Celiac Disease and Diet with and with out Gluten*

Presented byZeeshan Naseer

*This document is prepared especially for Pakistan.

WHAT IS CELIAC DISEASE?

• Celiac disease is an autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. It is estimated to affect 1 in 100 people worldwide.

• When people with celiac disease eat gluten (a protein found in wheat, rye and barley), their body mounts an immune response that attacks the small intestine. These attacks lead to damage on the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.

•Symptoms

• Bloating or Gas

• Diarrhea

• Constipation

• Fatigue

• Itchy Skin Rash

• Tingling/Numbness

• Pale Mouth Sores

• Joint Pain

• Delayed Growth

• Poor Weight Gain

• Thin Bones

• Infertility

• Headaches

• Depression

• Irritability

• Discolored Teeth

Diets with Gluten

• Atta (chapatti flour)• Barley (flakes, flour, pearl)• Beer, ale( شراب کی lager , (جو• Breading and bread stuffing• Brewers yeast• Bulgur( گندم وا پیسا ( خشک• Communion wafers• Couscous( یں پکات گوشت اور غل جسمیں کھانا افریقی (ایک• Croutons( طور ک سجاوٹ میں پلیٹوں کی سالد جو ,کڑا ُٹ ,وا .ال ت کا روُٹی ڈبل ، کروُٹن

جاتا پیشکیا .ر ہےپ  )• Dinkel ( قسم خاص ایک کی ُد�م گن ُد�وئی بنی لیے کے (چارے

Diets with Gluten• Durum ( کے بنانے لچھے کے ِننشاستے یا سویاں آاٹا اور ہے ہوتا سخت دانہ کا ِن-س ِنقسم ایک کی گیہوں

ہے آاتا (کام• Einkorn ( گیہوں کا قسم (ایک• Emmer ( ہے -اتا بویا لیے کے چارے کے مویشیوں تر زیادہ -و گن�م کا طرح (ایک• Farina ( َططعام دار دانے ُد8م�ہ ، آاٹا ، ِنليا َطد )• Farro or Faro ( قسم خاص ایک کی ُد�م گن ُد�وئی بنی لیے کے (چارے

• Graham flour( آاٹا چھنا بے کا (گن�م• Hydrolyzed wheat protein

• Kamut (ancient grain, and a close relative to durum wheat)

• Malt, malt extract, malt syrup and malt flavouring

Diets with Gluten

• Malt vinegar• Malted milk• Matzoh, matzoh meal• Modified wheat starch• Oatmeal دانے کے گھاس ، ُدطمان قر ، oat bran, oat flour and whole oats ,( -تی• Pastas ( آاٹا ہوا ُدگن��ا کے خمیر بغیر ، آاٹا (فتیری• Rye bread and flour• Seitan (tandoori dish) Made from vital wheat gluten• Semolina (سو-ی)

•Diets with Gluten

• Triticale (Hybrid of wheat and rye)

• Wheat bran( ر وک چ م � (گن• Wheat flour

• Wheat germ

• Wheat starch

•Gluten free diets

• Rice

• Corn (makai)

• Millett (bajra)

• Sorghum (jawar)

• Lentils and Pulses (daal)

• Oats (only if pure and uncontaminated)

• Nuts and seeds

Gluten free diets• All fruits and vegetables

• Milk and dairy products

• All types of meats

• Eggs

• Salt, pepper, turmeric and other spices

• Water, tea, fruit juices and most other beverages

Availability in Lahore

•Essa G (M. M. Alam Road and DHA)•Makro (Model Town Link Road)•Victoria (Model Town Link Road)•Al-Fatah Stores(Liberty Market and DHA)• Jalal Sons (Main Market, Gulberg)•Panjeeri Shop (Mini Market, Gulberg)•H. Karim Buksh (DHA)

Reading Labels

Reading Labels

• It is not necessary any product which is mentioned above should be gluten free. It is the duty of every patient and his care taker to carefully read all the ingredients and source of that product and search for it if any ingredient contains gluten.

• Some times different flavor of same product, previously which is gluten free could contain gluten.