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Celiac disease: a chronic pain in the gut

celiac disease is a gluten allergy

May is Celiac Awareness Month. The Canadian government says as many as 300,000 Canadians could have this disease. But that’s a conservative estimate since many people remain undiagnosed. Providence Health Care registered dietitian Dani Renouf offers a primer on what celiac disease is, and how it can be managed.

What is Celiac Disease?

Celiac disease is a chronic and autoimmune disease that is triggered by the ingestion of gluten so it is a condition characterized by a true allergy, requiring the elimination of gluten from the diet as much as possible. This is because the presence of gluten damages the intestinal lining, and can lead to worsening health long-term. Celiac Disease is present in one per cent of the population, unlike Irritable Bowel Syndrome,, whose incidence is about 20 per cent. While IBS is driven by factors unrelated to immune function, celiac disease is the mounting of an immune response followed by inflammation and tissue damage due to gluten ingestion.

We suspect that the occurrence of celiac disease may be higher than reported, as people present with mild to no symptoms initially.  In some cases, people may present with non-digestive symptoms like fatigue, irritability, edema, iron deficiency anemia, and amenorrhea (the absence of menstrual periods).  So if you are not sure, it is a good idea to discuss screening for celiac disease with your family doctor.

How is Celiac Disease Diagnosed?

Dani Renouf, registered dietitian, St. Paul’s Hospital

People who have celiac disease may or may not experience digestive symptoms, and therefore, a blood test to look for presence of antibodies is needed. If there is a presence of antibodies, celiac disease is likely but should be confirmed by intestinal biopsy to make a definitive diagnosis.  Screening and diagnosis should occur while the person is still consuming gluten.

What are Recommendations for Managing Celiac Disease?

Current guidelines for managing celiac disease include a lifelong gluten-free diet, which requires the support and follow-up care of a registered dietitian. There are many hidden sources of gluten in foods that are packaged or prepared, and in home and restaurant environments that should be evaluated to ensure as little gluten contamination as possible. Many people follow a gluten-free diet with success and empowerment; especially if they seek the support they need in a timely manner and receive correct and trusted nutrition information.

People living with celiac disease should visit their doctor regularly to have their antibody levels measured annually and ensure overall health is achieved.  Most people achieve good healing of their gut and a reduction of inflammation long-term. In some cases, people may also experience ongoing digestive health issues, in which case working with a registered dietitian on a low Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols (FODMAP) diet may help with symptom management.

Where Can I Find Out More?

If celiac disease is in your family, or if you have symptoms, you can start by taking this symptom checker to find out how to explore further health care options in symptom management and diagnoses.  The Canadian Celiac Association has excellent resources and support for those living with Celiac Disease.