Gluten Free Diet

Gluten Free Diet and Celiac Disease

 What is a gluten?

Gluten is a protein contained in wheat, rye, barley, and possibly oats. A gluten-free diet means avoiding all foods that contain this protein. People following this type of diet can still have bread and pasta; however, they will have to have gluten-free breast and pasta which can be made with potato, rice, soy, or bean flour or purchase other products from special food companies.

Plain meat, fish, rice, fruits, and vegetables do not contain gluten, so people on a gluten-free diet can eat as much of these foods as they like.  

Celiac Disease: the need for a gluten-free diet

People who have Celiac disease cannot tolerate gluten. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine. Specifically, tiny fingerlike protrusions, called villi, on the lining of the small intestine are lost. Nutrients from food are absorbed into the bloodstream through these villi. Without villi, a person becomes malnourished--regardless of the quantity of food eaten.  

The only treatment for celiac disease is to follow a gluten-free diet--that is, to avoid all foods that contain gluten. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet, and the small intestine is usually completely healed--meaning the villi are intact and working--in 3 to 6 months. (It may take up to 2 years for older adults.).  

However, a small percentage of people with celiac disease do not improve on the gluten-free diet. These people often have severely damaged intestines that cannot heal even after they eliminate gluten from their diets. Because their intestines are not absorbing enough nutrients, they may need to receive intravenous nutrition supplements. Drug treatments are being evaluated for unresponsive celiac disease. These patients may need to be evaluated for complications of the disease.