University of Maryland Medical Center nutritionist Pam Cureton answers questions about celiac disease and gluten-free diets.
Q: What is gluten?
A: Gluten is a protein found in wheat, rye and barley. These grains in any form must be avoided. Foods labeled gluten free are safe to eat but if a food item is not labeled gluten free look for these six words in the ingredient list to see if it contains a gluten containing ingredient: Wheat, Rye, Barley, Malt, Brewer’s yeast and Oat (only use oats that are labeled gluten free).
Q: What exactly is wrong with gluten?
A: The problem with gluten is that it is not completely broken down into smaller amino acids that can be easily absorbed by the intestine. For the majority of people this presents no problem at all but in individuals with celiac disease, the body sees this protein as a toxin and this sets off a string of reactions leading to intestinal villous damage.
Q: What cross contamination problems should I look for in the kitchen?
A: Preventing gluten free foods from coming in contact with gluten containing foods make the difference in your guest enjoying a wonderful holiday meal or becoming ill and leaving early. Guest with celiac disease cannot simply take the croutons out of a salad or eat the meat from the wheat bread sandwich. Gluten free foods can be contaminated by using the same spoon to mix or serve foods, putting wheat products next to the gluten free dips, “double dipping” the knife into a condiment then gluten containing product then back into the condiments or using the same toaster.
Q: Can you taste the difference between gluten-free foods and their gluten counterparts?
A: Gluten free foods have come a long way in their taste and texture to be very close to their gluten containing counterpart. There are so many great tasting gluten free products on the market today that no one should be eating something they do not like.
Q: What are the symptoms of Celiac Disease:
A: Celiac disease can present itself in many different forms. Untreated, celiac disease causes multi-system complications such as diarrhea, constipation, gas, bloating, iron deficiency anemia, decreased bone density, failure to thrive, short stature, and behavior problems. If you have any concerns, please check with your primary care provider before you start a gluten free diet.
Q: I have severe reactions when I eat bread, such as stomach bloating and pain in my joints. Does this mean I could have celiac or gluten sensitivity?
A: We recommend that you see your primary care provider and ask to be tested for celiac disease. However, do not start a gluten free diet before this testing is done. The first step is a simple blood test for screening. If all the tests are complete and you do not have celiac disease, then try a gluten free diet to see if you improve as it may be non-celiac gluten sensitivity.
Q: How common is late-onset celiac disease and is there any way to know if other family members are at risk of developing it later in life?
A: It is possible to develop celiac disease at any age. You may have had celiac disease for many years before being diagnosed because symptoms may have been attributed to other conditions or you may not have had any symptoms with the active disease. We recommend that all first degree relatives be screened for celiac disease after the relative had been diagnosed and if negative at that time, repeat the screening labs every 2-3 years or if symptoms appear.
Q: Is there a cure for Celiac Disease?
A: Currently the only treatment for celiac disease is the gluten free diet. In most cases, this treatment works very well but it can be expensive, socially isolating and, at times, difficult to follow. Also, there are people that do not respond completely to the diet or take up to 2 years to heal after diagnosis. For these people, additional therapies are need to prevent additional complications of celiac disease.
Learn more about the Celiac Disease Program or call 410-328-6749 to make an appointment.