Celiac disease: eating gluten-free

Fall 2015

There is a popular misconception that eating gluten free is just the latest fad diet. However, for people with celiac disease, eating gluten free is not an option – it is a necessity to live normal, healthy lives.

When Theresa Misek was diagnosed with celiac disease in April 2014, she was surprised. She describes it as an incidental diagnosis.

Her son Luke had been diagnosed two months earlier. Luke, who was four-and-a-half at the time, had shown the classic symptoms of celiac disease -- losing weight, lack of energy, diarrhea and not thriving.

After blood tests showed the possibility of celiac disease, Luke’s family physician referred him to LHSC paediatric gastroenterologist, Dr. Kevin Bax, for further testing.

Following Luke’s diagnosis, the entire family was tested because celiac disease can run in families and that is when Theresa learned she had it as well. She was then referred to LHSC gastroenterologist Dr. James Gregor.

“While Luke had all the classic symptoms, I didn’t notice that there was anything wrong with me,” says Theresa.

Dr. Gregor explains, “We need to look for it in patients with chronic diarrhea, but we also need to look for unexplained anemia, osteoporosis, particularly in younger woman, and autoimmune diseases such as Type 1 diabetes.”

Celiac disease can be triggered by stressors such as pregnancy or a virus, and Theresa’s vague symptoms included low iron, hormone imbalances in pregnancy, frequent ‘stomach flu’, and if she didn’t take her iron pills she would feel very tired.

While celiac disease is not that common - the overall prevalence is about one per cent - more people are being diagnosed.

“There is definitely an increased awareness with interest in the gluten-free diet. There are more people diagnosed also because of increased access to the non-invasive screening blood test,” says Dr. Gregor.

“After initial diagnosis as well as medical and dietary counseling, most patients do not require ongoing gastrointestinal follow up if they don’t experience further symptoms, but most of my patients choose to be seen in our clinic on a yearly basis.”

While there is no cure for celiac disease, treatment consists of strict adherence to a gluten-free diet.

That means no wheat, barley, rye or oats (unless they are special oats grown away from wheat), for life.

“We had to look at every label, and Luke is a fussy eater to begin with, and then we started to find substitutes,” says Theresa.

Once both Theresa and Luke were diagnosed, they decided as a family to bake gluten free and that everyone would eat gluten-free dinners.

“Other meals would be regular, except Luke and I would substitute with gluten-free products such as gluten free cereal,” says Theresa. “The food itself tastes good, the family is happy, and it is so nice when meal times return to normal.”

With a new diet, Luke improved very quickly and felt better within a week. After a month he began gaining weight and thriving. Theresa also saw improvements within two months of diagnosis and changing her diet.

“I was able to go off the iron pills without becoming fatigued,” says Theresa. “Also, I used to be hungry all the time and was always eating without gaining weight. Now I have no issue with feeling hungry and I enjoy eating normal portions which actually last me until the next meal.”

If Theresa does eat something with gluten, she feels sick, nauseous to the point of vomiting.

Having celiac disease extends beyond eating gluten free to also living gluten free. Gluten can be absorbed through skin contact with products such as shampoo, or by cleaning up after gluten is eaten at the table.

Eating out involves an online search for restaurants that serve gluten-free options.

For get-togethers with family or friends, Theresa usually packs a big side dish that can also serve as a full meal for her and Luke, along with a dessert.

“The chocolate cake I make is a favorite,” says Theresa.

 In general, Theresa doesn’t crave foods containing gluten. “I have enough gluten-free options I am content with. I don’t crave wheat food, except maybe a Tim Hortons bagel.”

 As for gluten-free eating as a popular diet, Theresa is very appreciative. “Around the time I was diagnosed you really began to see the gluten-free labeling in grocery stores and at restaurants.”

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Luke and his mom Theresa are making a gluten-free chocolate cake.
Dr. James Gregor, gastroenterologist.
Gluten-free chocolate cake fresh out of the oven.