Dr. Donahue on Celiac Disease

Dear Dr. Donohue: My wife has been diagnosed with celiac disease. Since her diagnosis, she has adhered to a strict gluten-free diet and appears to be recovering nicely.

What can be expected if she were accidentally to consume a small amount of wheat from cross-contamination in a restaurant?

Is any effort being made to develop a medicine that could counteract the reaction to gluten? Please encourage food manufacturers to display "gluten-free" on their products when applicable.


Dear J.B.: If you're ever asked to name an illness that lived in quiet obscurity for decades and decades but has vaulted into the limelight in the past few years, the answer is celiac disease, a somewhat common disorder. It's intolerance to gluten, a protein found in wheat, barley and rye. In susceptible people, gluten creates havoc in the digestive tract. It gives rise to diarrhea, stomach pain, bloating and weight loss. Often, the diagnosis isn't made until people come down with another illness, like early-age onset for osteoporosis because their digestive tracts, damaged by gluten, can't absorb calcium.

A diet that excludes gluten is the treatment for celiac disease. That's somewhat of a tough diet to manage. Gluten is everywhere. It's in places where you'd least expect. It can be a filler for some medicines. Even communion wafers usually are made from wheat. So, small amounts of gluten have caused some celiac patients trouble, and I suppose cross-contamination with it in a restaurant is possible. The only way to know is to have your wife try eating in a restaurant and see what happens.

There are many efforts to find a control medicine for celiac patients. One effort focuses on finding an enzyme that digests gluten so it's no longer a problem.

You and your wife might not know of a powerful ally, the Celiac Disease Foundation, which can be contacted at www.celiac.org or (818) 990-2354. The foundation provides information for patients, fields their questions and puts them in touch with support groups.