For centuries, wheat has been known as the "staff of life." But this wholesome, nutritious grain can be devastating for people with a condition called celiac disease. Having this disease means that "comfort foods," like pasta and bread, and traditional holiday fare, like stuffing and fresh-baked pies and cookies, are off-limits. The reason? A protein called gluten, found in wheat, rye, barley, and oats.

The condition, also known as celiac sprue or gluten-sensitive enteropathy, is a genetic disease that runs in families, especially those of north-western European descent. In countries such as Italy and Ireland, celiac disease is the most common genetic disease. Although it was once thought to be fairly rare in the United States, experts now believe that celiac disease is prevalent here as well, especially because many Americans have European roots. Indeed, nearly 1 in 133 Americans has celiac disease, according to a recent study by the University of Maryland Center for Celiac Research in Baltimore. Having a relative with the disease increases your risk.

In this article, we will review how the body acts to gluten. For those who must live celiac disease, we will offer tips on how to avoid gluten in your daily diet.

Signs of Celiac

In people with celiac disease, gluten sets off an autoimmune reaction in which the body's own immune system produces antibodies that attack the small intestine, causing damage and illness. This damage impairs the small intestine's ability to absorb nutrients. Over time, this can lead to other illnesses, including delayed growth in children, malnutrition, premature osteoporosis (thinning of the bones), and cancer of the colon. Untreated celiac disease in pregnancy raises the risk of miscarriage and birth defects. Celiac disease also appears linked to a risk of other autoimmune disorders, such as type 1 diabetes and some types of arthritis.

Outward signs of this disease vary widely. Symptoms range from abdominal bloating and pain, chronic diarrhea, and weight loss to muscle cramps, joint pain, numbness, or a painful skin rash. Some people experience behavior changes, such as irritability or depression, or overall fatigue.

For some people with the disease, no symptoms are evident until the disease is triggered by the stress of surgery, pregnancy, or a viral infection. In children, chronic irritability is a red flag. Other signs include failure to thrive in infants, short stature, tooth discoloration, and behavioral or learning problems.

Screening and Diagnosis

For many sufferers, it's not uncommon to be diagnosed with an assortment of ailments -- such as anemia, depression, chronic fatigue, and irritable bowel syndrome -- before celiac disease is fingered. This may explain why the time between the first appearance of symptoms and diagnosis can often be months or years.

Screening is quite simple: It involves a blood test that detects antibodies to gluten. Anyone with a family history of celiac disease should ask for the blood test. The "gold standard" for diagnosis is a biopsy of the small intestine. Using an endoscope (a thin, lighted tube) threaded through the mouth and down the esophagus, the doctor removes a tiny sample from the lining of the small intestine to check for damage that signals celiac disease.

If the diagnosis is confirmed, the irritating gluten protein must be completely removed from the diet for the remainder of the patient's life. In most cases, this relieves symptoms almost immediately and allows the small intestine to heal, a process that begins within days but can take up to six months.

Avoiding gluten-filled foods will require persistence. Turn to the next section for some helpful tips on how to stay informed and choose a gluten-free diet.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.