Symptoms of Celiac Disease & Some Guides to Help

This is a great infographic of some of the major symptoms of celiac disease. The graphic is put together by The Gluten Dude, who has some interesting stuff on his site. If these symptoms ring true for you, look below the graphic for a few more articles that might help you figure this out with your doctor.

Celiac Disease Symptoms – Courtesy of Gluten Dude

Guides to Why & What to Do - Discuss with You Doctor

Interview with Alessio Fasano Part I: Should Anyone Eat Gluten?

Interview with Alessio Fasano Part II: How to Get Tested for Celiac Disease

Interview with Alessio Fasano Part III: Gluten Sensitivity

What is a Food Allergy, Anyway?

Follow Your Gut (Part 1): What's Eating My Daughter's Stomach?

Follow Your Gut (Part 2): Going Through a Celiac Biopsy

There is also something called "silent celiac" which can happen in some people who are asymptomatic but who have celiac disease. I hope this helps any of you who are trying to get to the bottom of some crazy stuff!

My Favorite Gluten-Free Breads

As seen in Women's Lifestyle Magazine's July/August 2012 Edition. 

BREAD IS YUMMY

When I speak to people who are newly diagnosed with a gluten allergy, sensitivity, or celiac disease, they nearly all say, “I miss bread!” Bread has become a huge part of our food culture.  The gluten in bread helps make it taste really good. It lends flavor, elasticity, and general “yumminess.” Bread is a comfort, a joy. Don’t take away my bread!! But alas, we need alternatives. With multiple allergies on the rise as well, these alternatives must be creative.

WHY “GOOD” ALLERGEN-FREE BREAD IS DIFFICULT TO FIND (AND MAKE)

Pastry Chef, Kyra Bussanich is the first Gluten-free winner of the Food Network’s Cupcake Wars.

She owns CRAVE BAKE SHOP in Lake Oswego, Oregon and is a guest writer for The Tender Palate. I asked Kyra why allergen-free bread is so tough to make:

There are three legs to fantastic baking: gluten, eggs, and sugar. Each contributes something to the texture and structure of the final product, and when you have already replaced one of the legs of the stool, it makes it more difficult to successfully swap out the remaining two legs without adversely affecting flavor or texture (or both).  This is why gluten-free and egg-free baking presents such a challenge.

~Kyra Bussanich, Owner of Crave Bake Shop

The good news is that you don’t have to travel to Oregon to get your comfort on. Here are a two of my favorite breads that you can get off the shelves in your ‘hood and one of my favorite sweet bread recipes that people have been loving.

MY FAVORITE BREAD MIXES

Breads From Anna – Bread Mix (All Purpose Flour Blend)

*Free of Gluten, Yeast, Corn, Dairy, Soy, Nuts, Peanuts, Rice, and GMO

I absolutely love this bread mix. It is sensuous, tasty, and versatile. I’ve used it for open-faced sandwiches, I’ve eaten it plain, and I’ve made stuffing out of it. It is the ultimate comfort bread with or without any kind of butter. Pictured at top is Anna’s sandwich bread, which is lighter and has a bit more structure to it. The All Purpose Flour Blend is fairly dense, which I happen to like, and this is the best bean flour bread that I’ve ever tasted. A side benefit of the Breads from Anna mixes is that they are high in protein and fiber, and quite nutritious!  So pay attention if you are a carbo-loader, this bread will make things happen, if you know what I mean. The mixes are easy to make, and though a bit pricey, they are totally worth it, kids.

Though Breads for Anna has not gone for certification, each ingredient is tested prior to making it to her factory.  She has a completely gluten-free processing plant and does not process any of the top eight allergens in her factory.

 “I have Celiac Disease and Type I Diabetes.  I knew a lot of people needed this and I eat my own products. I feel a lot of responsibility to my customers. You have to be committed in this market.  When I say it’s GMO-free and Gluten-free, I mean it.”

~Anna Sobaski, Owner, Breads from Anna

Chebe – All Purpose Bread Mix

*Gluten-free, can be made Dairy-free.  Does not contain any rice, nuts*, dairy or yeast (see below for processing).

Oh, this bread is wonderful. It is a little crusty on the outside with a wonderfully soft, chewy texture in the middle. It lends such a nice flavor to the sandwich itself, and has a truly crave-worthy texture. I first used it as a hamburger bun and it even held the olives and the organic ketchup on the burger. No mess! I’ve since used it for chicken salad, turkey, and a BLT!

I first saw a Facebook advertisement for Chebe and was intrigued. I wrote to the company for a sample and they immediately sent me a few mixes. This was fantastic because I was able to make their products several times. I found it easier to work the bread with a little olive oil already on my hands.  Kneed this dough well. It will feel like normal gluteny/yeasty dough, just a little stickier. If you do not use cheese (or even if you do) brush the top with olive oil to help it brown and add a sprinkle of sea salt to the top to round out the flavor. If you don’t use all of the resulting rolls, freeze them right away and they thaw and warm beautifully.

Though they do not test for anything but gluten (and they test to 5ppm which we love!), their mixes also do not contain a whole host of other common allergens like rice, nuts, yeast, dairy, etc. So compare your allergy needs to Chebe’s processing. Their factory line does have a separate, nut-free room, for instance, but it does not have a separate nut-free factory.

MY FAVORITE SWEET RECIPE:  DUTCH CINNAMON BREAD

Copyright:  Elisabeth Veltman

*Free of gluten, dairy, soy, rice, nuts, peanuts, yeast

Dutch Cinnamon Bread

This is a great recipe to make on special occasions or to bring to a brunch. It’s flavorful, and is a sweet, soft dessert bread. I find most gluten-free breads, even the good ones, to have a slight hole in the middle of the flavor. The sweet and spicy of this recipe fills that gap deliciously.

Pre-heat oven to 350 degrees

Bread Ingredients:

1 egg
1 cup sugar
1/4 cup sunflower, safflower or similar oil (a neutral oil is best, although coconut oil would work and lend a little coconut flavor)
1 cup GF teff flour
1 cup GF buckwheat flour
1/2 tsp. salt
1 tsp baking soda
1 can Thai Kitchen Coconut Milk (you need the can to include the coconut fat)

Topping / Swirling Ingredients

1/2 cup sugar
1 T. cinnamon

(In a prep bowl, mix these together and set aside.)

Grease a 9x5x3 loaf pan (use the same oil you are baking with). In a food processor or mixer, beat the egg, sugar and oil together until creamy. In a separate bowl, sift together the flour, salt and soda. Remove the coconut milk from the can into a bowl, and beat the fat into the rest of the milk. Add the flour mixture to the egg/sugar mixture alternatively with the coconut milk until blended. Pour 1/2 of the batter into the loaf pan. Sprinkle the top with 1/2 of the cinnamon sugar mixture. Add the rest of the batter to the pan, and then sprinkle the remaining cinnamon sugar over the top. Using a knife, swirl the sugar into the bread in a figure eight type pattern. Bake 1 hour. Cool for at least 30 min. then remove from the pan.  Slice and serve.  This bread freezes really well.

OTHER GLUTEN-FREE BREAD RESOURCES

Reprinted with permission from Women's Lifestyle MagazineThere is a wonderful recipe site run by Elana Amsterdam. She has Paleo Bread Recipes that I adore.
They are grain-free (made with nut flours, and high protein).  Find them at www.elanaspantry.com

I’m not able to eat these breads because of my specific allergies, but my readers often tout these brands:

Udi’s multi-grain is a consistent favorite.  Find them at www.udisglutenfree.com/

Genius Breads is a new favorite.  Find them at www.geniusglutenfree.com

Rudi’s Gluten-Free Bakery at www.rudisglutenfree.com is another that is mentioned by readers.

ABOUT THE AUTHOR:

Writer, owner of Blue Pearl Strategies, and lover of all culinary delights, Elisabeth is a Tender Foodie. She started The Tender Palate, a website for foodies with food allergies where she consults with experts from every area of the Tender Foodie life. She believes that everyone should live deliciously and have a healthy seat at the table. Find her at www.tenderpalate.com.

Follow Your Gut (Part 2): Going Through a Celiac Biopsy

Knowing For Certain

In Part 1 of this 2 part article, my friend Emily wrestled with the decision to have her young daughter undergo an upper GI endoscopy and biopsy to determine if she had celiac disease.  The risks of anesthesia were daunting, but the need for reassurance of  “knowing for sure if we needed to avoid cross contamination or food temptations” prompted Emily and her husband to schedule the procedure.  First,  their little girl, Nicky, had to endure a “gluten challenge” or 8 weeks of eating gluten on a daily basis to ensure that the biopsy results would be accurate.  

Endure?  Endure doughnuts and cookies and pasta? Yes, because Nicky’s primary symptoms of gluten intolerance were painful stomach aches and ADD-like symptoms, and thus, the daily barrage of gluten on her tender tummy soon proved to be almost too much for the little girl to bear.

Gluten Changed Her Daughter's Behavior - A Lot

Prior to the gluten challenge, Nicky’s diet was filled with “lots of fruits and veggies and only minimally processed foods” and almost no gluten in order to keep her difficulties with attention, impulsivity and other symptoms of gluten sensitivity in check. She had always been an excellent student and a well-behaved child, as long as she stayed away from the gluten-monster. Alarm bells began to go off shortly after ingesting gluten on a regular basis.  During the first month of the challenge, Nicky’s teacher expressed her concern.   Nicky’s  behavior had become disruptive in the classroom and she had periods of “explosive rage.” Her mother expounded, “Nicky was not coping…not managing…and having a really hard time letting things go.  She was no longer in control of herself.” 

While the endoscopy and anesthesia loomed in the near future, Emily found it almost unbearable to watch her sweet daughter’s personality change as the flood of gluten invaded her body.  “She would space-out…something like getting dressed in the morning was exceptionally challenging.”   Emily explained how Nicky couldn’t sequence the steps and how she ‘got lost” in the process.  “Twenty minutes later, I’d find her half-dressed and completely off-task and have to redirect her to finish getting on her outfit for school.”

The Day of the Endoscopy

Finally, the day of the endoscopy arrived.  The ease of the entire process was a complete surprise to Emily and so much more informal than she had anticipated.  Because she had chosen pediatric specialists, the complete procedure was family and child-centered.  The pediatric anesthesiologist called Emily the night before (a Sunday!) to introduce himself and see if she or her husband had any questions. The next morning,  Nicky had the procedure done in her “street clothes” and her parents were encouraged to go back to the procedure room with her.  They stayed there till she fell asleep, gave her a kiss and 15 minutes later met her in the recovery area, where she had a Popsicle™.  “I had pictured it in my own mind so differently!  If I had known it was that easy , I would have been less worried. Knowledge is key. ”

The Results Are In

Two weeks later, the biopsy results were revealed with two precious words: no celiac. According to the University of Maryland's Center for Celiac Research, 4 out of 5 distinct markers would necessitate a positive diagnosis (see a list of these markers here).  However, this little one had 3 out of 5.  This was good news.

When I asked Emily what her first thoughts were after hearing those precious two words, she expressed a sigh of relief.  “NOW we know.  Now we know that a little gluten here and there won't have serious, unseen side effects.  We will continue to respect her gluten sensitivity, but, thankfully, being a sensitivity, it allows us a little freedom.  She has chosen in the past to be gluten-free because of her stomach aches, and now we can continue to allow her a little independence in that choice.  But, I continue to be frustrated at some medical professional's dismissal of how significant gluten sensitivity can be for some people.  From what I’ve read online, there seems to be a definite identification of gluten sensitivity.  I guess it just needs more research to be more widely accepted.  I feel like so many people just think I'm crazy when I say how gluten affects her behavior. “ 

I admire my friend Emily.  She listened to her most powerful resource, her mother’s intuition.   She followed her gut and learned what was eating at her sweet daughter’s stomach.  “What’s the best part of once again going gluten-free?” I asked Emily.  “I’m excited for her attention and mood to improve.  I’m excited to watch her heal.”    I smiled: “Be gone gluten-monster!  Be gone!”

About Melanie

Melanie Potock, MA, CCC-SLPMelanie is speech language pathologist who specializes in feeding.  Her work brings her into the homes and schools of her clients, kids, who for various reasons have difficulty with food or with eating. She works with kids and their parents to develop effective strategies that help children become “more adventurous eaters”.  At least 50% of her clients have food allergies or intolerances, and for them, “adventurous eating” takes on a special meaning.  Melanie is also the author of Happy Mealtimes with Happy Kids” and the executive producer of “Dancing in the Kitchen.”

More Posts from Melanie

Why Children with Autism are Often Picky Eaters

Review:  The Magic of the BellyFull Kit (From the Hopeful Company)

The 12 Days of Christmas -- My Favorite Lunchtime Things (Part 1)

Tips to Help Your Food Allergic Child Belong During the Holidays

How to Talk Turkey (and Food Allergies) at Thanksgiving

How Can Parents Feel Less Stress with a Food Allergic Child in School?

Follow Your Gut: What's eating my daughter's stomach? (Part 1)

A Mother's Intuition

Ever heard of “mother’s intuition?”  It is that tiny voice in a mom’s head that says “hmm…something is not quite as it seems.”   That voice was what drove my friend  Emily to forgo her pediatrician’s relaxed approach to her young daughter’s stomach pains and embark on journey directed by her mother’s intuition.   Over coffee  at our local java stop, Emily described the events of the past two years to me.

Emily’s daughter, Nicky, who is now 6, began having constipation and separate periods of stomach pain at age 4.  She  was also having difficulty maintaining attention for age appropriate tasks, causing her  parents to discuss attention deficit disorder with their pediatrician.  While the physician leaned more toward treating the symptoms of the gastrointestinal (GI) issues, Emily asked herself why her daughter was in such agony.  What was causing this?  Because Nicky’s paternal grandmother had a history of stomach ailments and found relief via a gluten-free diet, Nicky’s parents suspected a gluten intolerance.  They took her off gluten in January 2011, and within 2 week the stomach aches and constipation went away.   Interestingly, so did her difficulties with attention and her tendency to be impulsive, which is a hallmark for children with ADD.

Over time, Emily did not worry about cross contamination or the occasional gluten-filled cookie.  Her daughter typically preferred to eat gluten-free foods, eating “lots of fruits and veggies, minimally processed foods” and only rarely,  a food with gluten.   By August 2011, Nicky had returned to daily tummy pains and the discomfort of chronic constipation.   Kindergarten had started, and at first, Emily suspected the culprit to be the stress that such a big transition can cause for a child.  But, by the start of 2012, mother’s intuition was shouting “Do something about this!” 

Time to Act

First stop: allergy testing.  A blood test for celiac, not always foolproof, came back negative.  Additional blood tests and scratch tests for food allergies were negative, but further testing revealed that Nicky had the permissive gene marker for celiac.  Consequently, Emily’s next step was to take Nicky to a pediatric gastroenterologist, who ordered a series of tests to rule out a multitude of causes for Nicky’s pain, including stool testing for parasites, an ultrasound of her liver and pancreas and tests for gastroesophageal reflux disease (GERD).   Again, all tests came back negative, leading Emily and her husband to consider taking one more step: an upper GI endoscopy involving anesthesia and a small bowel biopsy.

“What went through your mind when you considered this next step?” I asked my friend.  Emily gazed into her coffee, taking herself back to that moment.  “The risks of anesthesia.  I had the choice to do it or not to do it and that felt very heavy.  Ultimately, we decided to do it because it was important that we knew  for sure if we needed to avoid cross contamination or food temptations.”   Emily’s anguish over Nicky being 100% gluten free for life was clear.  “Mel, I mourned the loss of gluten.  I truly mourned it.”

Join us for Part 2 of “Follow Your Gut.”

In Part 2 of this article,  Emily is instructed to do a “gluten challenge”,  feeding Nicky plenty of gluten for the next 8 weeks prior to the endoscopy to ensure that the biopsy results would be accurate.   While she mourned the loss of gluten, the flood of gluten over the next 2 months proved to be the most challenging aspect of this journey, as little Nicky’s symptoms became almost unbearable for a mother to watch.

 For more information visit:  How to Get Tested for Celiac Disease.

About Melanie

Melanie Potock, MA, CCC-SLPMelanie is speech language pathologist who specializes in feeding.  Her work brings her into the homes and schools of her clients, kids, who for various reasons have difficulty with food or with eating. She works with kids and their parents to develop effective strategies that help children become “more adventurous eaters”.  At least 50% of her clients have food allergies or intolerances, and for them, “adventurous eating” takes on a special meaning.  Melanie is also the author of Happy Mealtimes with Happy Kids” and the executive producer of “Dancing in the Kitchen.”

More Posts from Melanie

Read PART 2:  Going through a Celiac Biopsy

Why Children with Autism are Often Picky Eaters

Review:  The Magic of the BellyFull Kit (From the Hopeful Company)

How Can Parents Feel Less Stress with a Food Allergic Child in School?

Golf Pro Michelle Wie Goes Gluten-free

Wie Inspired by Djokovic

Last Thursday, Michelle Wie, the U.S. golf champion and phemo, announced to the Tapei Times that she has gone gluten-free.  Her choice was inspired by Tennis Champ, Novak Djokovic.  In March, Djokovic announced that a gluten free diet was a key reason that his tennis game has improved so dramatically over the course of that season. 

The Tapei Times quoted Wie:

“I am allergic to everything in this world, I don’t really digest food very well . . . so I just thought maybe if I cut out gluten, I can feel better because I heard that it causes inflammation, everything ... but it’s been week three and I feel a big difference.”

Wei began her career at 16 and is currently going to Stanford.  She mentioned that she has no trouble balancing her class load at Stanford with her golf career. 

“You know, my joints don’t feel sore as much, I digest food a lot better, my hands feel less swollen so I feel really good,” she said.

 The Wall Street Journal wrote about Djokovic's rise from January 2011 to May 2011:

Djokovic's season has gone from good to great to outrageously, impossibly, unrealistically phenomenal.

Recent Studies Conducted Because of Gluten-based Illnesses

This is further evidence that supports Dr. Alessio Fasano's findings that no human being can properly digest gluten. The Tender Palate interviewed Dr. Fasano in December to help the general public become aware of and better understand his resarch.

Gliadin is a strange protein that our enzymes can’t break down from the amino acids (glutamine and proline) into elements small enough for us to digest.  Our enzymes can only break down the gliadin into peptides.  Peptides are too large to be absorbed properly through the small intestine. 

 As with Djokovic, It will be interesting to watch Michelle Wie throughout this year's performance.  It will also be interesting to see how the medical, research, marketing and farming industries behave as more celebrities and athletes adopt this diet. 

Read the articles and interviews with Dr. Fasano

Interview w/ Dr. Alessio Fasano (Part 1):  Should No One Eat Gluten?

Interview w/ Dr. Alessio Fasano (Part 2):  How to Get Tested for Celiac Disease

Interview w/ Dr. Alessio Fasano (Part 3):  Gluten Sensitivity, A New Food Allergy