Celiac Disease
How is it treated?
The American Dietetic Association has identified six elements of treatment for celiac disease following diagnosis. They correspond with the word, CELIAC:
- C: Consultation with a skilled registered dietitian
- E: Education about the disease
- L: Lifelong adherence to a gluten-free diet
- I: Identification and treatment of nutritional deficiencies
- A: Access to an advocacy group
- C: Continuous long-term follow-up.
Unfortunately, drug treatments are lacking for celiac disease. Since gluten aggravates the condition, the main focus of therapy is to avoid gluten.
So, where is gluten found? Gluten is mostly found in wheat, barley, rye, and oats. It can also be found in certain adhesives, cosmetics, and medicines. Wheat is used widely by the food industry as a thickener in products like ice cream, pasta, sausages, breaded fish and meats, cheese spreads, salad dressings, soups, sauces, mixed seasonings, and many others. All beers contain gluten and should be avoided. Also, use caution when using gluten-free products as many of them are manufactured in the same machines as are gluten-rich products and may become contaminated. Some products may include modified starch, which contain gluten in the ingredients. If the food label lists modified starch, oats, barley, or wheat the item should be avoided. Determining which foods do not contain any gluten can be difficult. A dietician can help determine which foods are safe in patients with celiac disease.
Retailers are starting to become more aware of the need for gluten-free foods. Some restaurants are offering gluten-free menus. Some companies are listing gluten content on the packages of their food products. Wal-Mart's brand "Great Value" is one of them. Whole Foods Market is also offering baked goods without gluten from their "Gluten-Free Bakehouse." The number of gluten free products has increased greatly over the past few years. Many websites exist that compile information on the gluten content of popular foods and can help aid in your diet choices.
There is no standard to what is considered gluten-free however. Each company sets its own standards, but no federal standard exists. The FDA will not have to develop a standard until 2008 under the Food Allergen Labeling and Consumer Protection Act.
Besides avoiding foods that contain gluten, an individual with celiac disease also needs to avoid medications that contain gluten. Some pharmaceutical companies do provide gluten free medications; however, most pharmaceutical manufacturers cannot absolutely guarantee that their drug products are 100% gluten free as their suppliers may change inactive ingredients (of which gluten can be contained). If you would like to determine the gluten content of a medication, it is best to ask your pharmacist or contact the specific manufacturer of the drug. If the manufacture is not listed on the medication bottle, talk with your pharmacist for information on how to contact the manufacturer.
Here is a brief listing of pharmaceutical company phone numbers:
Abbott products 1-800-633-9111
GlaxoSmithKline products 1-888-825-5249
Pfizer products 1-800-438-1985
Teva generic drug products 1-800-545-8800
Wyeth products 1-800-338-2872
Avoidance of gluten should result in improvements of celiac disease symptoms within 48 hours, although it may take weeks to months for full recovery from symptoms. If symptoms continue after gluten has been removed from the diet, either the diet has had traces of gluten or another disease may be the cause of damage to the small intestines.
The symptoms of celiac disease can be treated to bring comfort to the patient. Anti-diarrheal medication can be used for treatment of immediate diarrhea symptoms until celiac disease is under control. Anti-diarrheal medications are not generally recommended for long-term use. Supplements may be needed to relieve symptoms of vitamin and mineral deficiencies as determined by a physician.
For severe cases of celiac disease, glucocorticoids can be tried on a short-term basis. However, when glucocorticoid therapy is stopped symptoms generally return. Therefore glucocorticoids are not routinely recommended. Gluten avoidance is still the best way to avoid flare-ups of celiac disease.
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How is it treated?
