten-free diet. My rash
usually occurs on the shins of my legs, my elbows, my hips and upper back. I
found ibuprofen worsened the DH when I had an outbreak, but it would not
bring on an outbreak.
Although people with DH do not usually have the digestive symptoms
of celiac disease, they often
have the same intestinal damage as people with celiac disease. I
have the intestinal damage, having had the intestinal endoscopy
when we just could not figure out what was wrong with me. But, I also had
some of the digestive symptoms of celiac disease and didn't know what they
indicated. My own low
point was severe anemia and exhaustion, accompanied by a feeling of listlessness
and weight loss. I also had a DH skin biopsy, which involved removing
a tiny piece of skin near the rash and testing it for the IgA antibody. DH is often treated with medication to control the rash, such as Dapsone,
in addition to the gluten-free diet. However, Dapsone is particularly
toxic and I have opted not to use it myself. The gluten-free diet
and a steroidal cream works fairly well to control DH for me. When
people have asked me to describe it, I usually tell them to imagine the
worst case of poison ivy, but it's underneath their skin, not on the top
where they can actually scratch it. Really, you can scratch DH topically,
but the itching is coming from underneath and is so intense that it feels
like the back side of your skin is itching. Also, it appears in a
mirror-like image with a patch on each side of the body simultaneously,
and the patches can take weeks (sometimes months) to heal.
So,
what do you eat?
I eat a lot of rice and potatoes, which many people tend to avoid in their
attempt to cut carbohydrates and lose weight. Well, that's certainly
a mistake! Despite eating lots of rice and potatoes on a gluten-free
diet, the real key is to avoid the gluten, calorie-laden highly processed,
prepackaged food.
Foods freely allowed in gluten-free diets:
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Fresh
meats, fish and poultry
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Milk
and unprocessed cheeses*
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Dried
beans; nuts |
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Plain
fresh or frozen fruits and vegetables
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Corn
and rice |
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Arrowroot,
corn, rice, potato, tapioca flours
- bean flours, such as garbanzo bean flour, are also allowed,
but personally I dislike the taste when used as a flour |
Before now I
have not mentioned lactose intolerance, but many celiacs are also
lactose intolerant, which means they must avoid dairy products, too. Soy milk can replace milk in recipes. Eggs are another food I rely
on, but many people on a gluten-free diet also must avoid eggs. You
can buy egg replacer, which works really fine in recipes, but it doesn't
help much if you want scrambled eggs, I realize.
My favorite
gluten-free purchased foods:
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- Lara Bars (cherry pie is my favorite)
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What, no birthday cake? Actually,
yes! You can buy angel food, white, chocolate, and yellow cake mixes. I have made chocolate cake, carrot cake, and brownies (without a mix) using
potato starch, tapioca flour, some cornstarch and rice flour. 'Graham cracker' crusts for cheesecakes,
etc., can be made with other things, too. It's amazing how much you
can learn to cook without using wheat flour.
Informational Links
It's about time!
Chefs meet in Colorado, Aug.
26-28, 2006
It seems that many restaurants have not been very tuned in to the
problem celiacs have. However, it appears word has gotten out that
there are large numbers of us and the industry is becoming more aware of our
needs. A conference is being held this summer to widely inform professional
chefs about gluten-free living. If you would like to read
more on this topic check out the link below. The
Gluten Free Lifestyle Culinary Summit
will feature a product showcase, gluten-free gastronomy taught by leading chefs
and a chef's network for gluten-free awareness.
Where do you buy that stuff?
Here in the Midwest I find that many large
cities even have gluten-free sections in the supermarkets. If you
aren't that lucky, try your local health food store, and if they don't
have something ask if they will order it. There's a good chance
you aren't the only person who will buy it. Be prepared to give
the store manager the correct name of the product and the manufacturer,
as well.
Some leading manufacturers of
gluten-free food products:
How
can you go on vacations?
Remember
the international symbol
to indicate a menu is gluten-free.
Cards
in Foreign Languages to Print
--
very handy for a cook/chef to understand
your needs. This is a German web site, but the country flags appear next
to the languages so nearly anyone can use it. The English cards alone are
handy to have for those right here in the U.S. not familiar with our condition.
Note that in some European countries the Glutano brand is known as 3-Pauly.
Many cruise lines and travel
plans will accommodate special dietary requests, if the request is submitted
in writing at least two weeks prior to departure. I recommend meeting
with the tour director or head waiter immediately upon the start
of your vacation to reconfirm.
Major U.S. airlines do not usually
provide gluten-free meals, but if you can request a fruit plate, it will
be a gluten-free meal -- just don't eat any bread supplied with it! They
absolutely do not provide gluten-free meals on domestic flights (as you
know, they don't provide meals free of cost at all in coach class any
longer, but even in first class they won't provide gluten-free or other
special meals on domestic flights, including to Hawaii). International airlines generally have the option
of a gluten-free meal; especially British Airways, Lufthansa,
and SAS. Any special meal requests must be submitted
at least two weeks prior to your flight. Notify the flight attendant
as soon as it is convenient; do not wait until they begin serving meals.
One of the best vacations for gluten-free meals is on
cruise lines. I have found every line to be accommodating, but Carnival
slightly less so than others.
For an extensive listing regarding travel visit the
Clan Thompson Web Site.
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Some images on this page courtesy Microsoft® ClipArt. Page last updated
August 2006.
