About Celiac Disease
Celiac disease (CD) is a common disorder that is estimated to affect about one percent of the population. It is a condition in which the absorptive surface of the small intestine is damaged by a substance called gluten. Gluten is a group of proteins present in wheat, rye and barley and their cross bred grains. The damage to the intestine can lead to a variety of symptoms and result in an inability of the body to absorb nutrients such as protein, fat, carbohydrates, vitamins and minerals, which are necessary for good health.
Patients with CD can present with a variety of symptoms.
The classical (typical) symptoms include:
However, many patients now present with non-classical (atypical) symptoms including:
liver enzyme abnormalities,
dental enamel defects,
neurological problems, etc.
Children can present with:
Celiac disease occurs commonly in patients with other autoimmune disorders such as thyroid disease and type-I diabetes. It can also run in families, both in first and second degree relatives. Therefore, screening of these high risk individuals should be considered.
Since many patients with CD do not present with classical symptoms, delays in diagnosis can occur.
Dermatitis herpetiformis is “celiac disease” of the skin. The patients present with severely itchy blistering rash. The diagnosis can be confirmed with a skin biopsy. Treatment consists of strict gluten-free diet and, in some cases, medications.
In the past, physicians had to rely on clinical symptoms and signs alone to suspect the diagnosis of CD and select patients who would require further investigations for confirmation. Now, highly effective blood tests are available to screen for CD. The IgA-tissue transglutaminase (TTG) antibody is the currently recommended test for screening. The patients must be on a regular (gluten-containing) diet at the time of testing to make the results valid.
The definitive diagnosis of CD is made by a small intestinal biopsy. The biopsy is performed via endoscopy by gastroenterologists. Again, it is important that gluten not be removed from the diet before the biopsy is completed as it may impair the confirmation of the diagnosis.
At present, there is no permanent cure for CD but it can be effectively treated with a gluten-free diet. The adherence to the gluten-free diet must be STRICT and LIFE-LONG. Gluten-free diet can be challenging and complicated and a consultation with a registered dietitian with expertise in gluten-free diet is essential.
Individuals with celiac CD need to be vigilant about hidden sources of gluten and cross contamination in food products. Careful label reading each time when buying products is important.
Since celiac disease is a chronic disorder, regular long-term follow-up with the physician and dietitian is recommended.
Developed by the CCA Professional Advisory Council
Gluten Free Diet
New to Gluten Free? Where to start?
When you have Celiac Disease, eating gluten damages the intestinal lining of your small intestine and can cause a host of symptoms and health problems. The current treatment for Celiac Disease is an adherence to a lifelong gluten free diet. This may seem overwhelming at first, but there are many resources and a great community at the CCA to help you navigate the gluten free diet.
On a GF diet, all grains containing gluten MUST be avoided.
Gluten containing grains include:
Wheat (whole wheat, wheat berries, graham, bulgur, farrow, farina, durum, kamut, bromated flour, spelt, semolina)
Triticale (cross between wheat and rye)
Oats (unless certified gluten free can be contaminated with gluten)
Read labels when purchasing food to ensure there is no gluten. Look for foods that are Certified Gluten Free and read all ingredients to ensure the product is gluten free. The CCA offers an extensive guide to reading food labels:
Nutrition Tips for People Living with Celiac Disease Long Term
The CCA partnered with Ryerson University’s Masters of Nutrition Program to offer a webinar on potential nutrition deficiencies of people living with Celiac Disease long term and how they can boost their health. The webinar features 4 Ryerson dietetic interns discussing how to get important vitamins and nutrients on a gluten free diet. This in-depth webinar is 1 hour in length and discusses how to eat well on a GF diet (outlined using Canada’s food guide).
For more information go to www.celiac.ca under “Living Gluten Free”
The following is a list of resource materials created by the Canadian Celiac Association (CCA) as well as the Calgary Celiac Education committee available in a printable format.
Canadian Celiac Association (National) Resources
From symptom trackers to gluten-free diet guides, the Canadian Celiac Association has multiple resources on celiac disease available in several languages. Always check the National website for the most current and reliable information. We have included links to the most popular items here:
Dermatitis Herpetiformis- What is it
Celiac Disease Hidden and Dangerous
Celiac Disease: Oral and Dental Complications
Link to National Website: www.celiac.ca
Growing Up Celiac
A diagnosis of celiac disease or a gluten-related disorder can be overwhelming at first. For children, it might mean a change to their diet and having to enjoy different snacks and treats than the ones they might be used to having. They or their caregiver will need to carefully check labels for sources of gluten. Chocolates, sauces and treats often contain wheat but there are many that are safe to consume. It just takes some time, knowledge and a bit of practice.
It’s important for the child along with the parents to learn to read labels and advocate for themselves.