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March 2017 Most people have no problem with eating gluten which is found in wheat, rye, barley and non-gluten-free oats. Yet about one percent of the population has Celiac Disease, a serious autoimmune disorder where the ingestion of gluten causes the body to mount a response that damages the small intestine, making it harder for the body to absorb nutrients. The most common symptoms found in children with Celiac Disease are abnormal weight and height progression; abdominal bloating and/or pain after eating things like crackers, pasta, and/or bread; chronic diarrhea or constipation and tooth enamel defects. Adults are less likely to have digestive symptoms without additional symptoms like unexplained iron-deficiency anemia, osteoporosis or osteopenia (bone loss), infertility or recurrent miscarriage, and/or itchy, blistery skin rashes. If you think you may have Celiac Disease—or your parent, child, or sibling is diagnosed with it—talk to your healthcare provider about getting tested. It’s important to know, though, that for the test to be valid, you must be eating gluten (the equivalent of one piece of bread a day for at least six weeks before getting the blood test). The only treatment for Celiac Disease is a strict, no-cheating, life-long, gluten-free diet. Celiacs come in all shapes, sizes, and sensitivity levels. Some people have mild symptoms after eating a big meal of pasta or bread, and others end up in the emergency room if they ingest crumbs from sharing the same cutting board as someone who just sliced some bread. The important thing to remember is this: if you are diagnosed with Celiac Disease—even if you aren’t experiencing symptoms—you must adhere to a gluten-free diet for the rest of your life to avoid the risks that come with the disease. If you are diagnosed with Celiac Disease, consider connecting with a supportive community. It is amazing the difference it can make in your life. In Mendocino County, there is a small community on Facebook at Gluten Free Mendocino County (www.facebook.com/Gluten-Free-Mendocino-County-264141087266). We also have a much larger and more active support group in Santa Rosa (North Bay Celiacs at celiaccommunity.org). Support groups can help connect you with knowledgeable healthcare providers, give you information about great products and recipes and connect you with other Celiacs who understand exactly what you’re going through. For young people living with Celiac Disease, Camp Celiac in Livermore (celiaccamp.com) offers an incredible opportunity to get together with other kids and adults who have Celiac disease or who are gluten-free for other reasons. This year there will be two sessions: July 16-19 and July 19-22. We all know it’s best to eat mostly fruits, vegetables, whole grains and drink lots of water, no matter what diet we adhere to. Many of our local grocery stores have an abundance of gluten-free alternatives, including breads, pastas, frozen pizzas, cookies, crackers and more. However, just because these are available, doesn’t mean they are healthy for you. To avoid significant weight gain, I recommend you still focus the majority of your diet on healthy foods. For the occasional special occasion though, we are lucky to have many local restaurants and bakeries that offer gluten-free dishes. Living with Celiac disease takes planning, a willingness to ask a lot of questions, and the self-control to say no to things that could make you feel sick. With some time, practice, humor, routine and people to help support you, you will find yourself on a culinary adventure and a long and happy life. Jeni Guth-Crouch is a Family Nurse Practitioner in the Pediatrics Department at MCHC Health Centers, a local, non-profit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino Counties.