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May is Celiac Awareness month, and as all families face the new challenges of social distancingand self isolation to help prevent the spread of Covid-19, we remain vigilant in helping those withceliac disease manage their health.

During the month of May we are urging family members of celiacs, and especially those withsymptoms of the disease, to ask themselves two questions: Could it be Celiac? What’s my nextstep?

Having a first-degree family member with celiac disease increases the chances of having thedisease to 1 in 10. And with an estimated 80% of Canadians with celiac disease not diagnosed,testing family members is one of the most effective ways to reach those with increased risk.

COULD IT BE CELIAC? WHAT IS MY STEP?Learn More

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CELIAC DISEASE IS LINKED TO A PERSON'S GENETICS

Celiac disease, though not yet fully understood, is a hereditary disease strongly linked in part to aperson’s genetics. We know this from a broad perspective, as the risk of celiac disease increases 10-15%if a first-degree relative, such as a parent or sibling, also has the disease.

The family connection has also been made through genetic testing. Scientists have been able to identifytwo specific genes that appear more commonly in people with celiac disease - HLA-DQ2 and HLA-DQ8.However, there is no definitive genetic test for celiac disease. As 40% of North Americans have these

genes but only 0.5-1% of the population will develop celiac disease, having the gene does not mean youwill develop celiac disease. It’s another piece in the puzzle.

Celiac disease affects 1 in every 100 Canadians, but it is estimated that as few as 20 per cent have beendiagnosed. With first degree relatives running the risk of developing celiac disease at any age, blood testscreening for family members is highly recommended, especially if they have symptoms.

Research has shown that the risk of complications of celiac disease including osteoporosis, anemia,infertility, poor growth and certain cancers is reduced by a gluten-free diet in individuals with celiacdisease.

Early detection of celiac disease is key to maintaining long term good health, by adopting a gluten-freediet as soon as possible. Encourage family members to get screened!

MEETING THE NEEDS OF PEOPLE WITH CELIAC DISEASE

How well does your family understand and follow guidelines to help reduce the risks for celiacs?Ask them to take the quick quiz below, to put their know-how to the test.

What is celiac disease?A condition in which the stomach is damaged by glutenA condition in which the small intestine is damaged by glutenA condition in which a person is allergic to gluten

Answer: A condition in which the absorptive surface of the small intestine is damaged by a substancecalled gluten.

What is gluten?Type of protein found in wheat & other grainsMineral found in wheat & other grainsPreservative found in wheat & other grains

Answer: Type of protein found in wheat & other grains such as barley and rye, and related cereal grainssuch as triticale, spelt and kamut.

How many milligrams of gluten are considered safe for celiacs to consume daily?10, 20, or 50

Answer: 10mg, which is equal to about .002 or 1/500th of a teaspoon! Virtually ZERO, this amount isnot visible to the naked eye.

What is cross-contamination in the home?Preparing foods that contain gluten and other ingredientsInadvertently adding gluten to a gluten-free foodPreparing food without gloves

Answer: Inadvertently adding gluten to gluten-free food. Examples include using a contaminated utensilin a jam jar, leaving crumbs in a dedicated preparation space, putting gluten containing products in adedicated storage space.

Which of these things is it unsafe for celiacs to share with family members?Toaster, utensils, pots, glasses, dishes

Answer: T oaster. With thorough cleaning before preparing gluten-free meals utensils, glasses, dishescan be shared. Special toasting bags can be used, but as it is virtually impossible to clean a

toaster, having a separate one is the safest way to prevent cross contamination from toasting bread.

What are the signs that a person with celiac has ingested gluten?No signs at alldiarrheaconstipationstomach pain/bloating/gasall of the above

Answer: All of the above. Some people with celiac disease have no symptoms, but silent, invisibledamage is still occurring to the small intestine after ingesting gluten.

THE ONSET OF CELIAC DISEASE CAN HAPPEN AT ANY STAGE OF LIFE

Celiac disease is truly a family disease. Not only because of the increased risk of family membershaving the disease, but the onset of celiac disease can happen at any stage, upending “life asusual” for a person and their entire family.

While the digestive symptoms of the disease are the most commonly known – chronic diarrhea,abdominal pain, and unexplained weight loss – lesser known “atypical” symptoms can be equallydebilitating with severe long-term health consequences.

Celiac disease occurs commonly in patients with other autoimmune disorders such as thyroiddisease and type-I diabetes. Screening of these other high-risk individuals for Celiac should alsobe considered, and especially when a family member has the disease.

HERE'S HOW CELIAC DISEASE CAN LOOK DURING DIFFERENTSTAGES OF LIFE

Children: Signs of celiac disease in children include weight loss and digestive symptoms such asabdominal pain, bloating, vomiting, diarrhea or constipation. Some children however do not havedigestive symptoms, and other signs to look for are short stature, failure to thrive, delayed growth or development, irritability, behavioral or learning challenges. Nutrient deficiencies can include iron deficiency anemia and low bone mineral density.

Adults: Adults with celiac can have a variety of symptoms, including the typical digestive issues seen inchildren - chronic diarrhea or constipation, abdominal pain, malabsorption, and weight loss. However,adults may also have atypical symptoms including anemia, osteoporosis, extreme fatigue, oral ulcers,liver enzyme abnormalities, dental enamel defects, and neurological problems. Celiac disease can alsopresent as dermatitis herpetiformis (DH), or “celiac disease” of the skin. DH is characterized by blistering,intensely itchy skin. Female reproductive years: For women, celiac disease can affect their reproductive years. There areseveral causes of infertility, and one cause of unexplained fertility problems is undiagnosed celiacdisease (CD). Though the exact cause is not clear, damage to the small intestine could result indeficiencies of folic acid, zinc and selenium, nutrients that are important for reproductive health. Womenwith undiagnosed CD also have an increased risk of spontaneous miscarriages and giving birth to pre-term babies. The good thing is that women who are already diagnosed with CD and are on a gluten-freediet, do not have a higher risk of infertility compared to general population. Seniors: Seniors may have the typical or atypical symptoms seen in adults of all ages. Andwhile osteoporosis is a concern for all older persons, it is especially so for adults that may haveexperienced years of undiagnosed celiac disease. Before diagnosis, medications prescribed for agingpatients may not be properly absorbed, reducing their effectiveness in treating other ailments.

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CCA NATIONAL VIRTUAL CONFERENCE

SOLD OUT.. but you can still join us as we live stream on YouTube!

Saturday, May 2, 202011:50 am - 6 pm Eastern

Join us for world-class education.

www.ccaconference.ca

COULD IT BE CELIAC?Free Webinar – Tuesday, May 26 – 7:30pm Eastern

Join Dr. Mohsin Rashid, MD, Med, pediatric gastroenterologist, Dalhousie University to learn more aboutdiagnosis and management of celiac disease.

Registration link: https://zoom.us/webinar/register/WN_f1EBcr5ZT9KjsZv34XEymw

GLUTEN FREE 101

Getting Started on the gluten-free dietFree Webinar – Thursday, May 21, 2020 06:30 PM Eastern

Registration link: https://zoom.us/webinar/register/WN_S9m4PtbFTtCPtoNuGECbmA

Better Living Gluten Free is a monthly electronic publication of the Canadian Celiac Association.Copyright © Canadian Celiac Association

If you have any questions, please contact info@celiac.ca.

The contents of Better Living Gluten Free (BLGF) are provided in good faith, for information purposes only, andusing the most current information available subject to amendment and should not be used as a substitute for theadvice of a qualified health professional. The Professional Advisory Board of the Canadian Celiac Association (the

“CCA”) has not reviewed the contents of BLGF. Use of the information is at your own risk. The CCA does notendorse any product referenced in BLGF. To the fullest extent permitted by law, the CCA, its local Chapters and all

persons involved in compiling this publication disclaim any responsibility for, and make no representations orwarranties regarding, the information provided. In no event will the CCA, its Chapters, or those persons involved incompiling this publication be liable for any damages of any kind resulting from the use of the information. Please

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