What is Celiac disease?
People who suffer from celiac disease cannot digest gluten, a protein that is found in many types of grains, including wheat, rye, kamut, spelt, barley and more. Cases can range from mild to severe. Severe cases are usually discovered in childhood because the child will fail to grow and thrive. Less severe cases may not manifest until much later.

Gluten intolerance is often an inherited condition. Mild gluten sensitivities can progress to intolerance (Celiac disease) over time. Stress is one factor that can predispose an individual to this progression.

Gliadin, who?
Gliadin is the component of gluten that causes gastrointestinal damage. Gluten intolerance is an immune reaction. Read our article on other Autoimmune conditions. When an individual with celiac disease consumes gluten, the body attacks, like it would when exposed to a bacteria or virus. In doing so, this reaction destroys the microvilli along the lining of the gastrointestinal tract, primarily throughout the small intestine. Absorption of nutrients from food and supplements is compromised, resulting in malnourishment and further symptoms and conditions related to inadequate nutritional status.

Tell me more about gluten!
Gluten is a protein, found in a number of grains (and baked goods), as it gives elasticity to dough, allowing it to maintain shape and giving it rise. Wheat gluten is an additive in MANY products, making keen label reading a necessity for those with intolerance. Here are just a few of the many grains and other food products containing gluten: barley, oats, rye, wheat, spelt, kamut, hydrolysed vegetable protein, texturized vegetable protein, hydrolysed plant protein, malt, modified food starch, some soy sauces, grain vinegars, white vinegar, binders, fillers, natural flavour, hot dogs, gravies, most luncheon meats, beer, mustard, ketchup, non-dairy creamer, most processed foods, bouillon cubes, some chocolate, bottled salad dressing, and many prepackaged or mixed seasonings (taco seasoning, etc.). Some individuals with celiac disease can eat oats safely, however, oats are often contaminated with gluten. There are oats available on the market that are labelled as certified gluten-free and will be safe for consumption. If there is no label present, however, the oats could have been processed together with gluten-containing grains and will not be safe. Gluten can be present in some supplements as well, making up the capsule or acting as a filler. Check the label before proceeding. There are many gluten-free guides that can be used for safe product navigation and the Canadian Celiac Association is a great resource for those looking for more information.

Symptoms
Common symptoms of celiac disease include diarrhea, abdominal pain, bloating, nausea and vomiting. Stool is very often smelly and shiny or greasy (steatorrhea). Malnutrition, caused by impaired absorption, can also cause a number of symptoms or conditions, including, but not limited to anemia, weight loss, fatigue, infertility, canker sores, rashes, bone pains, arthralgias, osteopenia, asthma, thyroiditis, mood imbalances and depression. Definitive diagnosis of celiac disease should be done through a health professional. Blood tests looking for anti-gliadin antibodies are often used for screening, although histological examination of the mucosa of the small intestine is necessary to make a diagnosis.

Treatment
The only way to treat celiac disease is by eliminating gluten from the diet. Maintaining a gluten-free lifestyle will allow the microvilli of the digestive tract to heal. Reintroduction of gluten will usually cause a complete relapse of symptoms, meaning these dietary restrictions are, in almost all cases, permanent. Some adults with Celiac disease can tolerate small amounts of gluten in their diets. As the prevalence of celiac disease is increasing, due in some part to increased detection, so is the availability of a variety of gluten-free products.

When an individual is initially diagnosed, it is often recommended that they do an elimination diet, to rule out any other sensitivity that may be exacerbating their symptoms. As an example, dairy products may exacerbate a gluten intolerance. Other known food sensitivities should be avoided. Because of the damage that gluten intolerance causes to the gut, it is important for people with Celiac disease to maintain vigilance against disorders like Candida, Crohn's, and Irritable Bowel.

Gluten digestive enzymes?
Fairly recent to the natural health market are enzymes that can be taken as a means of supporting the digestion of gluten-containing products. These products contain DPP IV (dipeptidyl peptidase), from a protease enzyme specific to the digestion of gluten and casein. These enzymes are meant to support those individuals with a mild sensitivity and should be used with caution by individuals with Celiac disease. There are no studies to back up any claims, nor claims made by these supplement companies, stating that these enzymes are meant to allow those with gluten intolerance to eat gluten-containing foods.