Q: What is celiac disease?

Ans: Celiac disease, also called celiac sprue, is a digestive disease

that damages the small intestine and interferes with the absorption
of nutrients from food. People who have celiac disease cannot
tolerate gluten, a protein found in wheat, rye, oats and barley; it is
also found in some medicines and vitamins.

Q: What are the symptoms of celiac disease?

Ans: This disease may present with a broad range of symptoms and
severities.

Common symptoms are:

· Weight loss
· Lethargy, weakness
· Diarrhea (loose stools)
· Anemia (low hemoglobin)
· Stomach pain
· Skin rash (dermatitis herpetiformis)
· Mouth ulcers
· Weak bones (osteomalacia)
· Joints pain
· Menstrual irregularities
· Malnutrition

Q: How common is celiac disease?

Ans: Celiac disease affects people of all age groups across the
globe. It affects both male and female. The exact burden of celiac
disease in Pakistan is not known but international figures showed
that 1 in 33 people are affected by this disease.

Q: Do patients with celiac disease have other health problems?

Ans: Yes. Celiac disease patients are at risk of having other
autoimmune diseases like:

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 1. Diabetes (type 1)
2. Thyroid disease
3. Liver disease (autoimmune)
4. Addison's disease (a condition in which the glands that
produce critical hormones are damaged)
5. Joint disease

Q: How celiac disease diagnosed?

Ans: Celiac disease has long been under diagnosed; it is confused
with other conditions like intestinal infection.
Correct diagnosis is usually based upon symptoms, blood tests and
biopsy taken of small intestine during endoscopy.

Q: How celiac disease is treated?

Ans: The only treatment for celiac disease is to live a gluten free diet.
.
Dieticians can help patients choose foods which are free of gluten.
Following this diet will stop symptoms, heal existing intestinal
damage and prevent further damage. Eating even small amount of
gluten can damage the small intestine. Hidden sources of gluten in
preservatives and medicines need to be identified.

Q: How can I simplify my diet, as it seems difficult to avoid

foods containing gluten?
Ans: It is simple, given below is the table which will provide list of
food that can be taken and avoided. Do learn to read food labels
carefully and avoid readymade and restaurant food such as bread
rolls, breaded meats, fish, prawns, kebabs, nihari, cream soups
and so on.

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 FOOD GROUPS &
DAILY SUGGESTED FOODS ALLOWED FOODS TO AVOID
INTAKE
Milk: (2 or more Whole, low fat, skim Malted milk, some
cups) milk, butter milk(As commercial chocolate
desired) drinks
Cheese(can be All cheese such as Any form of cheese
used for meat/ cheddar, cottage, containing wheat/oat
milk group) cream and Swiss. gum as an ingredient
Meat, fish, Any plain. Grilled, Breaded, creamed or
poultry: (6-8 roast meats; fried thickened gravy of
ounces) provided if coating is wheat flour (patties,
Eggs: (whole/2 gluten free. meat samosas),
egg whites) Any form, as desired commercially prepared
omelets.
Vegetables: All fresh vegetables, Commercially seasoned
plain commercially vegetable mixes,
(2 or more commercial vegetables
servings) frozen or canned
vegetables ( As with cream or cheese
desired) sauce; canned baked
beans
Fruits: All plain or sweetened Commercial pie fillings,
(3 or more fruits; fruits thickened thickened with other
servings) with tapioca or corn than corn starch.
starch
Only those are All breads, rolls,
Bread/ chapatti:
specially made from biscuits, cake, samosa
(6 or more
rice, corn, soy bean, & nan, chapatti made
servings)
potato, arrowroot from wheat, millet, oat
flour. or barley flour.
All others containing
Corn flakes , rice wheat , malt and malt
Cereal: (1 or flakes, rice and sago flavoring, including
more serving) noodles, semolina,
macaroni, spaghetti,
vermicelli; porridge and
bran or wheat germ
containing breakfast
cereals

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Desserts Gelatin; custard ;fruitCommercial cakes,
ice; specially preparedcandies especially
cakes ,cookies, and chocolates, cookies,
pastries made with pastries; commercial
gluten-free flour or dessert mixes,
starch; pudding & fruitcommercial ice cream &
filling thickened with,sherbets, fruit tarts,
arrowroot or corn cream cones, typical
flour; ice-lolly, kheer.
Asian sweets like suji
halwa, punjeeri, shahi
tukray and habshi halwa
Soups Homemade broth & Canned soups & soup
soups made with corn mixes; bouillion &
flour. bouillion cubes.
Beverages Coffee, tea; Cereal beverages e.g
decaffeinated coffee, malt, ovaltine, barley
carbonated flavored drinks,
beverages; chocolate commercial chocolate
drinks made with pure milk, cocoa mixes, other
cocoa powder, soft beverages mixes,
drinks, & fruit dietary supplements.
squashes
Miscellaneous Salt, pepper; pure Prepared mustard;
spices & herbs; yeast commercially prepared
pure baking chocolate meat sauces, pickles,
or cocoa powder; flavoring syrups
flavoring extracts; (pancakes or ice-cream
artificial flavorings.

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References:
· Manual of nutritional therapeutics, fifth edition by lippincott williams & wilkins (2008)
· Krause's food & nutrition therapy, twelfth edition by saunders elsevier (2008)

Important Note:

Food provided during hospitalization to patients is disease specific

and during stay food from outside hospital is not permitted. Written
and verbal instruction related to dietary restrictions is explained by
clinical nutrition staff, where applicable.

Outpatient Nutrition Care Clinics

ICN # S215884

Nazarall Walji Building (NW 2) Gastroenterology Clinic

Phone: (021) 3486-5789-90 (JHS Building)
Monday to Thursday Phone: (021) 3486-1055 / 3486-6308
Timings: Morning 9:00am - 11:00am Thursday
Timing: Morning 9:00am - 12:00am
Consulting Clinic (CC 4) Sports & Rehabilitation Clinic
Phone: (021) 3486-1034 (Sports Centre)
August, 2014

Friday Phone: (021) 3486-1662

Timings: Afternoon 2:00pm - 4:00pm Tuesday
Timing: Morning 9:00am - 11:00am