Central California Faculty Medical Group (CCFMG) and its University Centers of Excellence are now Inspire Health Medical Group.

When Gluten-Free is Not a Choice

A more recent trend in the health and wellness space has been reducing the amount of gluten in your diet or cutting gluten out entirely. But there are some for whom not eating gluten isn’t a choice—it is a necessity.

Celiac disease is a genetically passed autoimmune disease. According to the Celiac Disease Foundation, it is estimated that 1 in 100 people worldwide are affected, but only about 30% of those affected are properly diagnosed. The American College of Gastroenterology has reported the diagnosis has risen in recent decades, likely due to increased awareness and testing, but also due to a rise in autoimmunity.

“Celiac disease can be difficult to diagnose as it can affect different parts of the body. Diagnosis is, however, important to avoid complications of this disease. Once a diagnosis has been made a multidisciplinary approach to treatment that includes the primary care physician, gastroenterologist, dietician and a mental health provider is best to help guide our patients through the challenges related to this new, life-changing diagnosis,” said Maricela Rangel-Garcia, MD, a CCFMG physician at University Gastroenterology & Hepatology Associates.

When someone has celiac disease, gluten in the digestive system triggers the immune system to produce antibodies, which cause inflammation in the walls of the intestines and can damage the mucosa, the lining of the small intestines.

According to Johns Hopkins Medicine, some symptoms of celiac disease include chronic diarrhea or constipation, weight loss, gas, unexplained anemia, early osteoporosis, stomach pain or swelling, pain in joints, painful or itchy skin rash, and more.

A health care provider will examine the patient’s past health and conduct a physical exam to diagnose the disease. They will need to check blood work to look for high levels of gluten antibodies and perform a biopsy of the small intestines. Next, a health care provider will check the biopsies of the small intestine for damages to the villi—tiny finger-like projections in the small intestine that absorb nutrients.

Long-term effects of celiac disease damage could result in malabsorption, bone disease and anemia. This happens when the villi become so damaged the body cannot absorb the nutrients it needs during digestion, leading to malnutrition, says Cleveland Clinic.

Fortunately treatment for celiac disease is relatively straightforward—patients must stop eating gluten. However, while there are an increasing number of gluten-free foods, it can still be challenging to find foods and drinks not contaminated by gluten. Many foods are processed in the same warehouses or transported in containers where foods with gluten have been processed or moved in. Patients with celiac disease must carefully read labels and be mindful of the ingredients in their food and drinks.

A celiac disease diagnosis is life-changing. It means a significant diet alteration and requires continuous specialized care, but it can be managed. The world-class physicians at University Gastroenterology and Hepatology Associates care for patients with celiac disease and other digestive conditions. Learn more about them at universitymds.info/gastro-hep.