What you need to know about gluten and celiac disease

We are used to seeing grocery items labeled “fat-free,” “sugar-free,” and “cholesterol-free.” These days, “gluten-free” products line our grocery shelves too. Bread, cereal, pasta, frozen food, and numerous other products proclaim “gluten-free” in eye-catching bold letters. We also hear celebrities promote “how to feel better” on a gluten-free diet as part of a healthy lifestyle. 

Is “gluten-free” just today’s popular health fad?

Gluten is a naturally occurring group of proteins in wheat. Rye and barley contain very similar proteins called “prolamins” that can trigger the same symptoms. Gluten is also found in a surprisingly large number of food products beyond the typical flour-based staples like bread.

But for people who have Celiac disease, gluten actively damages the small intestine. This organ helps the body digest and absorb nutrients from food. The symptoms include constipation, diarrhea, vomiting, gassy bloating, weight loss, and belly pain, which can be “silent” sometimes.

“Some people may have an allergy or sensitivity to wheat that mimics these common, often vague symptoms,” comments Kiran Mudambi, MD. Dr. Mudambi is a pediatric gastroenterologist and Celiac disease expert at Mary Bridge Children’s. “But there is no guesswork when it comes to Celiac disease, which we can accurately diagnose with blood work and an endoscopy procedure.”

Celiac disease is an autoimmune disorder

According to Dr. Mudambi, Celiac disease is not uncommon, affecting about 1 in 100 people. Exposure to gluten triggers a strong reaction in patients with Celiac disease, causing their immune systems to “fight off” gluten like an immune response to a virus or poison. The tissue cells that line the inside of the small intestine called villi become irritated.

“We know that chronic inflammation in the body is very damaging over the long term,” explains Dr. Mudambi. Over time, the constantly inflamed tissues can lead to significant health issues. “Research shows that untreated celiac disease is associated with osteoporosis, nerve damage, and depression,” Dr. Mudambi adds. “Even more seriously, chronic Celiac disease has also been shown to increase the risks of an intestinal lymphoma in adults.”

Diagnosing celiac disease

Dr. Mudambi says diagnosing Celiac disease can be tricky, so he recommends that adult or pediatric patients see an experienced gastroenterologist. While laboratory blood work confirms the presence of specific markers for the disease, a comprehensive endoscopy exam is often necessary for a complete diagnosis. During the endoscopy procedure, Dr. Mudambi inserts a tiny tube through the mouth, down the throat, and into the small intestine to remove adequate samples (biopsies) of the affected tissue. A pathologist examines the tissue biopsies to look for elevated lymphocytes and damaged villi, the telltale signs of Celiac disease.

How is celiac disease treated?

While there is no cure or medication, the harmful symptoms associated with Celiac disease can be successfully controlled by eliminating foods that contain gluten. Pediatric patients and their families work with Clinic nutritionists to learn about making the best food choices. The “cure” sounds straightforward, but Dr. Mudambi knows this process can be very challenging for many of his patients. “Luckily, we have a lot more gluten-free options these days, but we know managing Celiac disease requires constant monitoring,” he acknowledges.

For example, families may already deal with other medical conditions requiring dietary changes, such as diabetes. And some foods marked “gluten-free” may still have traces of gluten due to cross-contamination. “There is also a lot of misinformation swirling about,” he notes. “For example, a common misconception is that people with Celiac disease should avoid oats, but most people who don’t tolerate gluten do just fine with oats!”

Our Gastroenterology, Hepatology & Nutrition Clinic treats children with celiac disease & other digestive disorders

Schedule an appointment with one of our GI specialists by calling 253-792-6630. Because Celiac disease often runs in families, Dr. Mudambi recommends family members get tested, too, even if they don’t have any symptoms.

Kiran Mudambi, MD, is board-certified in pediatrics with a subspecialty in gastroenterology. He sees patients at Mary Bridge Children’s outpatient centers in Tacoma, Gig Harbor and Federal Way. (Outside the office, he is an avid superman fan and collector. His favorite vacation was a recent trip was traveling to Metropolis, Illinois to see the largest collection of superman memorabilia.)