Celiac Disease Diet

Sufferers of celiac disease must follow a gluten-free diet.

Gluten is an amorphous ergastic protein found combined with starch in the endosperm of most cereals. It constitutes about 80% of the proteins contained in wheat and is composed of the proteins gliadine and glutenine. Gluten is responsible for the elasticity of kneaded dough which allows it to be leavened, as well as the "chewiness" of baked products like bagels.

Coeliac disease (also termed sprue, celiac disease and gluten intolerance) is an autoimmune disease characterised by chronic inflammation of the proximal portion of the small intestine caused by exposure to certain dietary gluten proteins. Pathologic changes to the structure and function of the small bowel's mucosa impair the body's ability to digest or absorb nutrients from food. It is estimated that 1 in every 133 to 250 persons (up to 3 million) in the United States and 1% of people in the world are affected by coeliac disease.

The principal cause of the disorder is an immunologic reaction to components of certain dietary glutens. This is a cell-mediated reaction, not a typical IgE type allergy. The targets of the immunologic response are gliadin, hordein, and secalin, proteins contained in the gluten component of wheat, barley, and rye. Traditionally, oats have been included in the list as well, but some recent studies have brought into question whether this is necessary [1] (http://www.celiac.com/). Corn (maize), sorghum, and rice are considered safe for a patient to consume. They do contain types of gluten that do not trigger the disease.

In most patients, a strict wheat and gluten-free diet will relieve the symptoms. Some patients suffer from refractory sprue. Many cases of refractory sprue are in patients exquisitely sensitive to even trace amount of the problematic glutens; thus, dietary restriction fails due to trace contamination of products with wheat proteins. In other patients, a sprue-like condition may be due to intolerance to other dietary proteins such as those found in egg, milk, or soy.

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