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Sunday, August 21, 2011

HEALTH & NUTRITION: Go gluten-free!

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Shilpa Thakur, The Hindu / August 20, 2011.

Crunchy and tasty even when uncooked. Photo: Special Arrangement
Crunchy and tasty even when uncooked. Photo: Special Arrangement.

What is celiac disease? How does one cope with it? Here are some answers.
Celiac Disease (CD) is caused by an immune reaction (hypersensitivity) to gluten, a protein found in wheat, barley, oats, and rye. In people with CD, gluten triggers an autoimmune reaction in which the body produces antibodies that attack its own tissue. This reaction causes inflammation and damage to the lining of the small intestines.

Celiac Disease is also known as Celiac Sprue, Gluten Enteropathy, Gluten Sensitivity. The current treatment is a strictly gluten-free diet for life. In a gluten-free diet, wheat, barley, and rye are avoided. Oats are not toxic in over 95 per cent of patients with CD or dermatitis herpetiformis, but there is a small subgroup (less than five per cent) for whom oats are not safe. Rice and corn can be part of a gluten-free diet. Most patients have a rapid clinical response to a gluten-free diet (within two weeks), although the rate of response varies. Patients should be encouraged to eat natural high-iron and high-folate foods, as these deficiencies are common. Though the cornerstone of treatment remains a gluten-free diet, compliance due to palatability, inadequacies in food labelling and possible cross contamination are major challenges.
Symptoms vary from person to person. Digestive symptoms are more common in infants and young children and may include abdominal bloating and pain, chronic diarrhoea, vomiting, constipation, pale, foul-smelling, or fatty stool and weight loss. Irritability is another common symptom in children. Malabsorption of nutrients when nutrition is critical to a child's normal growth and development can result in other problems such as delayed growth, short stature, delayed puberty and enamel defects of the permanent teeth.
Celiac disease is a disease of children: No doubt celiac disease is commonly diagnosed in children but more cases are being diagnosed in adults too.
Diarrhoea is a constant: Diarrhoea is the commonest presentation but it may not be the presenting feature. It may be totally absent and other presentations like anaemia, osteoporosis, infertility may be the only presenting feature.

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