Understanding Celiac's Disease

Celiac disease is one of the most misdiagnosed, misunderstood diseases. It is often misdiagnosed as Irritable Bowel Syndrome, anemia, crohns, chronic fatigue to name few. It can be a hereditary condition. It is not an allergy. It is an auto immune disease. This means it will not go away. There is nothing you can take to lessen its symptoms. It is a life long multi-system, multi-organ disorder. In the past many people suffered with the symptoms of the disease for many years before it is officially diagnosed. Thankfully, now there is a blood test you can take which will identify the disease. The disease affects 1 out of 133 people. Celiacs cannot tolerate the protein known as GLUTEN, which is found in wheat, rye and barley. It is important to note that wheat free is not necessarily gluten free. Gluten is found in all kinds of food and substances you would not suspect. So it is important to look carefully at all ingredients. Less obvious sources of gluten include Vitamins, Medications and stamp and envelope adhesives.

In fact, gluten is hidden in many foods such as jarred salsa, BBQ sauce, mayonnaise, licorice, some yogurts and sour creams, soy sauce, malt vinegar, most processed/frozen foods, most fast foods, self-basting turkeys, many rotisserie chickens, soups some cold cuts, and many prepared stocks (esp. chicken and beef). Gluten is also used as a binder in some pharmaceutical products. It can be the starch listed as unidentified food starch, modified food starch, caramel coloring, hydrolyzed plant or vegetable protein. Be especially careful with products from Asia as many contain modified food starch. It's also important to avoid products where the ingredients are of questionable origin or are listed as simply "natural flavorings, flavor extracts, or spice extracts" as gluten may be used in processing them. Plain rice of all types (including wild rice), tapioca, potatoes, corn, and legumes are safe, oatmeal is often cross contaminated with gluten. The only treatment is a absolute maintenance of a gluten free diet.

Symptoms are varied from person to person and may include one or more of the following:

• gas
• recurring abdominal bloating and pain
• chronic diarrhea
• pale, foul-smelling, or fatty stool
• weight loss / weight gain
• fatigue
• unexplained anemia (a low count of red blood cells causing fatigue)
• bone or joint pain
• osteoporosis, osteopenia
• behavioral changes
• tingling numbness in the legs (from nerve damage)
• muscle cramps
• seizures
• missed menstrual periods (often because of excessive weight loss)
• infertility, recurrent miscarriage
• delayed growth
• failure to thrive in infants
• pale sores inside the mouth, called aphthous ulcers
• tooth discoloration or loss of enamel
• itchy skin rash called dermatitis herpetiformis

OR there could be no symptoms at all!

Eating out is a challenge for Celiacs. Here are a few suggestions for a safer dining experience:

When you attend a dinner or cocktail party don't be embarrassed to let the host/hostess know you have a food related medical condition. Concerns about diet and allergy related conditions are so prevalent these days that many host/hostess ask about allergies. However if they do not you might suggest:

• The host put a portion of salad aside before adding croutons and salad dressing
• A piece of meat, fish or chicken be set aside before marinade, sauce or barbecue sauce is added
• Choose selections from the vegetable, fruit and cheese platters (however be careful about how other guests are serving themselves. Often times the gluten from the knife or broken cracker pieces fall into the cheese making it unsafe). If you choose this option be careful about that French onion dip or ranch dressing-both contain gluten.
• You bring a dish to make things easier (gluten-free of course)
• Or you might enjoy GR foods at home and then go to the party to simply socialize without risking a growling stomach tempted by questionable foods.

• Simply telling a chef to prepare something Gluten Free is not enough. Carry a wallet sized card (free with every Sandrini Order) which you can discretely hand to the waiter/waitress. Ask that they share your information with the chef for best selections. Be sure to ask for the card back
• Make it clear to the chef and the server that this is a medical condition and that their help to make a meal that is safe is appreciated.
• Be pleasant and informative, not demanding or accusative. Don't be embarrassed to ask for specifics about sauce or marinade preparations. The more we educate, the more awareness the restaurant community will have. This helps us all.
• Avoid fast food chains where much of the food is pre-packaged. These chains often do not have the exact ingredients available.
• Deep fried foods are out! Often restaurants use the same oil for frying gluten based and non-gluten foods. The oil contaminates anything it touches. This includes french fries.
• Call restaurant chef or manager ahead of time (not during meal times) to ask if they can accommodate a gluten-free diet.
• Ask for grilled or broiled meat or fish whenever possible if Gluten free preparations cannot be guaranteed
• Opt for a baked potato
• Avoid rice unless prepared with water or homemade chicken stock without bouillon
• Ask for a plain salad with oil and wine or balsamic vinegar - no croutons. Often restaurants forget about the croutons. If this is the case politely request a NEW salad not one where the waiter simply takes the salad in back and picks out the croutons.