The Gluten-Free Diet: An Update for Health Professionals

Celiac disease (CD) is a genetically determinedcondition in which certain grain proteins cause anautoimmune response that damages the lining of the small intestine, causing blunting of the villi and malabsorption of nutrients. Gluten is the general term for the proteins that have been found to be toxic in those with CD—specifically the storage proteins (pro-lamins) in wheat (gliadin), rye (secalin) and barley (hordein). Many individuals with CD may be only mildly symptomatic or asymptomatic at diagnosis. Or, they may present with various nutrition or malabsorp-tion-related problems such as unintentional weight loss, bloating and gas, ongoing fatigue, lactose intoler-ance, diarrhea or constipation, iron deficiency anemia, folate deficiency, low serum levels of vitamin B12, magnesium and phosphorous. The length of time wit