Celiac disease, also called “gluten-sensitive enteropathy,” causes the person’s immune system to react negatively after ingesting gluten, a type of protein found in different species of wheat, as well as rye and barley. When this negative reaction occurs, it damages the inner lining of the small bowel, inhibiting the person’s ability to absorb nutrients including Vitamin D, calcium, iron, folate and some proteins and fats.
Celiac disease is inherited, so family members are at a greater risk of developing the disease; however, not everyone with the genes related to this disease end up inheriting celiac disease — which affects almost one percent of the population.
What are the symptoms of celiac disease?
Celiac disease is very difficult to diagnose because its symptoms vary greatly from person to person, and may be similar to several other conditions. Symptoms may appear at any age after a person ingests gluten. Sometimes there are no gastrointestinal symptoms, or the sufferer may seem to have an unrelated condition such as anemia or osteoporosis. Generally speaking, the most common symptoms are:
- abdominal pain
Sometimes, symptoms are not gastrointestinal at all, and may include:
- difficulty concentrating
- mouth ulcers
- bone pain
Diagnosis is typically done through a combination of blood tests, small-bowel biopsy, and reducing gluten from the diet and monitoring recovery. The only guaranteed way to prevent symptoms of celiac disease is to completely eliminate all gluten from the diet. If the disease is diagnosed early and gluten is removed from the diet, most tissue damage can heal and risks of other complications can be drastically reduced.
How is celiac disease different from gluten intolerance?
When someone with celiac disease consumes gluten, their immune system launches an attack against the gluten, damaging their body’s tissues in the process.
Gluten intolerance, also known as non-celiac gluten sensitivity, has similar symptoms to celiac, but the effects are usually short-term — temporary stomach pain and bloating. While the body of someone with a gluten intolerance also reacts to gluten as a foreign invader, triggering an inflammatory immune response, this reaction doesn’t damage the lining of the small intestine. The symptoms subside after the person has fully digested the food containing gluten.
What can food businesses do to protect people with celiac disease?
Food businesses have an important role to play in protecting customers with celiac disease and any form of gluten intolerance. Understanding celiac disease helps minimize food safety risks for customers. Here’s how you can help:
Be aware of foods that contain gluten
Bread, biscuits, pizza, crackers, pasta, cereal, cake, cookies, beer: these are a few of the well-known foods that have gluten.
Some culprits — for example, dry roasted nuts, some herb and spice blends, some ground meats like burgers or sausages, soy sauce, salad dressings and even chocolate — are not so obvious, so it’s important to read manufacturers’ labels and ingredients lists before claiming an item is gluten-free.
All staff should be conscious of what items contain gluten, and be confident conveying the correct information to customers.
Treat any gluten sensitivity as a severe allergy
Whether a customer has a mild gluten sensitivity or severe celiac disease, take it very seriously.
Food businesses are required to build a Food Safety Plan based on the seven Hazard Analysis Critical Control Points (HACCP) principles. This plan should include all the necessary steps to help protect people with celiac disease, including preventing cross-contamination by storing and preparing gluten-free foods well away from foods containing gluten, and thoroughly cleaning equipment and utensils after they’ve been in contact with food containing gluten.
Alternatives that have no gluten can be incorporated into recipes. These are foods such as rice, quinoa, potatoes, lentils, beans, seeds and nuts, fresh vegetables, meat, tofu and most cheeses.
It’s important to have gluten-free options available for customers who need them. Providing alternatives to common foods that contain gluten will accommodate a much larger range of people — which will not only keep customers safe, but will boost your bottom line.
The Canadian Institute of Food Safety (CIFS) is dedicated to reducing food-borne illness through education and advocacy for better food safety. While celiac disease is not a food allergy, it can cause severe symptoms in affected individuals and should be treated as a serious allergy. Use our Food Allergen Matrix to mark off which menu items contain gluten and other allergens, and ensure it is displayed prominently for both front and back of house staff.