Celiac FAQs

CELIAC DISEASE

What is Celiac Disease, or Sprue?
Who is most likely to have Celiac Disease?
What are the symptoms of Celiac Disease?
How do you diagnose Celiac Disease?
What is the cure for Celiac Disease?
What other diseases can Celiac lead to?
What other sources of information are there?

What is Celiac Disease, or Sprue?

Celiac Disease, also known as Sprue, Non-Tropical Sprue, Celiac Sprue, Coeliac, Coeliac Sprue, Gluten Intolerance and Gluten Enteropathy, is a hereditary, autoimmune disorder in which damage to the small intestine takes place when someone who is predisposed to it, consumes too much "gluten" over a period of time! Gluten is an elastic, rubbery protein, found in wheat, rye, barley and oat grains.

The small intestine, where the problem is found, is made up of (1) the duodenum, which receives pancreatic enzymes from the pancreas and bile from the liver and contains tiny, fingerlike protrusions called villi and even smaller ones called microvilli, which allow for greater absorption of nutrients and (2) the jejunum and the ileum, which are largely responsible for the absorption of fats and other nutrients. When the villi and the microvilli become damaged by the constant ingestion of "gluten," or more specifically the protein's core, "gliadin," people who are predisposed to Celiac become malnourished and more susceptible to other diseases no matter how much food they may eat over time.

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Who is most likely to have Celiac Disease?

Celiac Disease had been described as primarily a problem for (Euopean) Italians (1 in 250) and (Euopean) Irish (1 in 300), but also affecting others like the English, Germans, French and even Jews through, for instance, intermarriage, casual sex, or even rape down through the ages. A number of years ago, a Red Cross study, in which random blood samples were tested, showed that 1 in 250 Americans may have had Celiac. They estimated that 1 in 4,700 Americans had been diagnosed with Celiac Disease then. More recently, The Gluten Free Bible by Jax Peters Lowell, as well as other sources, revealed that "Work by Dr. Alessio Fasano and others at the Center for Celiac Disease at the University of Maryland would suggest that the condition may occur in a quiescent but insidious form as frequently as 1 in 132 individuals in the United States." Others have used simular figures such as "1 in 133" to show how urgent it has become to test more people.

According to Mary J. Shomon's book, "Living Well With Autoimmune Disease," on P.40 where she discusses the "Nationality, Ethnicity and Origin Factors" of autoimmune disorders, "Ulcerative colitis and celiac disease are more common in temperate climates. ... Celiac disease and ulcerative colitis are more common in people of Ashkenazi Jewish descent (from eastern or central Europe)." She repeats the same thing on P.312 in list-like form, making no mention of Irish, or Italians when referring to Celiac Disease. She also reports that American Jews have the highest number of cases of IBD (Irritable Bowel Disease) in the U.S. IBD includes Crohn's and Ulcerative Colitis. Celiac Disease has often been misdiagnosed as either of the former two IBDs. Celiac is rarely diagnosed in those who appear to be (black) African, Chinese, and Japanese, but if so, it is very likely that one of their ancestors, unbeknowns to them, was a non-(black) African, non-Chinese, or non-Japanese person who had Celiac and who passed it on to them through the family tree.

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What are the symptoms of Celiac Disease?

The following are some of the major known symptoms:

(NOTE: You may have some, many, most, all, or none of the symptoms now (even before age 50), but still have it show, or come about later in life.)

• Recurring abdominal bloating and pain
• Chronic diarrhea
• Weight loss - malnutrition
• Pale, foul-smelling stool
• Unexplained anemia (low count of red blood cells) - malnutrition
• Gas
• Bone pain
• Behavior changes
• Muscle cramps
• Fatigue
• Delayed growth - malnutrition
• Failure to thrive in infants
• Pain in the joints
• Seizures
• Tingling numbness in the legs (from nerve damage)
• Pale sores inside the mouth, called aphthus ulcers
• Painful skin rash, called dermatitis herpetiformis
• Tooth discoloration or loss of enamel
• Missed menstrual periods (often because of excessive weight loss)

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How do you diagnose Celiac Disease?

Diagnosing Celiac Disease could be difficult since some of the symptoms are similar to other diseases like the following:

Irritable Bowel Syndrome (IBS)

IBS is a disorder of the mobility of the entire gastrointestinal tract that produces abdominal pain, constipation, or diarrhea.

Crohn's Disease

Crohn's, an inflammatory bowel disease (IBD) most common among Jews, according to the "Merck Manual" (P.578) and Mary J. Shomon's "Living Well With Autoimmune Disease" P.251, (regional enteritis, granulomatous, ileitis, ileocolitis) is a chronic inflammation of the intestinal wall.

Ulcerative Colitis

Ulcerative Colitis, an inflammatory bowel disease, is a chronic disease in which the large intestine becomes inflamed and ulcerated, leading to episodes of bloody diarrhea, abdominal cramps, and fever.

Diverticulosis

Diverticulosis, which seems to develope after middle age, age 40, is the presence of diverticula, usually in the large intestine.

Intestinal Infections

Intestinal infections affect the kidneys as well as the liver, but could also affect the heart, lngs and the brain.

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome is an illness that occursmainly among adults aged 20 to 40 years. More women suffer from it than men. Symptoms include debilitating fatigue, interference with the ability to concentrate, and, in some cases, a low grade fever and swelling of the lymph nodes.

Depression

Depression is a feeling of intense sadness; it may follow a recent loss or other sad event and persists beyond an appropriate length of time. It is the most common psychiatric disorder after anxiety, beginning between ages 20 to 40.

Now, if someone suspects that he, or she, might have Celiac Disease, rather than any of the above diseases, then that person should request a blood test, and if results seem to be pointing to it, have a small intestine biopsy, both from a physician, or doctor. If the biopsy points further in the direction of what most likely is Celiac, then that physician, or doctor, should then ask you to refrain from anything that contains "gluten" for at least three days to see how you will feel. At the end of the three days, or so, if you feel much better, you will probably, if diagnosed with CD, be put on a "gluten-free diet" for life.

A blood test looks for a higher than normal level of antibodies (in the blood) to gluten. These anti-bodies are antigliadin, anti-endomysium, and antireticulin. The physician, or doctor, performs an intestinal biopsy, a relatively painless procedure that involves removing a tiny piece of tissue from the small intestine with an endoscope, but only if tests and symptoms strongly suggest Celiac Disease. This is the easiest method for discovering if you had been suffering from eating "gluten" (found in wheat, rye, barley and possibly oat), the primary cause of Celiac Disease.

Also, screening for CD may be necessary since Celiac Disease is a hereditary disease. Family members, particularly first-degree relatives, may need to be tested too. Consult a reputable physician, or doctor, about the details before complications set in with you and possibly your family.

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What is the cure for Celiac Disease?

Shop for and eat no food, even if it is marked Kosher, that contains the protein, "gluten," which is found in wheat, rye, barley and possibly oat (through contamination) and their by-products. When you shop in most food markets, though many super market chains now carry some "gluten-free" items, and many health food and natural food stores probably carry much more of the same, you must avoid, unless otherwise noted on the label of the container, all of the following and more wherever you go:

• Bread (most breads in all markets contain gluten)
• Cookies (most cookies in all markets contain gluten)
• Cake (most cakes in all markets contain gluten)
• Pizza (most pizzas in all markets contain gluten)
• Bagels (most bagels in all markets contain gluten)
• Ketchup (contains distilled white vinegar unless otherwise noted)
• Mustard (contains distilled white vinegar unless otherwise noted)
• Pickles (contains distilled white vinegar unless otherwise noted)
• Matzos (all matzos must be made from at least one of the 5 Biblical grains [wheat, rye, oat*, barley, spelt {an older form of wheat}] according to Rabbinic sources. There is no such thing as a substitute grain such as rice, quinoa, amaranth, or millet, when it comes to making matzos!.)
• Deli meats - Kosher, or not - (salami, bologna, ham)
• Deli cheeses (some veined cheeses contain gluten such as bleu)
• Herring bits and salads (contains distilled white vinegar unless otherwise noted)
• Foods containing Gluten (most bread, pasta, cereals)
• Foods containing Modified Food Starch (sauces, sour creams)
• Foods containing White Vinegar (mustards, ketchups, pickles)
• Foods containing Malt (milk, Ovaltine, beer, ale, gin, whiskey)
• Foods containing Flavoring (coffees, herbal teas - with malted barley)
• Foods containing Sauces (most soy sauces, many tomato sauces)
• Foods containing Hydrolyzed Vegetable Protein (bouillon cubes)

*Oat grains? According to the Celiac Sprue Association, on a page on their web site titled The Scoop on Oats, "The appropriateness of oats in the gluten-free diet has been pondered for over 20 years. Studies continue with mixed conclusions on this subject of whether the consumption of oats evokes an immune response in those with celiac disease and dermatitis herpetiformis. Until it can be determined if the responses that occur are due to cross-contamination in commercially processed oats, to the protein structure of the grain or to other individual differences, CSA recommends that excluding oats is the only risk free choice for those on a gluten-free diet. As always, the individual is responsible to make decisions that he or she deems best for optimum health and well-being." This statement probably sums it up. If you wish to know more about the history of this, please go to their web site and check this out. That is one of the reasons why I will not eat "oat matzos," which some rabbis say are OK to eat on Pesach. Do it at your own peril!

Allergic Reactions to certain foods! - If you are not allergic to other things such an "egg, peanut, tree nut (walnut, cashew, etc.), fish, shellfish, soy, and wheat, " as named by The Food Allergy & Anaphylaxis Network, then as far as going to the market, you should be good to go as the saying goes! Of course, you could be allergic to almost anything, so stay as alert and aware as possible.

NOTE: When you go shopping, please read all the labels again and again each time you go out for that item. Companies do change ingredients without warning. The same holds true for vitamins and over-the-counter drugs. Call them to make sure, if you are in doubt about any of the ingredients on any label of any box, can, bottle, jar, or other container. That includes the current mandated law concerning Allergens too. When in doubt -- do not buy it! Better safe than sorry.

The following list includes the basic foods in the Western World that a person who has Celiac Disease should be able to live with - including the Blood Type Diet requirements:

• Rice flour (white, brown and wild) - (organically grown if possible) - *Good for all Blood Type Celiacs
• Quinoa flour - *Good for all Blood Type Celiacs
• Amaranth flour - *Good for all Blood Type Celiacs - * Not Good for Blood Type AB Non-Celiacs
• Tapioca flour - (organically grown if possible) - *Good for Blood Type A & B, but not AB & O Celiacs
• Soy bean flour - (organically grown if possible) - *Good for Blood Type A & AB, but not B & O Celiacs
• Soy bean cheese - (organically grown if possible) - *Good for Blood Type A, but not B, AB & O Celiacs
• Soy bean flakes - (organically grown if possible) - *Good for Blood Type A & AB, but not B & O Celiacs
• Soy bean granules (lecithin) - (organically grown if possible) - *Good for Blood Type A & AB, but not B & O Celiacs
• Soy bean milk - (organically grown if possible) - *Good for Blood Type A & B, but not AB & O Celiacs
• Eggs (chicken) - (from chickens fed organically grown feed if possible)
• Milk - (cow: skim, or 2%) - *Good for Blood Type B & AB, but not A & O Celiacs
• Milk - (cow: whole) - *Good for Blood Type B, but not A, AB & O Celiacs
• Milk - (goat) - *Good for Blood Type B & AB, but not A & O Celiacs
• Meat - (cow beef) - *Good for Blood Type B & O, but not A & AB Celiacs
• Meat - (lamb) - *Good for Blood Type B, AB & O, but not A Celiacs
• Fish - (with scales & fins) - *Good for all Blood Type Celiacs - Some are Carp, Cod, Mackerel and Perch
• Poultry - chicken & cornish hen- *Good for Blood Type A & O, but not B & AB Celiacs
• Poultry - turkey - *Good for all Blood Type Celiacs
• Vegetables - (organically grown if possible) - *Good for all Blood Type Celiacs - Examples: - asparagus, bbeet, bok choy, broccoli, carrot, collard greens, daikon radish, garlic, kale, kelp, onion, parsnip, green-pod-snow pea and spinach
• Fruits - (organically grown if possible) - *Good for all Blood Type Celiacs - Examples: - blueberry, boysenberry, all cherries, cranberry, black & red currants, dark blue & purple elderberries, fig, grape, grapefruit, lemon, lime, peach, pear, pineapple, plum, raisin and watermelon

NOTE: * I do not recommend Corn meal flour because it is no good for all Blood Types even though it is Kosher.
* I do not reccommend Pork & Pork Products such as ham and bacon because they are not only tref (unclean, or Not Kosher, but are No Good for all Blood Types. See Blood Type Diet for more on that subject.
* I do not recommend fish "without scales and fins" because they are Not Kosher (See Kosher FAQs) for more on that subject.
* I do not recommend "shellfish" such as oysters, clams, crabs, shrimp and so on because not only are one, or the other kinds of "shellfish" Not Good for you, or the other Blood Types, but they are Not Kosher (See Kosher FAQs) for more on that subject.
NOTE: You are free to do as you please and to ignore what I say about this, or that being Kosher, or even this, or that being "Good," or "Not Good," and again for this, or that Blood Type, but this is how I, a Jewish Celiac, does it here and years of studying the situation as I will put it, I think that I got it right. Thank you.

FOR A COMPLETE LISTING OF
WHAT YOU SHOULD AND SHOULD NOT EAT,
GO TO FOOD GROUPS - ALLOWED-NOT ALLOWED.

READ ALL LABELS CAREFULLY!!!

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What other diseases can Celiac lead to?

People who are diagnosed with Celiac Disease tend to also have other autoimmune diseases as well. Some of them, which may also be genetic, are the following:

• Dermatitis herpetiformis - (This has the identical symptoms of Celiac Disease.)
• Thyroid disease
• Systemic lupus erythematosus
• Insulin-dependent diabetes
• Liver disease
• Collagen vascular disease
• Rheumatoid arthritis
• Osteoporosis
• Sjogren's syndrome
• Anemia
• Seizures
• Cancer

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What other sources of information are there?

The following organizations that deal with the problem of Celiac Disease had been listed below in the past, but can now be found on my Cool Links page. Some of the names and address are for CSA (Celiac Sprue Association), CDF (Celiac Disease Foundation) and GIG (Gluten Intolerance Group). When you contact them, by calling, e-mailing, or by going to their web sites, you will probably be able to find a support group in your area. Good luck!

NOTE: If any of the information above is wrong, or out-of-date, e-mail me at and let me know. Thank you.

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