Beer. Mustard. Hamburger. Pizza. If you are one in 133 Americans with celiac disease, chances are you won't eat any of these foods because they contain gluten — a protein found in wheat, rye and barley. And if you do eat them, then you're miserable with gas, bloating, constipation and diarrhea.
Maryann Pollock of Grants Pass was diagnosed with celiac disease last year at age 73. "I remember from my 20s, I started having gastrointestinal problems, like diarrhea and constipation," she says. "Nobody but nobody knew what it was and I was getting medication for regurgitation."
Many food products and condiments are now labeled as gluten-free, but don't assume that anything, including foods labeled natural or organic, is made without gluten. Be particularly wary of baked goods, mixes and condiments.
You can find gluten-free products in the specialty and diet sections of the grocery, and you'll find lots more shelved throughout the store. Visit www.glutenfree.com and you'll be surprised to see what brands have gluten-free products you can count on.
Your best bet for good health? Read the label!
Celiac disease is a diagnosis that's easily missed, like Maryann's presumed esophageal reflux. Some people with early stage and mild celiac disease may show no or only occasional symptoms, but for others who are severely allergic, even a trace of wheat can raise painful blisters and rashes. Celiac disease is a lifelong, progressive disease that without treatment gets worse and worse over time. As with many medical conditions, it's important to make the diagnosis so the cause of the symptoms can be treated.
"People can have a lot of diseases that mimic celiac disease such as irritable bowel syndrome, lactose intolerance, fructose intolerance or small intestine bacterial overgrowth," notes Medford gastroenterologist Dr. Paul Schleinitz.
A screening blood test and intestinal biopsy is the only way to know for sure that you have celiac disease and the only known treatment is to eliminate gluten from your diet. And that's a radical change in anybody's life, but without it, you might end up in the hospital, like Maryann did last year — down to 70 pounds, anemic, and severely depressed.
"The immune system thinks gluten is bad and attacks the small intestine," explains Dr. Schleinitz. "It [the small intestine] is less and less able to absorb nutrients." And that means diarrhea and malnutrition.
"It took me a long time before I was well, because I was still eating gluten," Maryann remembers. "Now I'm being more cautious — anything that says fillers or artificial this or artificial that, people have to stay away from it, that's very important."
Gluten can hide in the most unexpected places like salad dressing, envelope adhesive, and even vitamins.
"When you're first diagnosed, you have to read every label," advises Cathy Miller, a registered dietician at Providence Hospital. "But once you recognize the crackers that you like, some mixes that you like, then it's easy. People get in the habit of buying the same products or similar products week after week."
Miller remembers that when she first became a dietician, gluten-free foods were only available by mail order. "It's come a long way since then," she says. "Not only has the access to products improved, but the taste of the products improved." Gluten-free cake and bread mixes, cereals, bread, noodles and desserts are now readily available in health food stores, the farmers market and in the grocery.
"You just have to know where you can go and what you can eat," Maryann points out. "I get the tapioca bread and the brown rice bread — those two to me are excellent, but they have to be toasted. It's a learning experience."
"It takes a little time, and yes you get depressed when you're first diagnosed. Yes, you're going to have some mishaps," says Maryann. "Have hope. You can eat all the fruit, all the fresh vegetables you want. The food's getting better all the time, even in the last year, but you have to toast your bread."