Posted: April 9th, 2022

Celiac Disease Management

Celiac Disease Management: A Guide for Patients

Celiac disease is a chronic autoimmune disorder that affects the small intestine and causes various digestive symptoms, such as diarrhea, bloating, abdominal pain, weight loss and malabsorption of nutrients. It is triggered by the ingestion of gluten, a protein found in wheat, barley, rye and some other grains. The only effective treatment for celiac disease is a strict and lifelong gluten-free diet, which can help heal the intestinal damage and prevent further complications.

However, following a gluten-free diet can be challenging, especially for newly diagnosed patients who need to learn how to identify and avoid gluten-containing foods, supplements, medications and other products. Moreover, patients with celiac disease may also need to address other aspects of their health, such as nutritional deficiencies, bone health, vaccinations and mental well-being. Therefore, celiac disease management requires a comprehensive and multidisciplinary approach that involves the collaboration of patients, physicians, dietitians and other health care professionals.

This article aims to provide some practical tips and resources for patients with celiac disease on how to manage their condition effectively and improve their quality of life.

## Diagnosis and Follow-up

The diagnosis of celiac disease is based on a combination of blood tests, genetic tests and intestinal biopsy. Blood tests can detect specific antibodies that are produced by the immune system in response to gluten exposure. Genetic tests can rule out celiac disease by looking for certain genes that are necessary for developing the condition. Intestinal biopsy can confirm the diagnosis by showing the characteristic damage to the villi, the finger-like project ( help with nursing paper writing from experts with MSN & DNP degrees)ions that line the small intestine and help absorb nutrients.

It is important to be tested for celiac disease before starting a gluten-free diet, as eliminating gluten from the diet can affect the accuracy of the tests. If you suspect you have celiac disease or have a family history of the condition, you should consult your doctor and request to be screened.

Once diagnosed with celiac disease, you should have regular follow-up visits with your doctor and dietitian to monitor your response to the gluten-free diet and check for any complications or associated conditions. You may need to repeat blood tests and intestinal biopsy to assess the degree of healing and inflammation in your small intestine. You may also need to check your nutritional status, bone density, liver function and other parameters that may be affected by celiac disease.

## Gluten-Free Diet

The gluten-free diet is the cornerstone of celiac disease management. It involves avoiding all sources of gluten, which include wheat, barley, rye and their derivatives, such as spelt, kamut, triticale, malt, bulgur and farina. Gluten can also be found in some oats that are contaminated with other grains during processing or transportation. However, pure oats that are certified gluten-free are safe for most people with celiac disease.

Eating gluten-free does not mean eating bland or boring food. There are many naturally gluten-free foods that you can enjoy, such as fruits, vegetables, meat, poultry, fish, eggs, dairy products (unless you are lactose intolerant), rice, corn, quinoa, buckwheat, millet, sorghum and teff. You can also find gluten-free alternatives for breads, cereals,
pastas, crackers and baked goods that are made from gluten-free flours or grains.

However, you need to be careful when choosing processed or packaged foods that may contain hidden sources of gluten or cross-contamination. You should always read the labels carefully and look for the gluten-free certification symbol or statement. You should also avoid foods that have ingredients such as modified food starch,
hydrolyzed vegetable protein,
maltodextrin,
dextrin,
maltose,
malt vinegar,
brewer’s yeast,
soy sauce,
teriyaki sauce,
barley malt syrup,
wheat germ oil,
wheat starch or any other ingredient that indicates the presence of wheat,
barley or rye.

In addition to food products,
gluten can also be found in some medications,
supplements,
cosmetics,
toothpastes,
mouthwashes,
communion wafers,
envelope glue
and play dough.
You should check with your pharmacist,
doctor or manufacturer before using any of these products
and make sure they are gluten-free.

Following a gluten-free diet can be challenging at first,
but it gets easier with time
and practice.
You can find many resources online
that can help you plan your meals
and recipes
and provide you with tips
and support.
Some examples are:

– Celiac Disease Foundation: https://celiac.org/
– Beyond Celiac: https://www.beyondceliac.org/
– Gluten-Free Living: https://www.glutenfreeliving.com/
– Gluten-Free Watchdog: https://www.glutenfreewatchdog.org/

You can also join a local or online support group
where you can share your experiences
and learn from others
who have celiac disease.
You can find a list of support groups here: https://celiac.org/about-the-foundation/featured-news/2016/04/support-groups/

## Nutritional Support

One of the main complications of celiac disease is malnutrition,
which results from the impaired absorption of nutrients
due to the intestinal damage caused by gluten.
Malnutrition can lead to various symptoms and health problems,
such as anemia,
osteoporosis,
growth failure,
neurological disorders,
infertility and miscarriage.

Therefore, patients with celiac disease need to ensure that they consume adequate amounts of calories,
protein,
fat,
carbohydrates,
vitamins,
minerals and fiber
to meet their nutritional needs
and prevent deficiencies.
A balanced and varied gluten-free diet
that includes a variety of foods from all food groups
can provide most of the nutrients required for optimal health.

However, some patients may need to take supplements
to correct or prevent specific deficiencies
or to treat certain conditions associated with celiac disease.
For example, iron,
folate,
vitamin B12,
vitamin D,
calcium and magnesium supplements
may be recommended for patients with anemia or osteoporosis.
Zinc,
selenium and vitamin E supplements
may be beneficial for patients with dermatitis herpetiformis,
a skin manifestation of celiac disease.
Probiotics,
prebiotics and digestive enzymes
may help improve the intestinal flora and function.

The type and dose of supplements
that you may need depend on your individual situation
and should be determined by your doctor or dietitian
based on your blood tests and symptoms.
You should also make sure that the supplements you take are gluten-free
and do not interact with any medications you are taking.

## Vaccination

Patients with celiac disease may have a higher risk of developing certain infections
due to the impaired immune system and the reduced production of antibodies in the intestine.
Some of these infections include pneumococcal pneumonia,
influenza,
hepatitis B and rotavirus.

Therefore, patients with celiac disease should receive appropriate vaccinations
to prevent these infections and their complications.
The recommended vaccinations for patients with celiac disease are:

– Pneumococcal vaccine: This vaccine protects against 23 types of bacteria that can cause pneumonia, meningitis, sepsis and other serious infections. It is recommended for all adults aged 65 years or older and for adults aged 19 to 64 years who have chronic medical conditions, such as celiac disease. The vaccine is given as a single dose and may need to be repeated every 5 years depending on your risk factors.
– Influenza vaccine: This vaccine protects against the seasonal flu virus that can cause fever, cough, sore throat, muscle aches and respiratory complications. It is recommended for all people aged 6 months or older every year before the flu season starts. The vaccine is given as an injection or a nasal spray depending on your age and health status.
– Hepatitis B vaccine: This vaccine protects against a virus that can cause liver inflammation, cirrhosis, liver cancer and death. It is recommended for all infants at birth and for children and adults who have not been vaccinated before or who have not completed the series. The vaccine is given as three doses over six months.
– Rotavirus vaccine: This vaccine protects against a virus that can cause severe diarrhea, vomiting, dehydration and death in infants and young children. It is recommended for all infants at 2, 4 and 6 months of age. The vaccine is given as an oral liquid.

You should consult your doctor about your vaccination status and schedule
and make sure you receive all the vaccines that you need to protect yourself from these infections.

## Mental Health

Celiac disease can have a significant impact on your mental health
and well-being.
You may experience various emotional reactions
and psychological challenges
related to your diagnosis
and treatment.
Some of these include:

– Shock, denial, anger, sadness, guilt or grief: These are normal responses to learning that you have a chronic condition that requires lifelong changes in your lifestyle and diet. You may go through different stages of coping and adjusting to your new reality.
– Anxiety, fear, worry or stress: You may feel anxious about the consequences of celiac disease on your health, the possibility of accidental gluten exposure, the availability and cost of gluten-free foods, the social implications of eating differently from others, the risk of developing other autoimmune diseases or complications or the genetic transmission of celiac disease to your children.
– Depression, low mood, hopelessness or helplessness: You may feel depressed about having to deal with celiac disease on a daily basis, the loss of enjoyment in eating certain foods, the isolation from family or friends who do not understand your condition, the lack of support or resources in your community or the impact of celiac disease on your self-esteem, body image or sexuality.
– Irritability, frustration, resentment

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