What is Celiac Disease?

Dear Blogosphere,

A good friend of mine posted a comment on my "lets list the weird things that contain gluten" posting. I thought, hey, why not give a good explanation of that mysterious protein called gluten!

Gluten is a protein found in wheat. For ease, pretty much everyone (except probably gastroenterologists who work in labs) refer to the potentially harmful proteins in barley and rye as gluten as well. Gluten is not "bad" but can be harmful to some people. Gluten is the protein that gives bread all of its fabulous textures -- chewy and elasticy, fluffy and soft.

Gluten is harmful for people who have Celiac Disease or Gluten Intolerance. I do not know much about Gluten Intolerance, so I will stick to explaining Celiac Disease. Celiacs occurs in about 1:133 Americans. It is a genetic auto-immune disorder. About 10% of type 1 diabetics have Celiac Disease. The cause of Celiac Disease is an inappropriate immune reaction to gluten. When the immune system detects gluten in the small intestine, it decides to attack and kill the cells on the surface of the small intestinal walls.



The picture above shows what happens after time as the immune system continues to attack the small intestine. This is called villi atrophy. The left is a healthy tissue sample; the right is unhealthy. If you have learned about digestion before, you will know how the villi are so important. The villi allow for more surface area, and therefore, more absorption of nutrients. So, those with Celiac Disease (before treatment) tend to be vitamin and mineral deficient and their bodies are often starved or in starvation mode.

Usually, doctors diagnose Celiac Disease by running blood tests for antibodies and then, the gold standard, by biopsy. I went to my endocrinologist in June for a regular diabetes check-up. He asked me about my general health and I told him that I had upset stomachs often, but that's just because I'm too stubborn to stop eating cheese and ice cream (I thought I was lactose intolerant). He told me that he was going to order some blood work for Celiac Disease. I told him that I didn't think I had it, but he sort of demanded. Anyway, the blood work came back "very positive" (I had a lot of activity going on) so I went for the small intestine biopsy. It is very easy. They knocked me out for about 5 minutes and did an endoscopy (I do have pictures) and biopsy. A few weeks later, a pathologist had determined that I had moderate damage due to Celiac Disease.

The only treatment for Celiac Disease is avoiding gluten. And might I just say... THANK GOD! Although it has been difficult to cut out all of the delicious glutenous foods, to not have to deal with more injections and drugs that have side effects is fabulous. Within three days of starting the gluten free diet, I had energy I never knew existed. It takes about 6 months for the SI to heal itself, so I'm sitting tight. I have accidentally ingested gluten a few times (by cross-contamination), and it has been unpleasant. The worst part is the exhaustion that can last for days.

Perhaps the best thing that happened with getting Celiacs is the excuse to try new and delicious (and often expensive) foods. Since being diagnosed I have eaten polenta, made lots of Pad Thai, tried Amy's gluten free meals, and talked my mom into buying me sugary cereals (like Fruity Pebbles and Trix). I get to experiment and find the best versions of pizza crusts and pastas. I've also become even more aware of the food I eat. Since I now have to look hard at ingredient lists, I try to pick foods where I can pronounce all of the ingredients.

The one thing though... the bread will never be as good. No xantham gum can change that.

Love,
Natalie