Lowering the Treatment Burden of Celiac Disease

B.S. Dietetics, Dietitian, Health Professional

Celiac disease is bad enough. But if you ask patients, dealing with the dietary changes necessary to manage the disease can be a pain in its own right.

Celiac disease, a condition in which the immune system reacts to the ingestion of the protein gluten, affects approximately 1 in every 133, or at total of 2 million people in the U.S. According to the Mayo Clinic, foods with gluten can cause painful symptoms such as severe diarrhea and weight loss. Some lesser known symptoms can also include:

  • Anemia
  • Acid reflux or heartburn
  • Damage to tooth enamel
  • Fatigue
  • Headaches
  • Hyposplenism
  • Itchy skin
  • Joint pain
  • Nervous system problems
  • Osteomalacia
  • Osteoporosis

Left untreated, celiac disease can cause permanent damage to the GI tract so it is important that patients take an active role in controlling their condition. This means completely avoiding gluten as this is the only treatment for Celiac Disease.To get you started, the American Diabetes Association has a detailed list of products that may contain gluten.

But though a gluten-free diet might seem like a "no brainer,” a 2014 study by Daniel Leffler et al., published in The American Journal of Gastroenterology, found that treatment for celiac disease often feel like a daily burden as many patients stated that adherence to the GFD plan was too hard to maintain. In particular, there were four reasons as to why those with celiac disease feel they have a difficult time going gluten-free, which I’m going to address.

1. Perception that dietary adherence isn’t important.

Dietary changes as outlined in the GFD are essential to eliminating the symptoms of celiac disease and other related health problems such as malnutrition, low bone density, infertility, miscarriage, lactose intolerance and even cancer.  So why risk these additional issues when you can simply change your diet?  Still not convinced? Make an appointment with your GI physician to further discuss the benefits of going gluten free.

2. Costs of food.

Food can be expensive, especially specialty food items. For example, my gluten-free girl asked for yogurt covered pretzels that cost over $5 for a two serving bag - twice as much as regular pretzels A good alternative is to stick to foods that naturally don’t contain gluten. Some widely available examples are potatoes, rice, quinoa, fruits and vegetables.

Another way to save money is to buy gluten-free food only for the person who needs it. For dinner I would serve spaghetti with regular noodles in one pot and serve the gluten-free ones in a separate pot for my daughter. This prevents me from having to buy gluten-free food for everyone in our family.

3. Eating outside of the home.

Avoiding gluten can be a huge pain if you’re eating out. So instead, try packing your own lunch as it can save you money as well as insure that your food is gluten-free. If you do decide to eat out, make sure to do a little planning ahead. Look at menus online and check for gluten-free options. You can check out the Celiac Foundation’s additional tips for how to eat our gluten free safely.

4. Time limitations for food prep.

We all get busy and sometimes feel too inundated to prepare food. One way to make it easier and more fun is to get together with a few of your friends to cook.  Three people in the kitchen can make enough for your family as well as theirs and can be prepared in less than two hours. Store the meals you won’t be making in the freezer  so that they’ll be ready to quickly pop into the oven on those busy days.

Another way to save a lot of time is to pick a day for prepping the meals.  Use that day to make up a bunch of proteins, starches, chop veggies and any of the other prep work that can take up a lot of time during the week. Dinners can then be mixed and matched from the items you already prepared. For more ideas check out these Easy Make Ahead Meals.

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Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition.She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years.Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).