Celiac disease is a genetic (inherited) digestive disorder of the small intestine manifested by
interference with absorption of nutrients from food. Other names for celiac
disease are sprue, nontropical
sprue, and celiac sprue. Individuals who have
celiac disease cannot tolerate a protein called gluten,
which is present in wheat, rye, and barley. When people with celiac disease
eat foods containing gluten, their immune system reacts, resulting in damage
to the lining of the small intestine. Celiac disease can be diagnosed with
blood tests and by examining a small piece of the intestine from a biopsy.
The May 18, 2005, issue of JAMA includes an
article reporting that infants who had initial exposure to foods containing
wheat, barley, or rye either in the first 3 months of life or after 6 months
were at increased risk for celiac disease. This Patient Page is adapted from
one originally published in the March 20, 2002, issue of JAMA.
Celiac disease symptoms may start in childhood or adulthood, with onset
and severity influenced by the amount of gluten that is eaten.
Stomach pain, gas, and bloating
Pale, foul-smelling bowel movements
Bone or joint pain
a painful rash of itchy blisters
Stunted growth (in children)
There is no specific medicine or surgery to treat celiac disease. The
only cure is strict and complete avoidance of gluten. Following a gluten-free
diet is a lifetime requirement for individuals with celiac disease. A gluten-free
diet will stop symptoms and allow for healing of the intestinal damage. Gluten-free
flour, bread, pasta, and other products are available.
Recommended Gluten-Free FoodsBreads
or baked goods prepared from corn, potato, rice, or soy flours or from cornmeal Cereals
prepared from soy, corn (hominy), rice, cornmeal, or quinoa Noodles
and pasta prepared from rice or other allowed ingredients All
meats, chicken, and fish Milk and unprocessed cheese Dried
beans, nuts, and peanut butter Corn and rice Unprocessed
fruits and vegetables
Gluten-Containing Foods to AvoidBreads
or baked goods prepared from wheat, barley, or rye Cereals made
from wheat, rye, or barley Pasta prepared from wheat, rye, barley,
or semolina Creamed or breaded vegetables Salad
dressings, gravies, sauces, and soups prepared with gluten-containing ingredients
Celiac Disease Foundation 818/990-2354 http://www.celiac.org
Celiac Sprue Association 877/272-4272 http://www.csaceliacs.org
National Institute of Diabetes andDigestive
and Kidney Diseases 301/654-3810 http://www.niddk.nih.gov
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on nutrition
was published in the April 26, 2000, issue.
Sources: American College of Gastroenterology,American Gastroenterological
Association, Celiac Disease Foundation, Celiac Sprue Association, Mayo Clinic,
National Institute of Diabetes and Digestive and Kidney Diseases
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
TOPIC: DIGESTIVE DISORDERS
Stevens LM, Lynm C, Glass RM. Celiac Disease. JAMA. 2005;293(19):2432. doi:10.1001/jama.293.19.2432