People with celiac disease react to gluten – a nutritious protein in wheat and others grains – as if it poison. Gluten damages their intestines so badly that they cannot absorb food, vitamins or minerals. They suffer abdominal cramps, gas diarrhea, malnutrition and weight loss. The disease is so debilitating that children with it grow slowly if at all.

Celiac disease isn’t an allergy. But it's related to allergy in that many cases are provoked early in infancy by an allergic reaction to cow’s milk. The damage intestines then reject not only wheat and milk, but sometimes other food as well. And celiac disease is treated much like an allergy – by careful avoidance of gluten containing grains.

The four offenders in celiac disease are wheat, rye, barley and oats (although some celiacs can eat oats safely). Their close botanical relative, rice, and distant cousins, corn and millet, have such low levels of gluten that most celiacs can tolerate them, especially after several months of totally avoiding all sources of gluten.

But even when eating high gluten grains, some celiacs do not get as severally ill as others. A study in Britain tested the effects of barley, rye, rice and corn in a group of celiacs. As expected, rice and corn did no harm. With barley and rye, the damage varied from one person to another, even though everyone ate the same amounts.

Evidently, celiacs vary in how much damage their intestines suffer when they eat gluten (Quarterly Journal of Medicine, January, 1978). Standard treatment for celiac disease begins with a high protein, gluten free diet of skimmed milk, egg white, lean meat, fish, liver and protein rich vegetables such as peas and beans.

Starchier foods such as fruit, vegetables and low gluten grains come later, after the digestive system has healed enough to be able to handle them. But because gluten can show up where you least expect it, you need to stop and think before you put anything in your mouth.

For example, a woman in Toronto was doing very poorly despite a strict gluten free diet. Doctors finally discovered that the woman, a Catholic, was receiving daily communion – and that the wafers were made of wheat flour. Within two days of taking Communion without wafers, she no longer had abdominal cramps, bloating or diarrhea (Lancet, November 8, 1975).

”It's not unusual for a person to adhere strictly to the diet but to unaware that the Communion wafer stick of gum may be an unsuspected source of gluten,” says Joyce Gryboski, M.D., a pediatrician at Yale University School of Medicine (American Journal of Disease of Children, February, 1981).

Finding Your No-Allergy Diet, gives tips on how to avoid hidden source of gluten, especially when you’re shopping for bread and baked goods. If you prefer to bake your own, the Cooking Without Wheat gives directions on how to substitute rice flour, potato starch and other gluten free starches in recipes that call for wheat flour.

Until you heal, you will probably need to take a B-complex vitamin and other nutritional supplements to replace nutrients lost either through poor absorption or from avoiding grain and other B-vitamin rich foods. After you’ve done well on the high protein, low gluten diet for six months, you can work toward a regular diet by adding one food at a time.

It may take a year or two for the intestinal damage to heal completely. Some celiacs can eventually eat wheat and other sources of gluten, especially if they begin with rice or corn. A few lucky ones – mostly children – are able to eat gluten indefinitely without symptoms.

But the basic tendency for gluten intolerance will remain, so it's best to eat only small amounts of gluten containing foods occasionally rather than making them a major part of your daily diet. Some people, however, may not improve until milk or egg has also been removed from the diet. One doctor noticed that out of 120 people with celiac disease, 10 did not improve on a gluten free diet until milk protein was avoided.

Two other celiacs failed to get better until egg was avoided (Progress in Gastroenterology, vol. 1, 1968). Other doctors report the case of a woman who was careful to follow a strict gluten free diet, yet failed to improve. They noticed that her symptoms were the worst when she ate egg, chicken or tuna.

But when those foods – along with gluten – were removed from her diet, she made a full recovery, say Alfred L. Baker, M.D., and Irwin H. Rosenberg, M.D., of Chicago, Illinois. The doctors emphasize that while celiac disease due to foods other than gluten is unusual, it does occur (Annals of Internal Medicine, October, 1978).

Celiac disease seems to be somewhat preventable. The first step is for women to breastfeed their babies, especially if celiac disease or allergies run in their family – or if they're Irish (Irish people or their descendants are genetically more susceptible to the problem).

A study done a few years ago shows that celiac are more likely to have asthma, hay fever and eczema than non-celiacs. While no one understands the full significance of the celiac allergy connection, it could indicate that since breastfeeding protects against allergies, it may guard against celiac disease too.

Also by developed the proper enzymes to handle it, breastfeeding also prevents the intestinal damage that sets the stage for celiac disease. And don't be too hasty to add cereal and other solid food to the baby’s diet. Wait until the infant is at least four to six months old, and then add each grain, one at a time, in small amounts. Begin with rice, millet and other low gluten grains.

”Delayed introduced of gluten to the diet in infancy may prevent gluten intolerance and lead to a drop in the number of people who get celiac disease,” says doctors in Britain. Other doctors report that as more mothers breastfeed – and breastfeed no longer – the incidence of celiac disease seems to be dropping.

”We believe that the incidence of celiac disease in childhood is falling and that this is directly related to changes in infant feeding practices occurring in the mid-1970s,” they conclude (Lancet, December 20-27, 1980). It's nice to hear that even some of the most mysterious health problems are within our control – if we know what to do about them. See also Colic, Colitis,Colitis, Indigestion, Bloating and Abdominal; and Schizophrenia.