What is celiac disease?

Shelley Case, a registered dietitian and member of the advisory board of the Canadian Celiac Association, and the author of Gluten-Free Diet, reminds consumers that a blood test is only the first step toward a definitive diagnosis. The second is a small bowel biopsy, performed by a gastroenterologist, which will show if there’s been damage to the small intestine. As well, notes Case, the blood test and biopsy will give a false negative if your diet has been gluten-free, so don't change your diet before visiting your doctor if you suspect you may have CD.

Still, the only way to manage CD is with a strict, lifelong gluten-free diet. This is becoming easier each year thanks to a rapidly growing gluten-free foods industry in North America and better food-labelling policies. Case says there are now more than 3,000 gluten-free specialty products, and more are becoming available at mainstream grocery stores. And just this year, the federal government introduced new labelling requirements for food allergens and gluten sources in prepackaged foods. Even restaurants are getting the picture, says Case, who notes Pizza Pizza in Toronto now offers a gluten-free pizza.

The CCA has established communities of support, and they have also made a difference in the quality of life for Canadians with CD. Dale Franklin, a former member of the London, Ont., chapter of the CCA, says she swaps recipes, information, advice and stories with other parents of kids with CD, "so they don't have to repeat mistakes I've made, and vice versa."

What is celiac disease?
CD is not the same as a wheat allergy or wheat sensitivity. A person with a wheat allergy has an abnormal reaction to the proteins in wheat, causing eczema, rashes and even anaphylaxis. CD, by contrast, is an autoimmune condition in which the lining of the small intestine is damaged by gluten. 
A healthy intestine has tiny villi – or microscopic hairs – that absorb nutrients as food passes through your system. If you have CD, gluten will cause your immune system to attack the small intestine, resulting in inflammation and damage to the tissues. The microscopic villi in the intestine then atrophy and become flattened, unable to absorb healthful nutrients such as protein, vitamins and minerals.

Over time this autoimmune reaction to gluten can cause an array of disruptive symptoms. Most common are abdominal pain, gas or bloating, diarrhea and weight loss; fatigue, anemia, infertility, recurrent oral ulcers, bone pain and menstrual irregularities are also often reported. Additional symptoms in children may include irritability, vomiting, delayed growth and defects in dental enamel. Untreated CD can also increase the risk of osteoporosis and intestine cancer.

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