Q: What is celiac disease?

Ask Our Expert About Celiac Disease

• What is celiac disease?
• What foods contain gluten?
• How can I tell which foods are gluten-free?
• What foods are safe for me to eat?
• How can I prepare gluten-free meals?
• Can I go out to eat?
• If I feel ok, can I go back to regular eating?
• Is there anyone who can help me with this?

Q: What is celiac disease?

A. Celiac disease is an auto-immune disease. People with celiac disease can’t tolerate gluten, a protein found in wheat, barley, rye and oats. The only way to control it is to avoid gluten. Symptoms are extremely varied and include abdominal cramping, intestinal gas, bloating, chronic diarrhea and/or constipation, fatty stools, anemia, generalized body itching, headaches, weight loss with a large appetite or weight gain.

Q: What foods contain gluten?

A: Obvious sources of gluten include breads, cereals, pasta and pastries, but gluten can also be hidden in gravies, marinades, thickeners, drink mixes and prepared foods. You’ll even find it in vitamins, medications, envelope glue, toothpaste and lip balm.

Living gluten-free can seem overwhelming at first, but new foods, restaurants and resources are becoming available all the time to help you make the transition. There are still have a wide variety of foods you can eat, especially fresh foods. In time, it will become a routine part of life.

Q: How can I tell which foods are gluten-free?

A: Many products are now labeled as “gluten-free,” and they’re showing up in specialty food stores and regular supermarkets. Read the nutrition facts label on products and look for flavorings, colorings, hydrolyzed protein and modified food starch, in addition to wheat, barley, oats and rye. Call the company’s 800 number or e-mail its dietitian or product line manager and ask questions about the product like, “What is the source of the modified food starch?” Because food formulas change often, check labels regularly.

Q: What foods are safe for me to eat?

A: Fresh fruits, vegetables, meats, fish, poultry, eggs, milk, yogurt and some cheeses are naturally gluten-free. Certain flours are safe, including brown rice, garbanzo beans, fava beans, white beans, sweet potato and nut flowers. Corn and corn products like corn bran, corn flour, corn grits, cornstarch, corn gluten, hominy and corn tortillas are safe. Good grains include rice, amaranth, arrowroot, sorghum, buckwheat, flax and teff . You can also eat tapioca, nuts, seeds and legumes and use vegetable oil.

Most drinks are safe. Read labels on herbal teas, drink mixes, flavored coffees and soft drinks. Wine, hard cider and distilled alcohol are alright, but stay away from beer or malt beverages and wine coolers.

Q: How can I prepare gluten-free meals?

A: Start simple and experiment by substituting products containing gluten with gluten-free products. For example, try almond flour instead of regular white flour in a dessert recipe. The taste and texture will be different, but try different formulations until you find one you like. Give your tastes time to adapt to your new diet.

You also need to watch for cross-contamination with gluten. Have separate food preparation areas and tools, and keep gluten-free foods on separate shelves in the pantry and refrigerator. Buy single-serving sizes. Thoroughly clean your kitchen after cooking or baking. Remember, it takes about 24 hours for flour dust in the air to settle.

Q: Can I go out to eat?

A: Dining out is fine as long as you order carefully. Call ahead to ask about the menu and whether the restaurant has gluten-free items. Make sure language is not an obstacle. Avoid rush times. Ask your server how foods are prepared, and ask that your meal be prepared on a clean surface with new gloves and clean utensils. Carry a gluten “allergy” card.

Most fine dining restaurants are able to accommodate special diet needs. Manny B’s, in Bethlehem, offers a complete gluten-free menu, including gluten-free pizza. Carrabbas, Outback Steakhouse, Jack Creek Steakhouse and Boston Market also offer gluten-free items.

Popular restaurant foods that should be alright include nachos made with real cheese, salads (no croutons, bacon bits or bleu cheese), grilled chicken or fish (ask about marinade ingredients), prime rib (ask about au jus), chili (ask whether flour or thickeners are used) and baked potatoes.

Standard communion wafers generally contain gluten, but you can ask your church to purchase gluten-free communion wafers.

Q: If I feel ok, can I go back to regular eating?

A: No, this is a diet for life. Even if you don’t have symptoms, you can experience damage that can lead to digestive problems, osteoporosis, malnutrition, anemia, other auto-immune diseases like diabetes, liver problems and cancer.

Q: Is there anyone who can help me with this?

A: Yes! The Lehigh Valley Celiac Support Group meets five times a year at 2166 S. 12th Street in Allentown. Speakers and participants provide information, tips and support, covering everything from restaurants and products to health concerns. They have food you can try and recipes to share. You can even participate in a food co-op, saving you money and allowing you to buy in smaller quantities. For more information, contact Kathleen Heist at 610-767-1622 or Beverly Kistler at 610-776-1178.

There are many other online and community resources that can help you with recipes, food preparation tips and product information. Talk with your doctor or call 610-402-CARE to consult with a registered dietitian who can help you get started on the diet. Contact the national Celiac Sprue Association at 877-CSA-4CSA (877-272-4272) or www.csaceliacs.org. For a list of support groups and other resources, click here.

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