Topic Overview
What is celiac disease?
Celiac disease is a
problem some people have with foods that contain gluten. Gluten is a kind of
protein found in foods like bread, crackers, and pasta. With celiac disease,
your
immune system attacks the gluten and harms your
small intestine when you eat these kinds of foods. This makes it hard for your
body to absorb nutrients that keep you healthy.
Gluten comes from
grains like wheat, barley, and rye. It’s important to get treatment, because
celiac disease can lead to
iron deficiency anemia and
osteoporosis. It can also raise your risk of
lymphoma.
Celiac disease can slow growth and weaken bones in
children. If it is not treated, your child can get very sick. Call a doctor if
your child is losing a lot of weight, has diarrhea, or feels weak and tired for
many days for no reason.
What causes celiac disease?
Doctors don't really
know what causes the disease. Having certain genes can increase your chance of
getting it. You are more likely to have these genes and get celiac disease if a
close family member has it.
What are the symptoms?
Symptoms of celiac disease
include:
- Gas and bloating.
- Changes in
bowel movements.
- Weight loss.
- Feeling very
tired.
- Weakness.
These symptoms can be very mild.
Some
people vomit after they eat gluten. This is more likely to happen in children
than in adults.
How is celiac disease diagnosed?
Your doctor will
ask questions about your symptoms and do a physical exam. You may have blood
tests to see if you have certain
antibodies that could mean you have the disease. To
make sure you have celiac disease, you will probably have an
endoscopy. In this test, a doctor uses an endoscope—a
thin, lighted tube that bends—to look at the inside of your small intestine.
During the endoscopy, the doctor may take small samples of tissue to be tested
in a lab. This is called a
biopsy.
Often celiac disease is mistaken
for another problem such as
food intolerance or irritable bowel syndrome. You may be treated for one of these problems first.
After your celiac disease diagnosis, your doctor may do more tests, such as blood tests to check for anemia or a bone density exam. These will help your doctor
find out if you have other problems, such as osteoporosis, that can arise when
you have celiac disease.
How is it treated?
To get and stay well, you need
to avoid all foods that have gluten. Do not eat any foods made with wheat, rye,
or barley. Don't drink any beer or ale.
You can still eat eggs,
meat, fish, fruit, and vegetables. Flours and starches made from rice, corn,
buckwheat, potatoes, and soybeans are also okay. Within 2 weeks after starting
a gluten-free eating plan, most people find that their symptoms have
improved.
For a short time after your treatment starts, you might
also need to stop drinking cow's milk and foods made with it. Most of the time,
but not always, people can have these foods again after their intestine has
healed.
Some foods that are labeled "wheat-free" may still have
gluten. Gluten can be in things you may not expect, like medicine, vitamins,
and lipstick. Be sure to read labels. Those with "modified food starch" or
"hydrolyzed vegetable protein" may contain gluten.
Frequently Asked Questions
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Being diagnosed:
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Getting treatment:
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Ongoing concerns:
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Living with celiac disease:
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Cause
Although the exact cause of
celiac disease is not known, having certain
genes increases your risk. You are more likely to have
these genes and may get celiac disease if you have a first-degree relative
(mother, father, brother, sister, son, or daughter) with the condition.
Environmental factors, such as viral or bacterial infections, may trigger
changes in the small intestine of a person with these genes. Then, eating foods
that contain gluten can trigger an abnormal
immune system response. Eventually, digestion and
absorption problems may result.
Research continues on how
genetic, environmental, and immune factors interact and affect a person's
symptoms, at what age they begin, and whether long-term health problems
develop.
Symptoms
Symptoms of
celiac disease occur after eating foods containing
gluten. These foods trigger an abnormal
immune system response that damages the intestine.
Symptoms vary widely: they may be very mild and go completely unnoticed, or
they may be severe and impact daily life.
Common symptoms related
to celiac disease may come and go. They include:
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Gas, abdominal swelling, and bloating. These
symptoms result from a failure of the
small intestine to absorb nutrients from food. You may also have mild stomach
pain, but it is usually not severe.
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Abnormal stools. Diarrhea or bulky, loose (or
watery), pale, frothy, and foul-smelling stools often occur. The stools may
contain a large amount of fat and may stick to the sides of the toilet bowl,
making them hard to flush. Although children and adults often experience the
same types of symptoms, intestinal problems, such as constipation, are more
likely to occur in children.
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Weight loss. Adults and children may have
unexplained weight loss despite having a normal appetite. Younger children may
fail to gain weight and grow as expected, a condition known as
failure to thrive.
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Fatigue and weakness. Celiac disease can result in
a general lack of energy and strength. Sometimes poor nutrient absorption
causes fatigue and weakness.
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Vomiting. Some people may get sick after eating
gluten. Children are more likely than adults to have this reaction.
Celiac disease may also lead to:
Symptoms of celiac disease also occur with a variety of
other conditions, which can delay the initial
diagnosis.
What Happens
Celiac disease
is a lifelong (chronic) condition that occurs when
gluten triggers an abnormal
immune system response that damages the
small intestine. Tiny, finger-shaped tissues (villi)
line the small intestine. The villi create a large surface that
absorbs vitamins, sugars, and other nutrients as food passes through the small
intestine.
When a person who has celiac disease eats gluten, the
villi flatten out and the intestinal lining becomes inflamed. This decreases
the area in the intestine that can absorb nutrients. In some cases, the
inability to absorb nutrients (malabsorption) may be severe enough to stunt
growth and weaken bones. The loss of vitamins and minerals may lead to
illnesses such as
iron deficiency anemia,
folic acid deficiency anemia,
rickets, or
osteoporosis.
People who have celiac disease
may have periods when their symptoms seem worse. Or symptoms may sometimes not
be noticed at all.
Celiac disease in children
In some children,
symptoms begin shortly after introducing cereal into the diet, usually after 6
months of age.
A child who has celiac disease may not grow and
gain weight normally because the child's body is not absorbing needed vitamins
and other nutrients. Children who have untreated celiac disease can become very
ill. They may need hospitalization for treatment with fluids and medicine to
restore nutrients. These treatments are usually short-term, and most children
recover completely.
As children who have celiac disease grow into
adulthood, they may be at a slightly increased risk for developing cancer
(lymphoma) in the small intestine, the mouth, or
esophagus, although the evidence for this is not clear. But studies have found
that following a gluten-free diet lowers the risk for lymphoma.1 Even if a child with celiac disease does not have symptoms
after eating gluten, it is critical that he or she stay on a lifelong
gluten-free diet to avoid intestinal damage. You can
help your teenager follow a gluten-free diet by
recognizing his or her need for independence. For example, you can let your
teenager plan meals and choose gluten-free foods.
Although a
gluten-free diet relieves symptoms and promotes the health of the intestines,
children may not reach their full height if prolonged lack of nutrient
absorption stunted their growth before treatment began.
Celiac disease in adults
Many adults who have
celiac disease do not have any symptoms, or they have only mild symptoms.
Symptoms may occur at any age but most commonly develop during the 20s, 30s,
and 40s.
Adults who have celiac disease have a slightly
higher-than-average risk of lymphoma, which usually develops in the intestine.
They also may have a slightly increased risk of developing cancer of the
esophagus. Following a gluten-free diet can reduce this risk.
You
are likely to get better if you consistently and permanently follow a
gluten-free diet. Most people find their
symptoms improve within 2 weeks of beginning a gluten-free diet.
After the villi return to normal, which usually takes several months to several
years, the body can absorb nutrients properly. Maintaining a gluten-free diet
even when symptoms disappear is very important. Doing so usually prevents
symptoms from returning and reduces the risk for
complications of celiac disease, which may include
lymphoma.
Symptoms usually return any
time foods with gluten are eaten. Although some people who have celiac disease
may be able to eat foods that contain gluten without developing symptoms, this
does not mean that the body is absorbing all nutrients normally. Even without
symptoms, if the small intestine is injured from gluten, the lack of absorption
of nutrients may cause complications such as
iron deficiency anemia and
osteoporosis.
In rare cases, people who
appear to have celiac disease do not get better on a gluten-free diet. Some people get better after starting a gluten-free diet and stay better for awhile, but their symptoms come back even though they are still eating a gluten-free diet. This
condition is called refractory sprue. In these cases,
corticosteroids or other medicines that change the
immune system response may be used to control
symptoms. People who do not improve on a gluten-free diet should be tested for
other conditions, including T-cell lymphoma.
What Increases Your Risk
Celiac disease
is an
immune system disorder in genetically predisposed
people that results in damage to the lining of the
small intestine when foods with gluten are eaten. The
risk for the disease may be inherited, since about 10% of first-degree
relatives (mother, father, brother, sister, son, or daughter) of people who
have celiac disease also develop the condition. In people who are genetically
predisposed, celiac disease may be triggered by environmental factors,
including viral and bacterial infections.
People who have celiac
disease are also more likely than others to have:
When To Call a Doctor
Call a doctor if you or your
child has symptoms of
celiac disease. These symptoms include:
- Losing weight
unexpectedly.
- Diarrhea that lasts longer than 1 to 2
weeks.
- Failure of a child to grow or gain weight as
expected.
- Unusual fatigue or mood changes, especially if these last
more than a week and are not related to any other illness, such as the flu.
If you or your child has been diagnosed with celiac
disease, call a doctor if:
- Symptoms recur after having been
absent.
- A change in symptoms occurs, such as increased tiredness or
increased stomach pain.
- Your child has symptoms such as diarrhea or
unexplained weight loss, and you know your child has not eaten
gluten.
- You can't tell whether your child has eaten foods that
have gluten, and his or her symptoms continue.
Watchful Waiting
If celiac disease is suspected
If you think that
you or your child may have celiac disease, watchful waiting is appropriate if
mild symptoms of diarrhea or vomiting last only for a few days. Talk with a
doctor if your child continues to have diarrhea and does not seem to be gaining
weight as expected even though he or she has a good appetite.
If you or your child has celiac disease
If
symptoms of celiac disease return after your child or you were symptom-free
while following a
gluten-free diet, it usually means that foods
containing gluten were eaten. Try documenting your or your child's recent diet.
Check food labels, looking closely for ingredients that may be sources of
hidden gluten. Your local library or bookstore should
have resources that can help you identify potential sources of hidden gluten.
Also, a nearby hospital can usually direct you to local and national
organizations that can help you follow a gluten-free diet. For more
information, see the Other Places to Get Help section of this topic.
If your child has celiac disease and symptoms return, be sure to ask
detailed questions about what he or she has recently eaten away from home. As
children get older and more independent, they may be tempted to stray from a
strict gluten-free diet. You can
help your teenager follow a gluten-free diet by
recognizing his or her need for independence. For example, you can let your
teenager plan meals and choose gluten-free foods.
Call your doctor if you are confident that your or
your child's diet is gluten-free but symptoms have returned or continue.
Who To See
Health professionals who may evaluate symptoms of
celiac disease in adults or children include:
A doctor who specializes in problems with the digestive
system (gastroenterologist) should be consulted to confirm the
diagnosis with a small intestine
biopsy. In addition, a
dietitian can help you plan and stay with a
gluten-free diet.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
In many cases of
celiac disease,
other conditions with similar symptoms, such as
food intolerance or
irritable bowel syndrome, are first suspected. Often,
celiac disease is only considered after the initial diagnosis of another
condition is rejected because treatments are not effective.
A
medical history, physical examination, and lab tests
often point to celiac disease. The diagnosis is confirmed with a small
intestine
biopsy collected during an
endoscopy. For this procedure, an endoscope is guided
down a person's throat to the small intestine.
Tests for celiac disease should be done when you or your child is still eating a diet that includes gluten. If you have already started a gluten-free diet before these tests are done, the doctor may suggest you or your child eat a certain amount of gluten before the tests.
Blood antibody tests
Celiac disease triggers the
immune system to produce certain
antibodies. If celiac disease is suspected, your
doctor will order certain blood tests to detect and measure specific
antibodies.
- IgAtTG: Immunoglobulin A (IgA) anti-tissue
transglutaminase (tTG) antibody
- IgAEMA: Immunoglobulin A (IgA) antiendomysial antibody (EMA)
If your test results are positive, your
doctor may perform a
biopsy of the small intestine to confirm a diagnosis
of celiac disease.
Endoscopy
A biopsy taken during an
upper gastrointestinal endoscopy may be done to
confirm celiac disease after antibody tests are positive. Sometimes a biopsy
detects celiac disease when a person is being tested for another
condition.
If the biopsy shows signs of celiac disease
(such as abnormal villi and inflammation in the
small intestine), a
gluten-free diet will be recommended. If the symptoms
go away on the gluten-free diet and antibody tests are normal, a diagnosis of
celiac disease is confirmed.
Other tests
Other tests may be done
when celiac disease is suspected. These tests may include:
If a diagnosis of
celiac disease is suspected but symptoms don't improve with a gluten-free diet,
further testing for
other conditions and diseases, such as
Crohn's disease or
cystic fibrosis, may be needed.
Prepare your child for exams and tests that are needed
to diagnose suspected celiac disease. Doing so will help your child understand
what to expect and can help reduce fears.
Early Detection
Blood tests to measure
antibodies, such as immunoglobulin A anti-tissue
transglutaminase (IgAtTG) or the immunoglobulin A antiendomysial antibody
(IgAEMA), can be useful screening tools for people who are at increased risk
for having celiac disease. This includes people with a family history of celiac
disease or those who have
type 1 diabetes,
Down syndrome,
dermatitis herpetiformis, an
autoimmune disease, unexplained
anemia, abnormal liver function tests not caused by
another disease, or unexplained
osteoporosis. Talk to your doctor if you think you or
your child should be screened for celiac disease.
Treatment Overview
The treatment for
celiac disease is a strict
gluten-free diet, which means:
- Avoiding all foods with wheat, barley, rye, or
oats. Oats may later be gradually reintroduced into the diet.
- Not drinking beer unless it says it is gluten-free. Beers
with and without alcohol, including lagers, ales, and stouts, contain gluten unless they specifically say they are gluten-free.
- Eating meals that
include rice, corn, millet, and buckwheat.
Most people with the disease who adopt this diet
permanently and consistently do not develop health problems associated with
celiac disease. If nutritional deficiencies are present, other treatments may
be needed, such as vitamin, iron, and calcium supplements.
Initial treatment
When
celiac disease is diagnosed, you should immediately
adopt a strict
gluten-free diet. Eating even the smallest amount of
gluten can cause symptoms such as weight loss and diarrhea. You may be advised
to temporarily avoid milk or milk products until your intestine heals, at which
time you may be able to gradually reintroduce them. A
registered dietitian can help you learn how to
incorporate this diet and its restrictions. Most people also find local and
national celiac disease support groups helpful. For more information, see the
Other Places to Get Help section of this topic.
Within 2 weeks
after starting a gluten-free diet, most people with celiac disease find their
symptoms improve. Symptoms should completely
disappear within 3 months. But it takes 2 to 6 months or longer on a
gluten-free diet for the tiny, finger-shaped, raised tissues (villi) of the
small intestine to return to normal.
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Celiac Disease: Eating a Gluten-Free Diet
Some children with untreated celiac disease become very sick and require
hospitalization. Usually, they recover quickly after treatment with fluids and
medicines. A gluten-free diet usually prevents these symptoms from
returning.
Ongoing treatment
A
gluten-free diet usually will eliminate symptoms of
celiac disease and prevent long-term damage to the
small intestine or other
complications.
Symptoms of the disease
are controlled by adopting a gluten-free diet, but you should see a doctor
yearly for monitoring. A child especially needs to be watched for:
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Delayed growth. Children with celiac disease do
not absorb needed nutrients if they eat gluten. This may result in delayed
growth if gluten is eaten regularly over a long period. The vast majority of
children catch up in growth unless diagnosis is delayed beyond puberty.
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Nutritional deficiencies. Eating gluten also can
lead to an imbalance of chemicals, minerals, and vitamins. These deficiencies
should reverse with a gluten-free diet, but vitamins, iron, or calcium
supplements are sometimes needed.
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Tumors. As children who have celiac disease grow
into adulthood, they may be at a slightly increased risk for developing cancer
(lymphoma) in the small intestine and the esophagus,
although the evidence for this is not clear. But studies have found that
following a gluten-free diet lowers the risk for lymphoma.1
Treatment if the condition gets worse
The most
common cause of recurrent symptoms of
celiac disease is eating foods containing
gluten. In some people, eating even the smallest
amount of gluten can cause symptoms of celiac disease, such as diarrhea and
weight loss. Continuing to eat gluten causes inflammation and damage to the
villi in the small intestine, regardless of whether symptoms are present.
Nutrients may not be absorbed properly, which can lead to long-term
complications, such as weak bones or growth problems
(in children). Prolonged intestinal damage may increase the risk for developing
severe complications, such as
lymphoma.
If you or your child
experiences symptoms or complications, you may need:
- A diet evaluation to ensure that it is
gluten-free. Your doctor or registered dietitian can
help you find out if you are eating foods with
hidden gluten. Older children and teens may need to be
reminded about the importance of staying with the diet.
- Testing
for other diseases or conditions, such as
irritable bowel syndrome, if no gluten is detected in
your diet.
- Reevaluation of your original upper
endoscopy and
biopsy to ensure the accuracy of diagnosis.
- Oral steroids (in very rare cases). Experts disagree about using
steroid medicines to treat people who have celiac disease and do not get
better on a gluten-free diet. The American Gastroenterological Association
recommends using injectable steroids to treat a sudden (acute),
life-threatening attack of celiac symptoms. Oral steroids or other medicines
that change the
immune system response may be used to treat refractory
sprue that doesn't respond to a gluten-free diet if
other possible illnesses have been ruled out.
Treatment for complications varies depending on the
specific problems and their severity. For example, some adults may require
long-term treatment for complications, such as
osteoporosis.
What To Think About
Sometimes a person who has
celiac disease does not have symptoms after eating foods that contain
gluten. But damage to the small intestine is still
occurring. Such damage prevents the absorption of needed nutrients, which may
cause
complications such as growth delays in children. The
damage to the small intestine can also cause an increased risk for
lymphoma in the intestine.
Following a
gluten-free diet can be challenging, especially for
people who do not experience symptoms. Some teenagers find it extremely
difficult to consistently avoid eating foods with gluten because it makes
eating out with their friends difficult. You can
help your teenager follow a gluten-free diet by
continuing to emphasize its importance and thinking of ways to make it as easy
as possible. If you are concerned about permanently staying on a gluten-free
diet, talk with your doctor.
Prevention
Although
celiac disease cannot be prevented, symptoms and
damage to the
small intestine can be reversed by maintaining a
strict
gluten-free diet. At first, you may also have to avoid
milk and milk products. After you stop eating gluten, the intestines begin to
heal and you likely will be able to gradually reintroduce milk products into
your diet without triggering symptoms.
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Celiac Disease: Eating a Gluten-Free Diet
Some adults with celiac
disease have a poorly functioning or nonfunctional
spleen, which is a risk factor for developing a
pneumococcal infection. For this reason, your doctor may recommend that you get
immunized with the
pneumococcal vaccine(What is a PDF document?).
Home Treatment
Having
celiac disease means that you will need to follow a
gluten-free diet for the rest of your life.
Permanently following a strict diet can be difficult, especially if you do not
have symptoms. But intestinal damage occurs when you eat foods with
gluten, regardless of whether you notice symptoms. For
more information, see:
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Celiac Disease: Eating a Gluten-Free Diet
The following strategies may help you stay with your
gluten-free diet:
- Seek guidance from a
registered dietitian, other health professionals, and
celiac disease support groups for ways to incorporate gluten-free foods. In the
beginning, it may be helpful to keep a food diary until you are more familiar
with planning meals without gluten.
- Be aware of foods that contain
hidden gluten. Read labels of prepared or processed
food carefully. For example, "hydrolyzed vegetable protein" may come from wheat
and contain gluten.
- When eating out, let your server know you have
special dietary needs. The Celiac Sprue Association has a "restaurant card"
that lists foods to avoid (see the Web site at www.csaceliacs.org or the Other
Places to Get Help section of this topic). Show this card to your server, who
can help you select gluten-free foods or direct the kitchen to specially
prepare a meal for you.
- Count calories and check your (or your
child's) weight weekly to ensure that enough nutrients are being
absorbed.
- Eat plenty of fruits and vegetables to avoid
constipation. If necessary, use gluten-free commercial fiber preparations, such
as those that contain rice bran.
Following a special diet may be especially hard for
children and teens, who often don't want to feel different from their friends.
Also, teens seem to have fewer symptoms than younger children after eating
gluten. But gluten, if eaten, will continue to damage the intestine. This is
why it is important for your teen to continue to follow a gluten-free diet. The
following strategies may help your child or teen to stick to a gluten-free
diet:
- Contact your local hospital, dietitian, or
doctor for information about support groups in your area. Most people find
these groups helpful for discovering ways to help them deal with their
condition.
- Think about different ways to help your child follow the
gluten-free diet at school. Talk to teachers or school nurses about everyday
strategies. Find out what other kids are taking for lunch. For example, if
other kids are carrying cold lunches, find ways to pack similar gluten-free
cold lunches. If your child prefers a hot lunch, work with the school cafeteria
to see whether gluten-free choices are available. The more "normal" the diet
can seem, the better the chances that your child will follow
it.
- Let your child have some responsibility. With younger children,
make a game out of choosing foods that are gluten-free. Allow older children to
choose gluten-free foods.
Helping your teen follow a gluten-free diet usually
includes recognition of his or her increasing need for independence. Although
your teen will make his or her own food choices, talk realistically about the
consequences of eating foods with gluten.
- Set realistic goals.
Understand that food can be a part of socializing and fitting in. Your child
may accidentally (or on purpose) eat some foods that contain gluten. If your
child experiences symptoms after eating gluten, focus attention on how he or
she feels physically. Periodically remind your child about these reactions,
especially before going to a social event where foods containing gluten will
likely be served, such as a slumber party. Try to plan ahead for these
occasions by talking to friends' parents or preparing something gluten-free
that the group can eat.
Some people with celiac disease and their family members
may benefit from counseling. Think about talking to your doctor about counseling
if you need some extra help managing the emotional challenges that can happen
with celiac disease. Counseling can also help you learn ways to talk with your
children better and help them follow a gluten-free diet.
Medications
Medicines usually are not needed to treat
celiac disease. If you or your child has been
diagnosed with this condition, your doctor may recommend taking a vitamin
supplement that has iron and calcium. After you or your child is on a
gluten-free diet, symptoms should get better within 2
or 3 weeks, nutrients should be absorbed more normally, and the
small intestine should gradually heal.
Medicine is only needed if you or your child becomes seriously ill with
celiac disease or if
complications develop. Medicines will be given only
long enough to correct these problems. Doctors may prescribe steroid
medications to ease swelling in the intestine and to help it absorb nutrients
better. But not all experts agree about the use of these medicines to treat
celiac disease. Some complications, such as delayed growth, cannot be treated
with medicine.
Other Places To Get Help
Organizations
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Celiac Disease Foundation (CDF)
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| 13251 Ventura Boulevard |
| Suite 1 |
| Studio City, CA 91604 |
| Phone: |
(818) 990-2354 |
| Fax: |
(818) 990-2379 |
| Web Address: |
www.celiac.org |
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CDF provides support, information, and assistance to
people affected by celiac disease and dermatitis herpetiformis. The Web site has information about diet and lifestyle changes, including a quick-start diet guide and lists of gluten-free resources. There is also a Kid's Korner with information especially for children and teens who have celiac disease and for their parents.
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Celiac Sprue Association
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| P.O. Box 31700 |
| Omaha, NE 68131-0700 |
| Phone: |
1-877-CSA-4CSA (1-877-272-4272) toll-free
(402) 558-0600 |
| Email: |
celiacs@csaceliacs.org |
| Web Address: |
www.csaceliacs.org |
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This nonprofit, member-based organization has information for people who have
celiac disease and for their families, such as ways they can incorporate a
gluten-free diet into their daily lives.
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Children's Digestive Health and Nutrition Foundation
(CDHNF)
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| P.O. Box 6 |
| Flourtown, PA 19031 |
| Phone: |
(215) 233-0808 |
| Email: |
cdhnf@cdhnf.org |
| Web Address: |
www.cdhnf.org |
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The Children's Digestive Health and Nutrition Foundation (CDHNF) Web site helps parents, children, and teens learn more
about reflux and GERD, celiac disease, inflammatory bowel disease, and other
digestive disorders in children.
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Gluten Intolerance Group of North America
(GIG)
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| 31214 124th Avenue SE |
| Auburn, WA 98092 |
| Phone: |
(253) 833-6655 |
| Fax: |
(253) 833-6675 |
| Email: |
info@gluten.net |
| Web Address: |
www.gluten.net |
| |
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This organization provides support, education,
awareness, and advocacy to people affected by gluten intolerances.
|
|
|
National Digestive Diseases Information Clearinghouse
(NDDIC)
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| 2 Information Way |
| Bethesda, MD 20892-3570 |
| Phone: |
1-800-891-5389 |
| Fax: |
(703) 738-4929 |
| Email: |
nddic@info.niddk.nih.gov |
| Web Address: |
www.digestive.niddk.nih.gov |
| |
|
This clearinghouse is a service of the U.S. National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the
U.S. National Institutes of Health. The clearinghouse answers questions;
develops, reviews, and sends out publications; and coordinates information
resources about digestive diseases. Publications produced by the clearinghouse
are reviewed carefully for scientific accuracy, content, and readability.
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References
Citations
-
Catassi C, et al. (2005). Association of celiac
disease and intestinal lymphomas and other cancers. Gastroenterology, 129(Suppl 1): S79–S86.
Other Works Consulted
- Agency for Healthcare Research and Quality (2004).
Celiac Disease (AHRQ Evidence Report/Technology
Assessment No. 104). Rockville, MD: Agency for Healthcare Research and Quality.
Available online:
http://www.ahrq.gov/clinic/epcsums/celiacsum.pdf.
- American Diabetes Association (2011). Standards of medical care in diabetes – 2011. Diabetes Care, 34(Suppl 1): S11–S61.
- Case S (2005). The gluten-free diet: How to provide effective education and resources. Gastroenterology, 128(4, Suppl 1): S128–S134.
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Credits
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By
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Healthwise Staff |
|
Primary Medical Reviewer
|
Susan C. Kim, MD - Pediatrics |
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Specialist Medical Reviewer
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Jerry S. Trier, MD - Gastroenterology |
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Last Revised
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June 18, 2010 |