Living Gluten-Free with Celiac Disease
“Gluten-free” has become a bit of a buzzword in the realm of healthy eating in recent years. Need proof? Look no further than the businesses selling bottles of “gluten-free water” — never mind that there’s no such thing as water with gluten (at least, none that you’d want to drink). Despite the trendiness of a wheat-free diet, the jury is still out on how effective it is overall for weight loss or digestive health.
But for quite a few people, gluten is a major obstacle between them and a happy, healthy life. It can even be a matter of life and death. Celiac disease is an intolerance or allergy to gluten that leads to inflammation in the small bowel. This inflammation can lead to poor absorption of nutrients, causing symptoms such as gas and bloating, diarrhea, abdominal discomfort and fatigue.
Between 0.5% and 1% of people have it, putting them at risk of metabolic bone diseases such as osteoporosis, nutritional deficiencies and lymphoma of the gastrointestinal tract. It might not sound like much, but that’s between 13,580 and 27,160 people in Chicago alone. Here’s how you can tell if you have celiac disease — and a few easy tips for how to live your best life with a sensitivity to gluten.
Diagnosing Celiac Disease
Celiac disease is an autoimmune disease that can be inherited. Patients with Type 1 diabetes, Down syndrome or a first- or second-degree family member with celiac disease are at higher risk of contracting the condition. Other diseases that are associated with increased risk of celiac disease include autoimmune thyroiditis, selective immunoglobulin A (IGA) deficiency, Turner syndrome, William syndrome and juvenile arthritis.
The symptoms of celiac disease can be very subtle and easily attributed to other, less serious conditions, such as irritable bowel syndrome (IBS). That’s why diagnosis by a gastroenterologist is key to relief. Celiac disease is often diagnosed with blood tests that search for specific antibodies. The gold standard for these tests is an endoscopy with small bowel biopsies. However, a particular rash known as dermatitis herpetiformis is so closely associated with celiac disease that it’s sometimes enough to diagnose the disease without the need for a biopsy.
Living (and Eating) Gluten-Free
Once a person with celiac disease has gone gluten-free, they might find that exposure to gluten makes them feel sicker than ever. Gluten can be found in wheat, rye, barley and many other grains, and it’s also often hidden in processed foods such as cold cuts, condiments and salad dressings — not to mention most beers. Even after you’ve adapted to a gluten-free diet, gluten has a way of sneaking onto your plate. Keep these tricks in mind to keep your meals gluten-free.
- Be careful in shared cooking spaces. You might have gone gluten-free, but that doesn’t mean your whole kitchen has. When you slide your gluten-free bagel in a community toaster, you can expect some cross-contamination. The same goes for unwashed cutting boards or bread knives. Be extra careful (and consider investing in a no-gluten toaster).
- Stick to fresh meats, fruits and veggies. In general, fresh produce and fresh meat at the grocery store are reliably gluten-free. Watch out for processed foods, which might have unexpected gluten.
- Read the labels. Not all processed foods have gluten, and many of them advertise themselves as being “gluten-free.” These labels are probably reliable. However, check back often; just because one of your favorite treats has been gluten-free in the past doesn’t necessarily mean it will remain that way.
- Use your phone to double-check. If you’re not sure whether an item is gluten-free or not, you can visit the manufacturer’s website to confirm. You could also download an app like Shopwell, which can scan items at the store to make sure they fit your dietary needs.
- Be extra-vigilant when eating out. At a restaurant, it can be a lot trickier to stay gluten-free. So-called gluten-free menu items have frequently turned out to be anything but. It’s part of the downside of “gluten-free” being so trendy, especially with the risk of cross-contamination in the kitchen.
- Speak up about your dietary needs. Always inform your server that you have celiac disease and cannot process gluten. Chefs use glutens for common cooking tasks such as dusting steaks in flour. Notifying them upfront will help them be extra-mindful when preparing your food.
Living with celiac disease doesn’t mean forgoing your favorite indulgences. It just means making slight modifications to your lifestyle to help improve your health, physical comfort and happiness.
Whether your digestive issues are caused by celiac disease, inflammatory bowel syndrome or another disorder, a gastroenterologist can help get your guts in order.