Celiac Disease (Gluten Enteropathy) (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Bhupinder Anand, MD
In this Article
What is the treatment for refractory celiac disease?
If diet therapy fails to resolve symptoms, refractory celiac disease is often treated with the same medications used in other autoimmune disorders to decrease inflammation. These medications include corticosteroids (prednisone), azathioprine (Imuarn, Azasan) and cyclosporine.
What are the complications of celiac disease?
The inability to properly absorb vitamins, minerals and nutrients from the diet can affect many organs in the body. Since the diagnosis of celiac disease is often delayed, there can be significant issues with iron deficiency anemia, osteoporosis because of decreased levels of calcium and vitamin D, and poor growth and development.
Aside from the other associated autoimmune disorders that might also be present, celiac disease is associated with an increased incidence of lymphoma and small intestine cancer. This risk is reduced in patients who maintain a strict gluten free diet.
What is a gluten-free diet?
Gluten is a complex protein found in wheat, barley, and rye grains. A gluten free diet excludes exposure to any of the foods that have this protein in its ingredients. It is easy to understand that regular wheat bread or pizza dough has gluten in it. However, it is less easy to realize that wheat flour is often used in many processed foods and in recipes for many foods that are prepared in a restaurant. Moreover, for it to be considered completely gluten free, processed foods should be prepared in a kitchen or factory that has no cross contamination with grains containing gluten.
The Federal Drug Administration has published new guidelines that define gluten free food as having less than 20 parts per million of gluten. Regulations regarding food labeling criteria require food to meet this standard to be labeled "gluten free." It is important to read the labels for all foods products. Aside from a gluten free designation, there may be food allergy statements that discuss the factory or kitchen where the product was manufactured.
Many restaurants have gluten free menus or can accommodate the gluten free dietary needs of their customers, but it is important for the person to ask the server, manager, or cook directly about whether it contains gluten.
Medically reviewed by Martin E. Zipser, MD; American Board of Surgery
Medically Reviewed by a Doctor on 2/10/2015
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