In a condition called celiac disease, consuming a diet containing wheat, barley, or rye can cause damage to the small intestine. This is due to a protein called gluten. A gluten-free diet helps overcome this condition, which is hereditary in nature and triggered environmentally.

Since gluten is harmful to people with celiac disease, it is necessary to follow a diet that contains no gluten. This involves avoiding the following food items:

• Wheat - einkorn, emmer, spelt, kamut, wheat starch, wheat bran, wheat germ, cracked wheat, hydrolyzed wheat protein

• Barley

• Rye

• Triticale (cross product of wheat and rye)

To make it easier for people with celiac disease and allergic tendencies, the Food Allergen Labeling and Consumer Protection Act was passed in 2006, requiring warning labels on all foods having wheat or wheat products in them. It is, nevertheless, important to read the ingredient list on any food product to ensure there is no gluten.

By eating a gluten-free diet, there is a reduction in symptoms and healing of the small intestine, which allows proper absorption of nutrients into the bloodstream. In adults, it can take several years to heal, but in children it normally takes three to six months. Usually, there is a definite improvement seen within days of starting a gluten-free diet. At times, when no improvement is seen, the reason is mainly due to small amounts of gluten still being consumed, such as those in preservatives and food stabilizers.

At times, corn and rice products produced in wheat factories may be contaminated with wheat gluten. Consulting a dietician can be helpful, so that by following the right diet, any damage to the intestine can be reversed.

Always remember to check the labels of food products for “gluten-free” language. You can also get clarification from the manufacturer, to be on the safe side. Foods that can be consumed safely include:

Grains and starches: Corn, cornmeal, buckwheat, arrowroot, gluten-free flours (rice, soy, corn, potato, bean), corn tortillas, rice, and tapioca

General items: Fresh meats, fish, poultry (not coated or marinated), fruits, most dairy products, vegetables, potatoes, nuts, seeds, and beverages

Oats: may be consumed depending on the individual situation (check with a doctor or nutritionist)

There are specialty stores dedicated to gluten-free foods, including bread and pasta.

As mentioned above, food and products made from wheat, rye, barley, and contaminated oats must be avoided. Foods containing the following ingredients must also be avoided: bran, bread flour, all-purpose flour, brown flour, brewer’s yeast, graham flour, malt, rye, semolina, whole meal flour, and matzo meal.

To be safe, the following food products must not be consumed unless labeled “gluten–free”: beers, breads, candies, cakes, pies, cereals, crackers, croutons, cookies, imitation meats, gravies, oats, pastas, salad dressings, sauces (including soy sauce), and soups.

Certain products used on a daily basis such as lipsticks, lip-balms, play dough, medications and vitamins can contain gluten as a binding agent. These must be avoided, and children having celiac disease should wash their hands after playing with play dough.

Following a gluten-free diet can result in low levels of certain vitamins and minerals, as most grains are rich in these nutrients. Check regularly with a dietician to ensure there is adequate iron, calcium, fiber, thiamin (vitamin B1), riboflavin (Vitamin B2), niacin (vitamin B3) and folate in your diet. Otherwise, supplements in the form of vitamins and minerals can be taken to make up for deficiencies.

Someone on a gluten-free diet may have other dietary considerations and should keep in mind that gluten-free food items may:

• Have a higher fat content

• Contain much lower calcium

• Result in weight gain

• Result in diarrhea/constipation

• Result in unhealthy weight loss

If – accidentally or otherwise – a product containing gluten is eaten, symptoms may or may not appear. This does not imply that intestinal damage is not happening, as even traces of gluten in the diet can be harmful. At times, there can be abdominal pain or diarrhea. Other conditions can also develop including:

• Autoimmune disorders

• Bone disorders (fractures)

• Low blood count (anemia)

• Low blood sugar (hypoglycemia)

• Infertility or miscarriage

• Liver disorders

• Intestinal cancer

If a gluten-free diet is not meticulously followed, your body may not get the right nutrients, and the small intestine may not function normally.

If someone close to you is diagnosed with celiac disease, the good news is that it is a very treatable disorder, without surgery, medications, or therapy. The best approach is to get accurate nutritional advice and stock up on gluten-free products, even if it means spending extra time in the grocery store reading food labels. You can also contact local support groups. Eating out is still an option, as many restaurants now serve gluten-free dishes.