Ahh, the Spring months have arrived, and warmer weather is slowing making it's way back. May is such a lovely time of year to envision how the remainder of the year will be and maybe even take a step back to revisit what has happened in the past year.
May has become an important month for me in the past 8 years; it's Celiac Disease Awareness Month! Yes, 8 years ago I was diagnosed with Celiac Disease, during my clinical dietetic internship program. I was definitely relieved to know what had been going on the past 3 years with my body (although over time I realized it probably was over the course of quite a few years), and as a future dietitian at that point in time, making the diet change to be completely gluten-free did not seem too hard to figure out, so in a way, I was blessed.
(Gluten-Free, Almond Flour Chocolate Chip Scones; from Elizabeth Rider Blog
What is Celiac Disease?
Celiac Disease is an autoimmue disorder in which your body attacks the protein- gluten, and causes inflammatory responses. Everyone with Celiac Disease is different in how they respond to gluten proteins, but there are common side effects from consuming gluten. These include abdominal pain, bloating, gas, changes in bowels (some constipation, others diarrhea or even steatorrhea-an excess of fat in the stools due to malabsorption), dermatitis herpetiformis (a skin rash), brain fog, migraines to name the most common ones.
What happens beyond the above mentioned side effects?
When the body attacks itself from the ingestion of gluten-containing foods and the side effects above occur, they are causing absorption issues. There are little finger-like projections in the small intestine (villi) which become damaged and die. These villi absorb nutrients such as vitamins, minerals, and fats and when damaged, can cause nutrient imbalances and deficiencies, potentially leading to malnutrition depending on the degree of someones side effects. This is when most people know something is not right; they are experiencing the inability to concentrate, possible weight loss or weight gain, severe fatigue, cracking lips or breaking nails, and severe and pain, bloating or other gastrointestinal issues consistently.
How does someone get diagnosed?
Due to the increased popularity of the gluten-free diet, it's important that someone who thinks they may have Celiac Disease actually be tested prior to being gluten-free. The proper steps are to have a few blood tests run, called the tissue transglutaminase antibodies. If these show up positive, then a biopsy of the small intestine through an endoscopy is the Gold standard (meaning the best way to confirm diagnosis) to determine if the villi in the small intestine are damaged, thus confirming diagnosis of Celiac Disease. There are also genetic tests that can be done to check for HLA-DQ2 or HLA-DQ8.
What happens once you are diagnosed?
If you or someone you know is diagnosed with Celiac Disease- then a completely strict, Gluten-Free (GF) diet is recommended. If gluten continues to be consumed, nutrient deficiencies may remain, furthering risk for malnutrition, osteoporosis, anemia, thyroid disease, and even certain cancers. It is very important to seek medical direction and advice from your doctor, and upon diagnosis, also request to see a registered dietitian nutritionist for review of nutrient deficiencies and how to follow a GF diet.
Where is Gluten found?
Gluten can be found in wheat, rye, and barley products (breads, cereals, cakes and cookies, pasta, pizza dough, malt beverages, etc.). There are also "hidden" sources of gluten in many processed food items such as chips, cereals, salad dressings, sauces, gravies, candies and many more. There are a lot of packaged foods that "may contain" or "may be processed in a facility with" gluten/wheat, and these also need to be avoided. Today's GF options are quite impressive, so finding substitutes for breads and pastas are not difficult and maintaining this diet is fairly simple.
(no sponsorship has been provided to this blog by any items in these photos).
Typically, following a GF diet will resolve most- if not all- of the symptoms noted earlier. The concern of a strict GF diet begins when dining out or going to family and friends for meals. Unfortunately, cross-contamination and knowledge deficits are the main reason someone with Celiac Disease may be "glutened" as we call it, when unknowingly, someone with Celiac Disease consumes gluten. Symptoms come back almost immediately and if not even worse than they were before diagnosis. This can result in days of being sick, having migraines, feeling severly fatigued and when Celiac Disease becomes mentally and physically draining.
Some examples of cross-contamination:
Sticking a fork in the regular pasta and then into the vegetables that are gluten-free
Using the same cutting board you use for a loaf of bread for all of your vegetables that you thought were gluten-free (but now are contaminated, no matter how well you "think" the cutting board is clean)
Using a cast-iron skillet that you cook french-toast in for gluten-free eggs.
Getting beer on your hands and then touching a lemon to cut it for a drinkand using it for the gluten-free friends water as well
Using the dishcloth for wiping your gluten-hands and then wiping the counters
Accidentally putting croutons in a salad and then picking them out because you forgot.
Main points here- CRUMBS... just ONE CRUMB can cause someone with Celiac Disease to be glutened. Use separate utensils for the gluten-free items. Single-use rags or towels should be used to clean up gluten areas.
What can I do to help someone with Celiac Disease?
Ask questions! If you are cooking for someone with Celiac, ask them what you should do to make sure the food remains safe. They'll appreciate that you asked and thankful that you care to ensure their tummies and body stay healthy!
Do not feel bad for eating gluten in front of them! We usually don't even notice or are happy with our food decisions, but when you bring it up, then it becomes awkward. Someone with Celiac Disease knows where to find gluten-free items and how to inform restaurant staff about their gluten-free needs.
Also, do not feel bad if someone with Celiac Disease doesn't accept taking your food. Cross-contamination is usually the main reason for this- due to how severe being "glutened" can be to someone, they don't want to take any risks.
Food is not always a friend; instead of buying candies or chocolates (as these may contain or may be made in a facility with gluten or wheat), turn to other kinds of goodies for celebrations.
Living with Celiac Disease is an eye-opening experience and one that's important for those close to someone with Celiac Disease to understand. As May is Celiac Disease Awareness Month, talk to someone you know with Celiac Disease to see how you can help! #RaiseYourVoice
Resources:
To learn more about Celiac Disease or how you can raise awareness visit the following websites:
Information provided on this website does not constitute medical advice and is not intended to assist in the diagnosis, treatment or alleviation of any medical condition. Persons seeking to address a medical condition should consult with a qualified medical professional. Emily Richters Fasciana LLC will not be liable for any damages, losses, injury or liability suffered as a result of reliance on the information provided on this website.
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