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Celiac Disease: Learning You Have it Can Mean the Start of a New and Better Life. New York, NY: Columbia University Medical Center, 2006. 8 p.
This booklet helps people newly diagnosed with celiac disease (gluten intolerance) and dermatitis herpetiformis understand their disease and some of the dietary changes they will need to make in order to follow a gluten-free diet. The booklet first reviews the different symptoms that can be associated with celiac disease, the physiology of the small intestine, symptoms that appear on the skin, and celiac disease as an of autoimmune disease. The booklet continues by reviewing the diagnostic tests to confirm the condition (blood tests and an intestinal biopsy, done by endoscopy), and the screening indications for celiac disease. It then describes the Celiac Disease Center at Columbia University, a research center established in 2001. The final section outlines the work being done at the Celiac Disease Center and invites readers to consider donating funds to support that work. Website addresses and telephone numbers of some of the researchers and administrators at the Celiac Disease Center are included. The booklet is printed with colorful graphics and written in nontechnical language.
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Guidelines and Goodies: Eating Gluten-Free and Enjoying It. New York, NY: Columbia University Medical Center, 2006. 13 p.
This brochure helps people newly diagnosed with celiac disease (gluten intolerance) or dermatitis herpetiformis understand some of the dietary changes they will need to make in order to follow a gluten-free diet. The brochure presents an upbeat, positive approach to the gluten-free diet as a relatively painless way to eliminate troublesome and problematic symptoms. The brochure reviews the requirements of a gluten-free diet, with an emphasis on all-around healthy and nutritious food. Topics include the foods that are permitted, the different grains that can and cannot be included, the basics of a nutritious meal plan, suggestions for dietary fiber and fats, the role of exercise, details about different types of grains and how to incorporate some of the lesser known but gluten-free, grains, creating tasty desserts that are gluten-free, how to follow a gluten-free diet while eating at restaurants, and how to cope with the first few days on a gluten-free diet by using foods that are already in the pantry or freezer. Specific brand-name foods are noted. The brochure is printed with colorful graphics and written in nontechnical language.
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Helping Your Child Cope with a Diagnosis of Celiac Disease. New York, NY: Columbia University Medical Center, 2006. 8 p.
This brochure helps parents of children newly diagnosed with celiac disease (gluten intolerance) understand some of the dietary changes they will need to make in order to have their child follow a gluten-free diet. The brochure presents an upbeat, positive approach to the gluten-free diet as a relatively painless way to eliminate troublesome and problematic symptoms. The author focuses on some of the psychosocial adjustments that the child and family will need to make, especially as some favorite foods will need to be eliminated from the child's diet. The author stresses that perfect adherence to a gluten-free diet has a learning curve and mistakes will be made as the family adjusts and learns about what foods can and cannot be eaten. Families are encouraged to focus on favorite foods that are naturally gluten-free and to plan meals around those favorites. The brochure reviews strategies for coping with particular situations, such as special holiday meals or birthday parties, and the need for parents to be advocates for their child and educators for other adults and children about the needs of people with celiac disease. The booklet is printed with colorful graphics and written in nontechnical language.
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Celiac Disease and Autoimmunity in the Gut and Elsewhere. Gastroenterology Clinics of North America. 37(2): 411-428. June 2008.
This article about celiac disease and autoimmunity in the gut and elsewhere is from an issue of Gastroenterology Clinics of North America that focuses on eosinophilic and autoimmune gastrointestinal disease. Celiac disease is a common immune-mediated enteropathy characterized by sensitivity to the wheat protein, gluten. The authors note that celiac disease is often difficult to diagnose due in large part to the silent form of the disease that affects the majority of patients. Overall mild clinical symptoms with nonspecific complaints such as fatigue, headaches, and arthralgias are common and can delay diagnosis. This article discusses the gut immunogenesis of celiac disease, the role of environmental factors, and the risk of autoimmune disease. The authors focus on the autoimmune connective tissue diseases, endocrine, and dermatologic conditions associated with celiac disease, as well as the related gut inflammatory disorders of refractory celiac disease, autoimmune enteropathy, collagenous enteritis, and collagenous colitis. Specific diseases discussed include Sjogren's syndrome, inflammatory arthritis, Addison's disease, autoimmune insulin-dependent diabetes mellitus (AIDDM), IgA deficiency, pernicious anemia, primary biliary cirrhosis, and autoimmune hepatitis. The authors conclude with a brief discussion of screening recommendations in patient populations with these immune-related illnesses. 1 figure. 2 tables. 79 references.
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Celiac Disease. Bethesda, MD: American College of Gastroenterology. 2008. 6 p.
This fact sheet provides basic information about celiac disease and its diagnosis. Designed to help increase health care providers’ and patients’ index of suspicion about the disease, the fact sheet describes how the intestine reacts to gluten, the epidemiology of celiac disease, the primary symptoms, diagnostic tests used to confirm the presence of the disease, and treatment with a gluten-free diet. A final section considers the complications of celiac disease, all of which can be avoided by following a gluten-free diet. The most common symptoms of celiac disease include abdominal pain, bloating and gas, diarrhea, stools that may float or smell unusually bad, weight loss, poor growth or weight loss in children, and anemia. Other symptoms or complications include weakness, tiredness, low vitamin levels, bone and joint pains, osteoporosis, and a chronic skin rash. Diagnostic tests used include blood tests and an endoscopic biopsy of the small bowel. The fact sheet includes a brief list of grains that contain gluten and must be avoided, as well as a list of frequently overlooked foods that often contain gluten. A full-color illustration of the intestinal villi is included. A list of 10 websites that have more information concludes the fact sheet. 4 figures.
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Genetics Test Peeks into Future: Tells Who Might Develop Celiac Disease. Gluten-Free Living. 2: 24-25. 2008.
This article describes some of the concerns regarding the genetic testing that can be used to determine who is at risk to develop celiac disease. This article is a follow-up to an earlier article that outlined the basics of genetic testing for celiac disease. In this article, the author answers questions that readers had about these genetics tests. Topics include people who have the genetic marker for celiac disease but never develop active disease, the interplay of celiac disease with other autoimmune diseases such as diabetes, triggers of celiac disease in people who have the genetic marker, recommendations regarding a gluten-free diet for people who test positive for the genetic marker for celiac but do not have active disease, concerns about child development and health, the official name of the test under discussion (Celiac Disease DNA Test, Kimball), the reliability of the genetic test, and recommendations for checking children, including newborns. One sidebar briefly describes the Genetic Information Nondiscrimination Act (GINA), recently passed U.S. legislation to control the improper use of genetic test results. 4 references.
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Q-Tip Holds the Answer: Genetic Testing Identifies Potential CD Patients. Gluten-Free Living. p. 25-26. 2008.
This article explains the use of a DNA test for the gene marker for celiac disease. More than 90 percent of all people with celiac disease carry the gene for HLA DQ2, and most of the remaining 10 percent carry the gene for HLA DQ8. The test results indicate whether a person is susceptible to developing celiac disease; it is not diagnostic of the disease. However, if the result is negative, this test can rule out the presence of celiac disease. The author explores when genetic testing is most appropriate, including when antibody or biopsy results are ambiguous, when the person being tested has already started to follow a gluten-free diet, when a person has a first-degree or second-degree relative who has been diagnosed with celiac disease, and when a person does not respond to the gluten-free diet. One chart lists the companies that offer genetic testing for celiac disease genes; one company will do the test for individuals, whereas the others require a physician’s order. The article concludes with a brief glossary of terms.
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Quick Start Diet Guide for Celiac Disease. Revised ed. Studio City, CA: Celiac Disease Foundation. 2008. 4 p.
This brochure offers a simple overview of the gluten-free (GF) diet used to treat celiac disease. Celiac disease is a lifelong autoimmune intestinal disorder characterized by a toxic reaction to the ingestion of gluten that interferes with the absorption of nutrients. Gluten is the common name for the proteins in specific cereal grains found in all forms of wheat, including durum, semolina, spelt, kamut, einkorn, and faro; and related grains, including rye, barley, and triticale. Celiac disease can be effectively treated by following a lifelong gluten-free diet. The brochure lists allowed and not-allowed foods, reminds readers of the importance of reading labels, lists frequently overlooked foods that may contain gluten, reviews the problem of contamination in food preparation, and reminds readers that not all adverse food reactions are due to celiac disease. A final section emphasizes the importance of a positive attitude and the need to take time to learn about healthy eating on a gluten-free diet. The contact information for the Celiac Disease Foundation (CDF) and the Gluten Intolerance Group (GIG) is provided.
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Antigliadin Antibody in an Ataxic Patient With No Other Evidence of Celiac Sprue. Gastroenterology and Hepatology. 3(4): 303-308. April 2007.
This article presents the clinical case study of antigliadin antibody in an ataxic patient with no other evidence of celiac disease. Celiac disease is a malabsorptive condition in which an allergic reaction to gluten, a wheat protein, causes mucosal injury and inflammation in the small intestine. The presence of neurologic disease among patients with sprue is estimated at 6 to 10 percent. The case study was a 53-year-old man who developed sudden onset ataxia while working in his garden. He began staggering and falling to the left or right, but not forward or backward, and noted a fine tremor in his hands, both at rest and with intentional movement. His speech became hesitant and occasionally developed into a stutter. His symptoms neither progressed nor regressed over approximately 6 months. The patient underwent exhaustive neurologic and gastroenterologic evaluation. Appended to the article is a review (Azam, Buckley, and Farrell), as well as a section of answers to common questions physicians may have about celiac disease. 50 references.
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Carbohydrate Intolerance and Celiac Disease. Lifeline. 27(4): 5-8. 2007.
This article, from a patient education newsletter, reviews the interplay of carbohydrate intolerance and celiac disease, which is characterized by gluten intolerance. The author notes that the most common carbohydrate intolerance in celiac disease is lactose, but more and more celiacs are being diagnosed with fructose intolerance. The author describes the chemical structure of these carbohydrates and how they are absorbed, where they are typically found in the diet, the symptoms of secondary lactose intolerance in patients whose intestines have been damaged by gluten ingestion, children with transient lactose intolerance, symptoms of lactose malabsorption, the use of oral lactase to improve lactose absorption, the differences between hereditary and acquired fructose intolerance, the sources of fructose including high fructose corn syrup, the difficulties in determining fructose and sucrose content in foods and beverages, and problems with sugar substitutes, also called artificial sweeteners. Readers are encouraged to consider other sources of their symptoms if they continue to experience gastrointestinal difficulties after 2 to 12 months on a gluten-free diet. Two sidebars list examples of hidden lactose sources and examples of dietary sources of fructose and sucrose. 5 tables. 7 references.
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Celiac Affects 1 Out of 133... Are You the One? The Face of Celiac Disease. Studio City, CA: Celiac Disease Foundation. 2007. 6 p.
This brochure describes the symptoms and incidence of celiac disease, defined as a multisymptom, multisystem disorder activated by eating gluten, the protein found in wheat, rye, and barley. Symptoms can vary and are not always intestinal, a situation which contributes to delays in diagnosis. The brochure lists the common symptoms and then lists other conditions often found in people with celiac disease, including type 1 diabetes, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome (IBS), Sjogren’s syndrome, eczema, peripheral neuropathy, thyroid disease, dermatitis herpetiformis, and osteoporosis. The brochure goes on to briefly describe the diagnostic tests used to confirm a diagnosis of celiac disease, as well as the importance of having close family members tested. The back cover of the brochure describes the work of the Celiac Disease Foundation (CDF), a nonprofit corporation dedicated to providing services and support regarding celiac disease and dermatitis herpetiformis through programs of awareness, education, advocacy, and research.
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Celiac Disease and Diabetes: Is There a Link?. Today's Dietitian. 9(7): 22-23. July 2007.
This article explores the interplay between celiac disease and type 1 diabetes mellitus, both immune-mediated illnesses that occur in genetically susceptible individuals. Having one of these diseases significantly increases one’s risk of developing the other. The author briefly reviews the research in the last few decades that examines the genetic and environmental factors affecting the two disorders. Finding a link between these and other autoimmune diseases may result in improved screening and early detection, as well as the development of guidelines for prevention and, eventually, a cure. The author reviews some of the hypotheses that have been proposed to explain the worldwide increase in the incidence of type 1 diabetes since 1950. A final section considers celiac disease and the concomitant risk of developing various other autoimmune diseases, including type 1 diabetes, thyroid disease, and lupus erythematosus. 1 figure. References available by request (references@gvpub.com).
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Celiac Disease. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 8 p.
Celiac disease is a digestive disease that damages the small intestine and interferes with the absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye, and barley. When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging the small intestine. This fact sheet describes celiac disease and its management; addresses the symptoms of celiac disease; its causes; diagnostic tests to confirm the presence of celiac disease, including screening and intestinal biopsy; the treatment of celiac disease with a gluten-free diet; what is allowed and what should be avoided on a gluten-free diet; the potential complications of celiac disease; dermatitis herpetiformis, an associated condition; and current research studies on celiac disease. Without treatment, people with celiac disease can develop complications, including cancer, osteoporosis, anemia, and seizures. The gluten-free diet is a lifetime requirement, and readers are encouraged to use the services of a dietitian to help learn about food selection, label reading, and other strategies to manage celiac disease. A listing of resource organizations is included. A final section describes the activities of the National Digestive Diseases Information Clearinghouse, including the Celiac Disease Awareness Campaign. 2 figures. 2 tables.
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Celiac Disease: What You Need to Know. Enfermedad Celiaca: Lo Que Usted Debe Saber. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 4 p.
This fact sheet familiarizes readers with celiac disease, a condition that means a person cannot eat gluten, a protein found in wheat, rye, and barley, and in some medicines. In people with celiac disease, the body's immune system reacts to gluten by attacking and damaging the lining of the small intestine. When this lining gets damaged, the body cannot absorb the nutrients it needs. Written in a question-and-answer format, the fact sheet covers the celiac disease risk factors, symptoms, and the use of a lifelong gluten-free diet as the only treatment for celiac disease. The fact sheet concludes with information about how to contact the National Digestive Diseases Information Clearinghouse (NIDDK) for more information. This fact sheet is from the NIDDK Awareness and Prevention Series. The fact sheet is presented in English and Spanish (2 pages each).
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Combination Enzyme Therapy for Gastric Digestion of Dietary Gluten in Patients With Celiac Sprue. Gastroenterology. 133(2): 472-480. August 2007.
This article considers the use of combination enzyme therapy for the gastric digestion of dietary gluten in patients with celiac sprue, or celiac disease. Celiac disease is characterized by an inflammatory response in the small intestine after the person ingests gluten, a protein found in wheat, rye, and barley. The authors report on a study of a new combination enzyme product that combines a glutamine-specific endoprotease (EP-B2) and a prolyl endopeptidase (SC PEP) to gain its ability to digest whole wheat gluten under gastric conditions. The analysis revealed that EP-B2 extensively proteolyzes complex gluten proteins in bread, whereas SC PEP rapidly detoxifies the residual oligopeptide products of EP-B2 digestion. The laboratory study was verified in an animal model of gastric gluten digestion. The authors discuss the use of this combination approach to increase the safe threshold of how much gluten a person with celiac disease can ingest, thus reducing the burden of a highly restricted diet. 7 figures. 1 table. 23 references.
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Combining Diabetes and Gluten-Free Dietary Management Guidelines. Practical Gastroenterology. 31(3): 68-83. March 2007.
Type 1 diabetes, celiac disease, and thyroid disease are a triad of autoimmune conditions with significant comorbidity. This article helps readers combine dietary guidelines for diabetes with those for patients following a gluten-free diet to treat their celiac disease (CD). The authors review nutrition recommendations from the American Diabetes Association (ADA) for diabetes management, which include healthy meal planning, carbohydrate counting, and potential use of glycemic index or glycemic load, as well as practical tips and suggestions for making the transition to a gluten-free, diabetes meal plan. Topics include the prevalence of CD in children with type 1 diabetes mellitus, screening for CD, overall goals of medical nutrition therapy (MNT) for type 1 diabetes, basic and advanced carbohydrate counting, the use of commercial gluten-free food, gluten-free flours, oats and the gluten-free meal plan, addressing weight gain, and the use of nutritional supplements. The authors conclude that a healthy eating plan for diabetes should always be individualized based on the patient’s needs and metabolic outcome goals. Regular follow-up with a dietitian specializing in both CD and diabetes is recommended. 5 tables. 18 references.
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Composing A Gluten-Free European Travel Itinerary. Lifeline. 27(4): 18-22. 2007.
This article, from a patient education newsletter, presents one reader’s experiences in traveling through Europe while following a gluten-free diet. The author and his wife spent a week in Vienna and another week in Slovakia in eastern Europe; the author describes their journey to Ireland a year earlier. He describes specific meals and treats that he enjoyed, where to find them, concerns about translating a gluten-free wallet card that he carried to help with communication in restaurants, the ease of finding gluten-free foods in Ireland, using the Internet to identify restaurants that identify gluten-free meals, the lack of finding gluten-free beer, and getting gluten-free meals on the flights. The author includes brief reviews of five restaurants in Dublin. One sidebar reports on the research studies against the product called Gluten-Ease (from Enzymedica), which highlights concerns about the product’s safety and lack of effectiveness.
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Easy-to-Find and Easy-to-Fix Foods. Auburn, WA: Gluten Intolerance Group. February 2007. 2 p.
This fact sheet offers suggestions for easy-to-prepare foods for people who are following a gluten-free diet to treat celiac disease (CD) or dermatitis herpetiformis. The first section lists more than 50 food items that are easy to find, including prepackaged foods, some listed by brand name; snack foods; and beverages. The next section lists 50 snack and meal items that are easy to fix; some note brand names in the simplified recipes. One side bar offers ideas for shopping and cooking, including the importance of reading food labels and appropriate food handling.
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Enriched Nutrient-Rich Foods Important on the GF Diet. Gluten-Free Living. 25(3): 22-26. Summer 2007.
This article from a magazine for people following a gluten-free diet considers the use of enriched products as part of a healthy diet. Many wheat-based products, especially bread and breakfast cereals, are enriched with vitamins and minerals that help replace the nutritional components lost during processing. Gluten-free bread, pasta, and breakfast cereals are often made from refined flour and starch, but they are not usually enriched. The author reviews the role of certain B vitamins and iron and encourages readers to educate themselves to get the most nutrition from the kinds of gluten-free food where lack of enrichment is a concern. The article covers pasta, bread, rice, cereal, and vitamin supplements. The author concludes by recommending that readers supplement the nutrients from whole grain foods by consuming a wide variety of foods, including low-fat milk, lean cuts of meat and poultry, fish, beans, nuts, seeds, vegetables, and fruit. Many of the foods that are naturally gluten-free are among the healthiest foods available. One sidebar considers the importance of folic acid in pregnancy or in women who are considering becoming pregnant.
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Gluten-Free Diet: Can Your Patient Afford it?. Practical Gastroenterology. 31(4): 75-84. April 2007.
The only treatment for celiac disease (CD) is to follow a strict, gluten-free diet (GFD) for life. This means the elimination of products containing wheat, rye, and barley. This article reviews the GFD and addresses patient concerns about the costs of following a GFD. The author considers a variety of the significant challenges and barriers to compliance to a GFD, noting that one of the greatest challenges is the cost of certain components of the diet. Although good-tasting, gluten-free alternatives are available and can greatly improve patient compliance, these alternatives come at a much higher cost than their gluten-containing counterparts. The author offers suggestions for dietitians working to help patients manage the cost of their GFD. Topics include gluten-free diet basics, the importance of focusing on foods that are allowed rather than foods that are forbidden, cooking tips for saving money, using samples of foods, shipping charges, and other savings suggestions. The bulk of the article consists of tables and charts; a section of recipes and meal plans is included. The author concludes that the role of the health care provider to assist their patient in overcoming the many barriers to compliance includes keeping treatment obtainable for all income levels by reducing the cost of the diet. 8 tables. 6 references.
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Good for You Grains: GF [Gluten Free] Diet Should Include Whole Grains. Gluten-Free Living. p. 16-18, 20-21. Spring 2007.
This article reminds readers that whole grain foods do not exclusively mean whole wheat, so even people following a gluten-free diet can and should incorporate whole grain foods into their healthy diet. The author cautions that the majority of commercially-available gluten-free breads, cereals and pastas are made using refined flour and starch, and they are not usually enriched with vitamins the way products made from refined wheat flour are enriched. The author then defines whole grains and offers strategies for incorporating more gluten-free whole grains into one's diet. Gluten-free whole grains include amaranth; brown rice; buckwheat; corn; millet; Montina Indian ricegrass; oats; quinoa; sorghum; teff; and wild rice. Sidebars explain the recommendations about serving sizes and amounts, as well as ways to understand food labels regarding whole grains. Another section offers tips for storing whole grains to maximize shelf life. The article concludes with a group of five recipes that utilize whole grains: Marvelous Morning Muesli, Not Your Ordinary Tuna, Teff Brownies, Oat So Good Cookies, and Puffed Amaranth Candy. 1 figure.
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Great American Sandwich. Gluten-Free Living. 18-19. Summer 2007.
This article from a magazine for people following a gluten-free diet describes a variety of sandwiches that can be used as part of a healthy, tasty diet. The author notes that, besides the bread, most gluten-free sandwiches are not much different than those made on gluten-containing bread. The sandwiches described include peanut butter and jelly, cold cuts, tuna salad, chicken salad, egg salad, and BLT––bacon, lettuce and tomato. The article reviews condiments, noting that most mayonnaise, mustard, and ketchup products are gluten-free. A final section considers whether to toast gluten-free bread and the use of alternatives such as corn tortillas.
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Having Their Say: Celiacs, Food Makers Weigh In on “Gluten Free” Gluten-Free Living. p 12, 32, 37. Fall 2007.
This article helps readers understand the current process of the Food and Drug Administration (FDA) as it develops guidelines for gluten-free labeling. The author reports on three major areas of contention: how much gluten should be allowed in foods labeled gluten-free; should there be two tiers of labeling, one gluten-free and one low gluten; and can foods that are naturally gluten-free be allowed to use the gluten-free label. The article describes some of the comments from individuals with celiac disease, specialty gluten-free food companies, mainstream food manufacturers, and representatives of grocery chains who all weighed in on these items. The FDA set its threshold for gluten at 20 parts per million because that is the lowest level for which it could find accurate testing. More studies need to be done on exactly how safe this threshold is before a final definition can be issued. The author considers cross-contamination issues, particularly with oats, during food processing. A decision from the FDA is due in August 2008.
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How I Eat Without Wheat. Bloomington, IL: Author House. 2007. 24 p.
This colorful children’s book depicts the story of a little boy who was happy and healthy but then started to have digestive troubles, even losing weight and failing to thrive. The story follows him through diagnosis of celiac disease and learning to find gluten-free foods that will not make him ill. The author emphasizes the importance of incorporating gluten-free foods, including breads and pasta, into a child’s diet. The story also briefly addresses what to do when a friend or classmate offers a food that has gluten in it. The story is illustrated with full-color line drawings of the little boy and his family and their activities. The book is designed for toddlers and very young children who have diets that restrict them from eating gluten and wheat.
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Kids and Gluten-Free Diet. Practical Gastroenterology. 31(2): 49-65. February 2007.
This article helps nutritionists and gastroenterologists counsel families who need to follow a gluten-free diet for a child with celiac disease. The authors review some of the unique challenges for children and their families. Prior to diagnosis, the child may have been quite ill, experiencing poor growth and developmental delay. Upon accurate diagnosis and treatment, children usually improve quickly. However, despite rapid improvement of symptoms, compliance with the diet may be less than optimal, putting the child once again at risk for the complications of the disease. The authors focus on the strategies of frequent follow-up and monitoring, along with the use of educational resources and support groups, as ways to aid families in maintaining the gluten-free diet. Specific suggestions are provided for empowering children, adding snacks and treats, making good school lunches, and coping with a gluten-free diet on a college campus. The authors conclude by reiterating the importance of ongoing education and support in order to maintain a gluten-free diet. 11 tables. 12 references.
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Labels Have You Scratching Your Head? Advisory Statements Can Cause Confusion. Gluten-Free Living. 8-9, 26. Summer 2007.
This article from a magazine for people following a gluten-free diet provides information on food labeling. The Food Allergy and Consumer Protection Act (FALCPA) does not address the use of advisory statements, which are designed to give consumers more information about the possibility that a food could be cross-contaminated by an allergen during processing. The author focuses on these advisory statements and explains what some of them may mean. Topics include proposed food labeling regulations, consumer confidence levels, safety issues, restricting food choices, and shopping tips. One sidebar lists six strategies to use to reduce confusion about food labels.
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Management Of Dialysis Patients With Celiac Disease. Practical Gastroenterology. 31(6): 70-72, 77-82. June 2007.
This article addresses the management of patients with celiac disease who are on dialysis for kidney disease. Celiac disease is characterized by inflammation of the small intestine and, in some patients, malabsorption after the ingestion of gluten. Celiac disease is managed by lifelong adherence to a gluten-free diet, primarily the avoidance of wheat and some other grains. Kidney disease is manifested by fluid and electrolyte imbalances, which also involves lifelong dietary restrictions. The author reviews the dietary guidelines for each of these diseases and offers strategies for successfully combining them in patients with both diseases. Topics include malnutrition, potassium, fluid and sodium, renal bone osteodystrophy, phosphorus, and common medications of dialysis patients. The author concludes by noting that, with careful instruction, patients can become very adept at combining the restrictions of both of these diets. 4 tables. 9 references.
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More Bottles of Gluten-Free Beer on the Wall. Gluten-Free Living. p. 22-24. Spring 2007.
This article describes the increasing interest in creating and distributing gluten-free beer. The author tells the story of one microbrewery that got interested in creating a gluten-free beer and the many hurdles that early breweries had to overcome. For example, the Federal Government originally required at least 25 percent barley in anything called beer; this has subsequently been changed for gluten-free beer—made without any barley. For the past few years, there were three small gluten-free brewers in the United States: Bards Tale, Lakefront Brewery, and Ramapo Valley Brewery. All three companies are increasing production to keep up with the demand. And Anheuser-Busch has recently entered the gluten-free market, a competitor whose participation may actually prove a boon to the other brewers' businesses. One sidebar summarizes the products available, including the brand names, distribution, price, ingredients, and strengths.
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Nutritional Deficiencies in Celiac Disease. Gastroenterology Clinics of North America. 36(1): 93-108. 2007.
Celiac disease is characterized by small bowel enteropathy, triggered in genetically susceptible individuals by the ingestion of gluten, a term that encompasses proteins of wheat, rye, and barley. This article, from a special issue of Gastroenterology Clinics of North America that covers nutrition in gastrointestinal illness, discusses nutritional deficiencies in patients with celiac disease. Although damage to the intestine heals with removal of gluten from the diet, the gluten intolerance is permanent and the damage will recur if the person eats gluten. The damage caused by eating gluten causes a wide variety of consequences, including maldigestion and malabsorption and resulting in the characteristic features of malnutrition. The authors examine recent advances in the understanding of the spectrum of celiac disease, illustrate the impact of celiac disease on nutrition, and describe approaches to the management of the disease. The authors note that adherence to a gluten-free diet, required for adequate disease control, requires dedicated, well-motivated patients who are provided with adequate personalized instruction by an expert dietitian, as well as family and community support. 2 tables. 100 references.
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Que Usted Debe Saber Sobre la Enfermedad Celiaca [What You Need to Know About Celiac Disease]. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 14 p.
Celiac disease is a condition in which a person cannot eat gluten, a protein found in wheat, rye, and barley. This Spanish-language brochure explains celiac disease, its causes, and how it can be managed. Written in nontechnical language, the brochure covers a definition of celiac disease, how serious the disease can be, the symptoms of celiac disease, diagnostic tests that might be done to confirm the condition or determine the cause of the problem, and treatment options. Celiac disease harms the small intestine, and people with untreated celiac disease cannot get the nutrients they need. Celiac disease is diagnosed through blood tests and a biopsy of the small intestine. Treatment is a gluten-free diet, which must be followed for the person‘s lifetime. Readers are encouraged to work closely with a dietitian to learn about and create a healthful, tasty meal plan. The booklet includes a summary of the information provided, a glossary of terms with pronunciation guide, a list of resources where readers can get more information, a list of acknowledgements, and a description of the Celiac Disease Awareness Campaign (www.celiac.nih.gov). A final section briefly describes the goals and work of the National Digestive Diseases Information Clearinghouse (NDDIC). The brochure is illustrated with line drawings designed to clarify the concepts discussed in the text. One chart summarizes allowed foods, foods to avoid, and processed foods that may contain wheat, barley, or rye. The brochure is also available in English. 1 table. 3 figures.
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Quick Start Diet Guide for Celiac Disease. Auburn, WA: Gluten Intolerance Group. August 2007. 2 p.
This brochure familiarizes readers with the basics of a gluten-free (GF) diet, as used to treat people with celiac disease. Designed for people recently diagnosed with celiac disease, the brochure presents a quick and simple view of the GF diet, to be used as a safe and temporary survival tool. Even small amounts of gluten in foods may affect those with celiac disease and cause health problems. Gluten is the generic name for certain types of protein found in the common cereal grains wheat, barley, rye, and their common derivatives. The brochure covers allowed and not-allowed grains and flours, the importance of reading food labels, the use of oats in the GF diet, alcohol and vinegar, not confusing “wheat free” to mean “gluten free,” contamination in food preparation, other adverse reactions that may be confused with celiac disease, the importance of a positive attitude, and the need to undergo diagnostic testing before removing gluten from the diet. One sidebar lists common foods that may contain gluten.
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Raising Your Celiac Child: Guidelines for a Gluten-Free Life. Boston, MA: Children’s Hospital Boston. 2007. (DVD)
This full-color DVD program was written and produced by members of the Celiac Support Group at Children’s Hospital Boston. The first in the new Family Health Education series from Children’s Hospital Boston, the program includes practical advice about disease education, lifestyle management, and emotional support. Designed primarily for children who are newly diagnosed with celiac disease and their families, the DVD is organized into 12 individually accessible modules: celiac disease, the gluten-free diet, shopping, baking, dining out, food safety at school and away from home, setting up a gluten-free kitchen, emotional adjustments, the role of support groups, and experiencing the disease from a child’s perspective. Corresponding to each module are printouts available about the Children’s Hospital Boston Celiac Support Group’s website, which offers additional tips, resources, and valuable up-to-date information. The Celiac Support Group at Children’s Hospital Boston has been serving New England’s pediatric community for more than 15 years, providing newly diagnosed families with education and support. Readers are referred to its website for more information, www.childrenshospital.org/celiac.
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Satisfying GF Sandwiches: Homemade Bread Key to Good Taste. Gluten-Free Living. 16-17, 20. Summer 2007.
This article from a magazine for people following a gluten-free diet extols the virtues of home-baked bread as a healthy, good-tasting way to cope with gluten intolerance. The author maintains that it is easy to make aromatic, crusty, gluten-free bread in one’s home kitchen for a fraction of the cost of ready-made bread. The author walks readers through the details of making gluten-free bread, which requires neither kneading nor rise time. The bulk of the article consists of recipes, including rice and almond flour baguettes, limpa, Swedish meat loaf, and teff flour wraps. Each recipe includes the list of ingredients, preparation instructions, and serving suggestions. One sidebar presents two sandwich recipes from readers: roast beef, and grilled salmon with cheese.
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Understanding Celiac Disease And Gluten Intolerance: A Video Program for Patients, Physicians, and Health Care Providers. San Diego, CA: New Era Productions. 2007. (DVD).
This two-disc DVD set provides an explanation of gluten intolerance and celiac disease, problems that can have symptoms ranging from gastrointestinal (GI) complaints to anemia, infertility, short stature, irritable bowel syndrome (IBS), joint pain, osteoporosis, neurologic problems, and skin problems. The DVD features 10 chapters covering an introduction and overview, definitions, symptoms, diagnosis and diagnostic tests, the interrelationship of celiac disease and diabetes, complications, treatment and food labeling, research and potential treatments, the gluten-free diet, and a resource directory. The video features 3D animation and an easy menu for quick review of specific chapters. The material is designed for people diagnosed with celiac disease and their families and friends, as well as physicians, nurses, and dietitians.
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Use Of Endoscopic Procedures in the Management Of Celiac Disease. Gastroenterology and Hepatology. 3(7): 518-519. July 2007.
This article from a series on advances in endoscopy answers common clinical questions about the use of endoscopic procedures in the management of celiac disease (CD). CD causes incomplete digestion of gluten, which leaves large toxic fragments that enter the lamina propria, probably during infections, and set off an immune reaction. This reaction results in villous atrophy, intraepithelial lymphocytosis, and crypt hyperplasia, which are the pathologic manifestations of CD. Topics include the prevalence and pathophysiology of CD, the presenting symptoms of CD, the role of endoscopy in the screening and management of patients with CD, patient selection for endoscopic screening, the use of video capsule endoscopy with or without double-balloon enteroscopy, and research topics currently under study on this topic. Endoscopy plays an important role in CD because the gold standard for diagnosis is duodenal biopsy. Patients undergo biopsy because they have abnormal serologic tests, because they have an abnormality of the duodenal mucosa noted at endoscopy, or simply because biopsy is often performed as a matter of course during endoscopy.
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What I Need to Know About Celiac Disease. Bethesda, MD: National Digestive Diseases Information Clearinghouse, 2007.
Celiac disease is a condition in which a person cannot eat gluten, a protein found in wheat, rye, or barley. This brochure explains celiac disease, its causes, and how it can be managed. Written in nontechnical language, the brochure covers a definition of celiac disease, how serious the disease can be, the symptoms of celiac disease, diagnostic tests that might be done to confirm the condition or determine the cause of the problem, and treatment options. Celiac disease harms the small intestine and people with untreated celiac disease cannot get the nutrients they need. Celiac disease is diagnosed by blood tests and a biopsy of the small intestine. Treatment is a gluten-free diet, which must be followed for the person's lifetime. Readers are encouraged to work closely with a dietitian to learn about and create a healthful, tasty meal plan. The booklet also includes a summary of the information provided, a glossary of terms with pronunciation guide, a list of resources where readers can get more information, a list of acknowledgements, and a description of the Celiac Disease Awareness Campaign (www.celiac.nih.gov). A final section briefly describes the goals and work of the National Digestive Diseases Information Clearinghouse (NDDIC). The brochure is illustrated with line drawings designed to clarify the concepts discussed in the text. One chart summarizes allowed foods, foods to avoid, and processed foods that may contain wheat, barley, or rye. 3 figures. 1 table.
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Where's my Brownie?. Lifeline. 27(1): 6, 8. 2007.
In this newsletter article, the author shares tales of her life growing up with and coping with celiac disease for 26 years. The author reports that she was fortunate in being diagnosed in childhood, a rare occurrence at the time, and in having parents who helped her learn how to substitute gluten-free foods and not feel deprived. The author discusses special issues of college life, the joys of meeting other people with celiac disease, getting involved with support groups, and increased opportunities to find gluten-free food. The stories are told in a humorous, lighthearted manner.
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You Can Have a Healthy Pregnancy: GF Diet, Good Prenatal Care Are Key. Gluten-Free Living. p 22-23. Fall 2007.
This article helps women with celiac disease understand how to have a healthy pregnancy while still caring for their nutritional and dietary needs. The author stresses that women recently diagnosed with celiac disease, or gluten intolerance, would be better off following a gluten-free diet until their intestinal villi are healed, before becoming pregnant. Women with celiac disease have to pay special attention to folic acid and the B vitamins because these nutrients can be lacking in gluten-free foods that are not enriched. Readers are encouraged to work closely with their health care providers for detailed prenatal care, including nutritional approaches. The author reassures readers that celiac disease itself should have no impact on the fetus and a baby born to a woman with well-controlled celiac disease has no increased risk of any health problems. Another section of the article notes that pregnancy itself can sometimes be a trigger for celiac disease. One sidebar summarizes four steps to a healthy pregnancy; another sidebar reports some research findings of pregnancy complications in women with celiac disease who are undiagnosed and thus being treated. 1 figure.
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