The “trendiness” of a gluten-free diet may have calmed down compared to a few years ago, but for some people, the gluten-free diet was never a fad. For people with celiac disease, avoiding gluten is a necessary part of their medical treatment.
Many people confuse gluten and wheat, but they’re not the same thing: Gluten is a protein found in certain grains, particularly wheat, barley, and rye. Technically, there’s nothing inherently wrong with gluten, and it’s a healthy part of most people’s diets.
But for people with celiac disease, the presence of gluten in the body can actually trigger an autoimmune response that leads to severe gastrointestinal distress, such as:
And pale, smelly stools.
Celiac disease is an autoimmune disease, and it causes the immune system to see gluten proteins as an invader. When gluten is present, the immune system launches an attack on the protein in the small intestine (which is where it gets digested).
Repeated attacks on the small intestine damage the villi, which are tiny, fingerlike projections that line the small intestine to absorb nutrients. Not only does this blunt their appearance—making them shorter and rounded—but it inhibits their ability to absorb nutrients. As a result, people with unmanaged celiac disease tend to be prone to nutrient deficiencies.
In addition to malnutrition, people with celiac disease may experience inflammation beyond the villi of their small intestine. Most commonly, celiacs are prone to inflammation of the joints, skin, and spleen. They also have a higher than average risk of developing osteoporosis, dental and mouth problems, pancreatic insufficiency, and infertility.
In other words, keeping celiac disease in check is vital for long-term health, and the only proven treatment for celiac disease is a strict gluten-free diet. For some people, that also includes avoiding cross-contamination, meaning they can’t share a toaster with someone eating standard wheat bread. (Here are foods that are surprisingly not gluten-free.)
With gluten-free diets piquing the interest of many Americans, it’s important to avoid self-diagnosing yourself with celiac disease. There’s a big difference between having celiac disease and feeling sluggish after eating too much pasta. There’s also a big difference between celiac disease and gluten sensitivity.
The only way to get diagnosed with celiac disease is with blood tests and possibly a biopsy of the small intestine. If you think you may have celiac disease, see a doctor. Autoimmune diseases can be serious if not properly managed, and getting help from a doctor and registered dietitian can seriously improve your quality of life.
Celiac disease. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on November 9, 2021 at https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease.)
Celiac disease. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on November 9, 2021 at https://medlineplus.gov/celiacdisease.html.)
Pathology, epidemiology, and clinical manifestations of celiac disease in adults. Waltham, MA: UpToDate, 2021. (Accessed on November 9, 2021 at https://www.uptodate.com/contents/pathogenesis-epidemiology-and-clinical-manifestations-of-celiac-disease-in-adults.)
What is celiac disease. Celiac Disease Foundation. (Accessed on November 9, 2021 at https://celiac.org/about-celiac-disease/what-is-celiac-disease/.)