Celiac Disease and Gluten-Free Diets

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Blog Reviewed and Edited by: Casey Seiden MS, RD, CDN, DCES

While we’ve all experienced a stomachache, bloating, or constipation at least once in our lives, could you imagine experiencing it on a daily basis? For many people with undiagnosed celiac disease, this is their reality. Celiac disease is an autoimmune disease in which the ingestion of gluten leads to damage in the small intestine. Over time, this immune reaction will continue to damage the lining of the small intestine, preventing the absorption of some nutrients. Today, this condition is considered fairly common, with 1 in 150 Americans diagnosed with it. 

Dr. Nathan Fox, a board-certified Obstetrician/Gynecologist with the subspecialty certification in Maternal Fetal Medicine, registered dietician, Casey Seiden, and Dr. Fox’s daughter, Nili Fox, who has been diagnosed with Celiac disease shared their take on this disease to help the public to learn more about this condition, and how to best manage it.

What Causes Celiac Disease?

Individuals with celiac disease experience an immune reaction when they consume anything containing gluten, during which the body’s immune system overacts, damaging the small hairlike projections known as villi that line the small intestine. The villi are important because they absorb minerals, vitamins, and nutrients from the food you eat. When your villi are damaged, you will not get the nutrition you need.

“The thought is that gluten, which is really a component of wheat, barley, rye, and sometimes oats, can have an effect on the intestine in an immune fashion, which can damage intestines,” explained Dr. Fox. “Classically, it was only diagnosed in people who didn’t absorb food, had tremendous weight loss, who were malnourished, and were very sick, but now that there’s a screening blood test we get to find it before any of those things happen. “

Diagnosing Celiac Disease

Many people who are living with celiac disease actually do not even know that they have it! This was the case with Nili Fox, who was diagnosed at the age of 10 and has been following a gluten-free diet ever since. “I was totally asymptomatic, so I had no clue that I had celiac,” Nili explained. “I went for an annual checkup and they took my blood just to test a few things and then the test results came back positive for celiac disease.  I was so confused; I had no clue what it even was.” She then went on to receive an endoscopy test, which further solidified the results.

The regular process for diagnosing celiac disease is a blood test known as serology testing, in which the doctor will look for certain antibodies in your blood. Elevated levels of specific antibody proteins can be proof of an immune reaction to gluten. An endoscopy is the next step, during which a small tube containing a camera is passed down your throat, allowing the doctor to view the small intestine as well as take a biopsy.

Following a Gluten-Free Diet

The good news is, following a strict, gluten-free diet is an effective solution to managing celiac disease. However, following a gluten-free diet can lead to some nutritional deficiencies in certain people. If you do follow a gluten-free diet, Casey Seiden stresses the importance of getting adequate amounts of iron, folate, B12, calcium, and vitamin D through supplements or diet. “Not everyone needs to supplement with a pill. In my role as a dietician, I assess what an individual’s intake looks like of certain foods and I can get a good understanding if they are falling short on some things.” She explained.

While those with celiac disease must follow a lifelong gluten-free diet to maintain a healthy body, what about people who do not have this disease? Should they avoid gluten as well? “For the vast majority of people who don’t have celiac, I don’t really recommend following a gluten-free diet unless we do a little bit of a trial elimination and we do see that potentially they’re more sensitive,” said Casey. “But going through that process, sometimes we realize that maybe it’s not the gluten that is causing symptoms, perhaps its other things such as FODMAPs, or fermentable carbohydrates.” In some cases, FODMAPs can create gastrointestinal symptoms similar to celiac disease. Overall, the best way to determine if your gastrointestinal symptoms are associated with celiac disease is to speak with your doctor regarding diagnostic testing.

Schedule an Appointment

While celiac disease is a lifelong condition, it can be managed with a gluten-free diet. To learn more about celiac disease or gluten intolerances, or for more information regarding how to manage celiac disease during pregnancy, feel free to contact Carnegie Women’s Health today to schedule a consultation appointment with our registered dietitian.

Carnegie Women's Health

Carnegie Women's Health

At Carnegie Women’s Health, we’re more than just a gynecological practice. We’re partnered with some of the most experienced and award-winning obstetricians and maternal fetal medicine specialists in the field of women’s health.

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