What is Celiac Disease?
What is Celiac Disease/Gluten Intolerance?
Celiac Disease is an autoimmune condition found in people of all ages who are genetically susceptible. To develop Celiac Disease, you must inherit genetics for it, consume gluten, and have the gene triggered. Celiac Disease causes gradual destruction of the inner lining to the small intestine, leading to poor absorption of a wide variety of nutrients, and consequently a wide variety of patient presentations.
Gluten intolerance is a similar, less severe condition in which a person who does not have overt intestinal damage, but still experiences negative health effects from consuming gluten containing foods. Gluten is found in wheat, rye, barley and products derived from these grains. Gluten is also a frequent contaminant of oats and perhaps other grains.
What are the signs and symptoms of celiac disease?
There are many signs and symptoms of Celiac Disease and gluten intolerance. They range from none (silent Celiac Disease), to severe weight loss and malnutrition. A selection of signs and symptoms include: weight loss, weight gain, abdominal pain & cramping, diarrhea, constipation, osteopenia or osteoporosis, fatigue, bloating, iron deficiency anemia, megaloblastic anemia, nutritional deficiencies, mouth ulcers, inadequate tooth enamel, lactose intolerance, inadequate growth in children and infertility.
What are the risks to the patient if they are not compliant with their gluten free diet?
A person with Celiac Disease risks continued intestinal damage when knowingly (or accidentally!) consuming gluten, even if they do not have symptoms. As a result of intestinal damage from continued exposure to gluten, the person may experience a worsening of the signs and symptoms they experienced before diagnosis, or one of a host of other possible additional symptoms. Over time, damage can become severe enough to cause both adenocarcinoma and lymphoma of the small intestine, ulcerative jenunitis or small intestine strictures.
Eating away from home was very difficult at first, but with practice, experience, and perseverance, I found eating out to be enjoyable again. Learning how to cook and bake gluten-free were huge, but very fun challenges
Can you share five of your favorite tips for coping with the challenge of this disease?
1) Learn how to cook and bake at home!
2) Keep a ready-mixed gluten-free flour substitute (home-made or purchased) on hand AT EVERY HOME YOU EAT FREQUENTLY for easy substitutions in favorite wheat-flour recipes.
3) Focus on eating nutrient-dense foods that are naturally gluten-free.
4) Always bring something you can eat to the potluck and keep GF snacks in your bag or car.
5) Avoid new restaurants during busy, peak times-you are more likely to end up with some unwanted gluten.
What do you typically eat for breakfast lunch and dinner?
Breakfast: Fresh fruit in season! We love gluten-free homemade waffles, Bob’s gluten-free oatmeal, cornmeal mush (polenta) and veggie frittatas.
Lunch: Leftovers to the rescue!
Dinner: We have a large rotation of recipes and strive to eat at least ½ plate of veggies along with the main dish. Household favorites include: turkey meatballs, chicken soup, lentil soup, tuna noodle veggie casserole, noodles with peanut sauce, vegetable soups, mixed salads, enchilada casserole, fish cakes, risottos, and a wide variety of creative homemade pizzas.
Care to share your favorite gluten free recipe?
Cheddar Dijon Waffles:
This is a wonderful recipe to start off an active day right, or a outside-the-box lunch or dinner. I like to serve these waffles topped with a gently fried egg (low temperature to avoid damaging the protein) and lots of chunky salsa. This recipe can be doubled or tripled and frozen for quick future meals.
Yield: 4-5 6” waffles
1.5 cup Pamela’s Pancake & Baking Mix (or substitute your favorite GF flour blend)
2 eggs, separated
¾ cup water
1-2T vegetable oil
1/3-1/2 cup shredded smoked or, less desirably, sharp cheddar cheese
1tsp-1tb Dijon mustard (to taste)
1 bunch thinly sliced green onions (white and light green parts only)
If necessary, spray waffle iron with nonstick spray or brush with oil. Preheat waffle iron.
Separate the eggs. Put the egg yolks into a small bowl or glass, and the whites into a medium bowl. Add the Dijon mustard and vegetable oil to the egg yolks, stir to combine and set aside. Whip the egg whites until stiff peaks form and set aside.
In a medium bowl, gently toss the green onions and cheese to coat with the Pamela’s Mix. Add the water, the egg yolk mixture and mix until no dry spots remain. The batter will be thick. Gently fold in the egg whites.
Cook on preheated waffle iron until golden brown. I use about ½ cup per waffle and spread the batter evenly before closing the lid, but use your judgment for your particular waffle iron. Repeat until remaining batter is used up.
Note: you can make these waffles using three whole eggs and skip the egg separating/whipping step. Just mix the whole eggs with the mustard and vegetable oil and skip folding in the egg white. The finished waffles will not be as light and fluffy.
Ps: If your waffle iron is from your “gluten days”, be sure to clean it very thoroughly to remove all gluten-containing crumbs before using for gluten-free waffles or replace the waffle iron with a new, dedicated gluten-free one.
What kind of resources and support groups are available for celiac disease?
ACK, the hyperlink thingy for The Gluten Intolerance Group is all messed up. It should be www.gluten.net
• Celiac Disease Awareness Campaign from the National Institutes of Health
• Celiac Disease Foundation
• The Gluten Intolerance Group
• Celiac Disease practice guideline from the World Gastroenterology Organisation (WGO)
• Celiac Sprue Association
• Outcomes of 2004 consensus development conference, National Institutes of Health
• National Foundation for Celiac Awareness
• University of Maryland Center for Celiac Research
Books and Magazines (does NOT include cookbooks)
Celiac Disease: A Hidden Epidemic by Peter Green, M.D. and Rory Jones
Gluten-Free Friends: An Activity Book for Kids by Nancy Patin Falini, M.A., R.D., L.D.N.
Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy Gluten-Free Children by Danna Korn
Next up by Dr. Selena Eon is a three part series of “How to Eat Gluten Free on a Budget.” If you have any questions about celiac disease, you are welcome to ask them in the comments section and they will be addressed in future articles.
Dr. Selena Eon practices in Bellevue, WA and you may contact her at
(206) 228-9537 or visit www.drselenaeon.com