By Pamella Binder

The easy part of treating celiac disease is to watch, at ALL TIMES, what you eat. The hard part is knowing exactly where gluten, the culprit, resides.

Gluten is a general name for proteins stored in wheat, rye and barley. These proteins call the autoimmune system of an afflicted person into action, by attacking the epithelial cells of various organs, primarily the small intestine. When looked at more closely, each of these wheats has its own specific protein that causes intolerance: Wheat has gliadin,rye has secalin, and barley has hordein.

Oats have their own confusing problems. Oats have the protein Avenin. “Controversy has swirled around oats since 1953 when it was declared toxic….The safety of oats [for those with celiac disease] has been widely debated.” (Case, 19) In addition, the majority of commercially grown oats are contaminated with offending glutens during, harvesting, transport, milling and processing.

The question of just what is a gluten even eludes governments around the world. They deal with the issue by passing laws about packaging labels: What needs to be on the label, how much of a substance makes it mandatory to list something as an ingredient, what are the tolerance levels for people afflicted with food allergies or diseases.

Yes! Unlike my statement made in Part I of this series, celiac disease is truly a disease. “Disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors such as infectious disease, or it may be caused by internal dysfunction, such as autoimmune diseases. Celiac disease is an autoimmune disease causing the body to attack itself in the small intestine causing specifically symptoms of diahhrea and weight loss.” (The American Heritage Medical Dictionary. Disease)

“Celiac disease causes malabsorption of food,” Dr. Abul F. Islam, MD, gastroenterologist, stated in an interview at his Bay City office. “Food is not completely digested; therefore it speeds through the patients digestive tract undigested.”

Continuing, Dr. Islam explained, “Since food doesn’t have time to be digested, the body misses getting all the calories, vitamins, minerals and nutrients it needs.” Because of this domino effect, a patient then can develop serious health concerns, making diagnosis of celiac disease vital.

Dr. Islam feels the two testing modalities available for diagnosis of celiac disease are equally reliable. The original method involved snipping tiny pieces of small intestine to see if it was destroyed, the most damning evidence of gluten’s presence. The newest method is a biochemical test: drawing blood from the patient, which is inspected for particular antigens.

“We see an increase in diagnosis of celiac disease because of more awareness and better testing,” Dr. Islam was quick to point out. “With a proper diagnosis of the presence of this auto-immune disease other complications and/or other auto-immune diagnoses are possible throughout a patient’s life.”

Persons diagnosed with celiac disease have many places to find guidance on gluten avoidance, the only true treatment for the disease: The internet; books on the subject; support groups and grocery shelves dedicated to prepackaged food stuffs, including ready-made mixes with wonderful recipes. This, however, has not always been the case.

When I first suspected our infant daughter, Katherine, might have celiac disease, the only product declared truly gluten- free was soy. I don’t know about you, but soy flavor is not one I cherish. It must be an acquired taste. After Katherine was professionally diagnosed with celiac disease some 17 years later, the market place was flooded with wonderful cookbooks, pre-packaged food items with a variety of safe “flours” and reliable sources for information.

“Since 2006 the United States Government , through the FDA rule 21CFR 105.62 for Hyperallergenic Food Labeling, assures consumers that guidelines are in place for the food manufacturers labeling process for products that purport to be or are represented to be for a special dietary use.” (Case, 66)

In closing, I highly recommend the book I have used throughout this two part series on Celiac Disease: Gluten-Free Diet- A Comprehensive Resource Guide, by Shelley Case, BSc, RD. Among all the excellent information, the book includes the following hints for shopping for gluten-free items:

Always read labels. Ingredients can change.

Have a resource guide with you. There are pocket guides available. They should include acceptable foods and ingredients for a gluten-free diet.

Call manufacturers with questions.

Case also includes a list of 88 gluten-free additives and ingredients. She also points out there are components of often used ingredients that are potentially filled with offending glutens: baking powder; seasonings; hydrolyzed plant or vegetable protein from wheat; soy sauce and Worcestershire sauce.

To begin your education about celiac disease, you need only visit your local library or a bookstore, such as the Saginaw Barnes and Noble Booksellers where 27 books are shelved on the subject. Barnes and Noble website: www.barnesandnoble.com lists 694 items under the search term celiac disease. There are nearly 20 national and international organizations affiliated with hospitals and non-profit volunteer agencies that can be a great source for information and support. A sampling of them includes: www.celiac.ca; www.csaceliacs.org; www.celiacdiseasecenter.columbia.edu; www.nutritioncaremanual.org.

The best action for people who suspect they have celiac disease is to talk to their physician and be tested, especially if it runs in their family.


Abul F. Islam, MD, Gastroenterologist, Bay City, MI, November 1, 2011.

Case, Shelley, BSc, RD. Gluten-Free Diet. Regina, Saskatchewan, Canada. Case Nutrition Counseling. April, 2006. Book.

"disease." The American Heritage® Stedman's Medical Dictionary. Houghton Mifflin. Company. 12 Sep. 2011.

Pamella Binder is a freelance writer specializing in health topics.

© Pamella Binder, 2012.