Understanding Celiac Disease

Reviewed by Wendy Marcason, RDN
gluten and grains

In people with celiac disease, the body's immune system responds to gluten by damaging the lining of the small intestine; thus, people with celiac disease cannot eat foods containing gluten — a protein found in wheat, rye and barley. Since most of the nutrients in food are absorbed through the small intestine, damage to the small intestine means nutrients cannot be fully used by the body which can lead to nutrient deficiencies.


An estimated 1 in 133 Americans has celiac disease. The condition is genetic, and if an immediate family member has celiac disease, the chance you may have it increases to 1 in 22. Because so many cases of celiac disease go undiagnosed, family history alone is not always an accurate gauge.

Some symptoms of celiac disease include:

  • Diarrhea
  • Stomach pain
  • Fatigue
  • Joint pain
  • Weight loss
  • Itchy skin rash (dermatitis herpetiformis)

There are dozens of symptoms associated with celiac disease and vary from person to person. Symptoms may occur in the digestive system or in other parts of the body. Properly diagnosing celiac disease includes a medical review of your symptoms. It also involves a blood test to look for high levels of certain auto-antibodies and a biopsy of tissue from the small intestine.

Though celiac disease cannot be cured, the condition can be managed. People with celiac disease can lead long, healthful lives.

Diet and Nutrition

The only treatment for celiac disease is to eat a gluten-free diet. There are plenty of foods that are naturally gluten-free, including fruits, vegetables, beef, poultry, fish, nuts, eggs and more. A growing number of foods are being developed by manufacturers to answer consumers' increasing interest in gluten-free products.

However, managing celiac disease is not just about eliminating gluten from your diet. It also involves making sure you get all the vitamins and nutrients you need — particularly iron, calcium, fiber and the B-vitamins thiamin, riboflavin, niacin and folate — and watching weight gain. Weight gain can be a side effect for people with celiac disease once they start following a gluten-free diet. This is because the body is absorbing more nutrients and calories from food.

Live Healthfully with Celiac Disease

  • Meet With a Registered Dietitian Nutritionist: A registered dietitian nutritionist can help you understand which foods are safe to eat and which to avoid — planning for meals at home and for eating out. An RDN will work within your lifestyle to help you keep a healthy weight and ensure you get all the nutrients you need for a strong, energetic life. Use the Find a Registered Dietitian Nutritionist tool to locate an RDN in your area.
  • Discover Alternate Grains: Several delicious and nutritious grains can be used in place of grains that contain gluten. Speak with your grocer about grains you would like to have available in your store. (Foods to Include on Your Grocery List)
  • Learn About Ingredients in Foods: Many packaged foods can contain gluten even if the ingredients don't include wheat, rye or barley. (See Processed Foods and Ingredients That May Contain Gluten.) Ingredients such as modified food starch, malt or soy sauce also contain gluten.
  • Look for "Gluten-Free" Claims on Food Packages: The Food and Drug Administration has a new rule that requires food labeled as "gluten-free" to meet all requirements of the gluten-free definition, including that the food must contain less than 20 parts per million of gluten. However, food products that seem like they would be gluten-free, such as a rice mix, may have traces of gluten if the manufacturer makes other products with gluten in the same facility. If a food does not have a "gluten-free" claim on the package, check directly with product manufacturers for more information.

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