diseases and disorders 
not the full list, but a useful resource   

DIVERTICULITIS

IRRITABLE BOWEL DISEASE

CELIAC SPRUE

GENERAL INFORMATION

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DEFINITION

Celiac sprue is also referred to as gluten sensitive enteropathy, non topical sprue or celiac disease. It is an inherited disorder affecting approximately 1 in every 300 people in the United States. This disorder causes damage to the lining of the small intestine so that food is not absorbed normally. The symptoms may appear during the first three years of life (after starting grains other than rice cereal). There is another peak incidence occurring in adults in their 30's and 40's. The disease appears to be rare in Africans and Japanese.

SYMPTOMS

There are a wide range of symptoms and include diarrhea, flatulence, bloating, weight loss, anemia, weakness, bone disease, menstrual abnormalities, iron deficiency, folate deficiency, bleeding abnormalities and muscular pain. Children may have poor growth, diarrhea or even projectile vomiting.

DIAGNOSIS

There are a wide variety of blood studies that a physician would collect as part of the screening for celiac disease and include: serum carotene, stool sudan III stain, folate, vitamin B12, iron studies, calcium, vitamin K, antigliadin antibodies and antiendomysial antibodies. If your doctor suspects celiac sprue based on one or a few of these studies confirmation is needed by obtaining tissue (small intestine biopsy) for examination under the microscope.

TREATMENT

A gluten free diet is the cornerstone for treatment of celiac sprue. This requires avoidance of wheat, barley, rye and oats. It is necessary to read labels carefully to search for "hidden" sources of gluten. It is important not to become overwhelmed. This requires initially taking a look at the big picture and dividing goods into good groups (fruits and vegetables, meats, fat, dairy, starch) and eating them in their natural form rather than ready mixes or convenience items.

CELIAC DISEASE AND LACTOSE INTOLERANCE

Lactose intolerance refers to the inability to digest lactose into the two component sugars, glucose and galactose. This occurs because of insufficient enzyme (lactase) to beak down the sugar. When this occurs, bloating, abdominal cramps, flatulence and diarrhea may ensue. Interestingly, many of these symptoms are present in and can be confused with celiac sprue. Diseases that damage the mucosa of the small intestine such as celiac disease may lead to temporary lactase deficiency. Additionally, This damage is the first to occur and the last to be reversed. It may take two to three months to build up lactase after a stringent gluten free diet is introduced to the individual. In the meantime it is very important to obtain the nutrients that milk provides such as calcium from another source. Keep in mind as well that one may develop lactose intolerance as they get older irrespective of any disease process.

FOODS TO AVOID ON A GLUTEN FREE DIET

BEVERAGES

malted milk, ovaltine, instant chocolate/ cocoa powder or syrup containing wheat flours, instant meal beverages, beer, ale, whiskey, vodka, gin, or other grain alcohol, some herbal teas

SOUP

thickened soups with gluten containing grains, some instant bouillon or soups

GRAINS

wheat, rye, oat, barley, starches containing these grains such as breads, pasta, cereals, cake, cookies, pastry, buckwheat, wheat germ, bran; wheat starch contains small amounts of gluten; other versions of wheat to be avoided: durum, semolina, spelt, kamut, bulgur, triticale; also avoid amaranth, millet, quinoa

CHEESE

some processed cheeses and those with annatto food coloring

MEAT, FISH, or POULTRY

breaded meats fish or chicken, Gefilte fish, some canned meats or sandwich spreads, cold cuts, and hot dogs unless noted as pure meat; meat and sausage extended with flours, imitation products.

SAUCES and GRAVIES

mixes or instant or ready sauces in jars; many are thickened with gluten containing grains

VEGETABLES

vegetables prepared with sauces, ready to cook casseroles, some commercially prepared potatoes

FATS

some salad dressings, vegetable dips, dressing mixes

DESSERTS

ice cream cones, some ice creams, frozen yogurts or sherbets, some puddings, cakes, pies, pie filling, pastries, cakes,

CANDY

candies with gluten containing fillers, those with caramel coloring, licorice; some gum may be dusted with wheat

CONDIMENTS

soy sauce, malt vinegar, or grain vinegar, seasoning salts, syrups with caramel coloring may all contain added gluten; check all condiment labels carefully as they may contain thickening agents with gluten

GENERAL

anything containing malt, instant rice products, microwave meals, some hydrolyzed plant protein or vegetable protein, emulsifiers, some rice syrup using barley enzymes, some medicines, frying oils where breaded foods are cooked in the same oil; avoid anything that says "filers", maltodextrin, mono and diglycerides may have wheat binders

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