Celiac disease is a condition that damages the lining of the small intestine. The damage is due to a reaction to eating gluten, the protein found in wheat, barley and rye. The exact cause of celiac disease is unknown. The lining of the intestine contains fingerlike projections called villi which help absorb nutrients. Celiac disease causes these villi to be damaged when people that have the disease eat foods that contain gluten. The damage affects the body’s ability to absorb nutrients properly and the risk of becoming malnourished exists.
The disease can develop any time in life from infancy to late adulthood. People with a family member who has celiac disease are at an increased risk for developing the disease. Women are affected with the disorder more often than men, and the disorder is most common in Caucasians and persons of European ancestry.
People with celiac disease are more likely to have autoimmune disorders such as rheumatoid arthritis, systemic lupus erythematosus and Sjogren syndrome. Other common occurrences with celiac disease are lactose intolerance, Addison’s disease, thyroid disease and type 1 diabetes.
The best diagnostic tests for celiac disease include measurements of antibody levels to endomysium and to an enzyme called tissue transglutaminase. The two tests are very specific for celiac disease in persons who are untreated. Measurements of antibodies to gliadin and reticulin are other diagnostic tests that are less specific for celiac disease. Biopsy samples of the small intestine can be obtained by introducing a small, flexible endoscope through the mouth, the stomach and into the small intestine while the patient is sedated. Biopsy samples of the small intestine can show mild, moderate or severe destruction of the villi depending on the severity of the inflammation.
I was recently invited to the Bangor area Celiac Sprue Support Group to provide information about how to get more fiber into their diets.
Fiber is a challenge for celiac sufferers because the most common sources of dietary fiber are whole-grain breads and cereals, but people on gluten-free diets cannot simply go to the supermarket and buy ready-to-eat whole-grain cereals. Research shows that people on gluten-free diets tend to eat inadequate amounts of fiber.
The fiber recommendation for adolescents and adults is 20-35 grams per day. Luckily there are plenty of naturally gluten-free high-fiber foods. Large amounts of fiber should be added to your diet slowly to prevent causing too much gas, bloating or cramps. It is also important to drink lots of water.
High-fiber foods for gluten-free diets include apples, asparagus, bananas, blueberries, pears, prunes, raisins, raspberries, strawberries, blackberries, broccoli, Brussels sprouts, carrots, kale, potato (baked), spinach, brown rice, buckwheat, corn, oatmeal, popcorn, quinoa, almonds, flax seeds, peanuts, soybeans, soy nuts, sunflower seed kernels, chickpeas, kidney beans, lentils, peas, pinto beans and refried beans.
Eating out is a challenge for people that require a gluten-free diet. One particular restaurant was mentioned by the members of the support group — Angelo’s on Hammond Street in Bangor. They apparently have wonderful gluten-free pizza and the owner has made the decision to sell the pizza at the same price as regular pizza. The owner told one of the group’s members that he can’t bring himself to charge people more for pizza because they have a disease. There are many other restaurants in the Bangor area, as well as throughout the state, that are offering gluten-free choices, including Frank’s Bakery in Bangor.
Whether you have had celiac sprue for two weeks, two months or 20 years, you will find out something new by attending the Celiac Sprue Support Group in Bangor. The group meets at 7 p.m. the third Tuesday of the month (except December) at the St. Joseph Room (the old fire station) across from the St. Joseph Hospital emergency entrance in Bangor. The group is lead by Ann Delaware, who is willing to take calls and answer questions at 827-2733.
Georgia Clark-Albert is a registered dietitian and adjunct nutrition instructor at Eastern Maine Community College who lives in Athens. Read more of her columns and post questions at bangordailynews.com or email her at GeorgiaMaineMSRDCDE@gmail.com.