• Originally published May 17, 2010 at midnight, updated May 18, 2010 at 4:45 p.m.

By Susan Sizemore

Given the continuing popularity of low-carbohydrate diets for weight loss, a gluten-free regime may seem like the latest incarnation of an anti-bread and pasta trend among those trying to slim down. Recent news reports have held up gluten-free diets as the solution for a variety of ailments, from arthritis to autism.

Celiac disease, an incurable immune system disorder, affects as many as 3 million Americans, and most people with the disease are unaware that they have it. It's estimated that only 3 percent of the people with celiac disease have been diagnosed.

People with celiac disease are unable to properly digest foods with gluten protein, which is found in grains like wheat, rye and barley. For these individuals, gluten causes a reaction in their immune system that damages the lining of the small intestine and impedes the body's ability to absorb important vitamins and nutrients: calcium, protein, carbohydrates and fats. Untreated, celiac disease can lead to severe damage of the gastrointestinal tract, lactose intolerance, anemia, osteoporosis, neurological complications and possibly cancer.

The disease is difficult to diagnose because its symptoms can be mistaken for other conditions, from irritable bowel syndrome to chronic fatigue, anemia or simple stress. Its symptoms vary and do not occur on a regular basis. Symptoms of celiac disease include fatigue, irritability, depression, arthritis, diarrhea, gas, bloating, vomiting, constipation and impaired digestion.

In fact, the National Commission on Digestive Diseases has noted that because of the way celiac disease is manifested, it takes an average of seven years for an adult to be diagnosed. A recent study at Columbia Medical School, suggested that this is because the criteria used to diagnose the disorder are too stringent, leaving many people with the disease to go undiagnosed.

Celiac disease is hereditary and affects both children and adults. Its exact cause is unknown. According to the Mayo Clinic, having a family member with the disease increases your risk of developing the disease by 5 to 15 percent. Traditionally, it has been considered a rare childhood disease - another reason it often goes undetected in adults - but it can show up at any time later in life, especially following an injury, after pregnancy, surgery or even severe stress.

Children with celiac disease may exhibit symptoms such as abdominal pain, nausea, lack of appetite, anemia, mouth sores, and allergic dermatitis (a skin rash), and may fail to gain weight, experience delayed puberty or have stunted growth. Other symptoms might include irritability, emotional withdrawal or excessive dependence.

Currently, the only remedy for celiac disease is a permanent change in diet, but don't try a gluten-free diet on your own prior to seeing the doctor, as this may actually mask symptoms of the disease. Celiac disease is not curable, but can be controlled with a proper diet. If you are diagnosed with celiac disease, a registered dietitian can formulate a gluten-free diet for you that will help alleviate symptoms and ensure good nutrition.

Susan Sizemore is a registered and licensed dietitian. Send questions or comments to dietitians@vicad.com.

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