A. More and more parents are trying gluten free diets these days, either because of specific recommendations for formally diagnosed conditions, such as celiac disease, or as an alternative treatment for autism, behavioral problems, and other conditions. Gluten is a protein that is found in many

foods, including wheat, barley, and rye. More surprising, gluten is also found in many other products, including vitamins, medications, and according to the National Institute of Diabetes and Digestive and Kidney Diseases, stamp and envelope adhesive. Although following a gluten free diet is challenging enough, avoiding gluten in these other products can be even more difficult and can require some research by parents and cooperation with your pediatrician, pharmacist, registered dietician, and other health care providers. Some people with a gluten sensitivity have very mild symptoms, but others can get very sick, and can even become malnourished, which makes avoiding gluten very important for them. Other symptoms of celiac disease, in addition to malnutrition, can include, but aren't limited to, gas, recurring abdominal pain, chronic diarrhea, weight loss, fatigue, and changes in behavior, including irritability. Gluten Free Diet To help avoid gluten, including many grains, pasta, cereals, and other processed foods with gluten, look for and avoid products with the following ingredients on the label:

• wheat, including durum, graham, kamut, semolina, spelt, triticale

• barley, including malt, malt vinegar, or malt flavoring which can be made from barley

• rye Gluten can also be found in some candy, cold cuts, soy sauce, vitamins, herbal supplements, over the counter medications, and prescription medications. Often overlooked, gluten is also found in communion wafers, lip balms, and Play Doh. What about oats? The need to avoid oats in a gluten free diet is controversial, with some experts saying you should and others saying it isn't necessary. The Celiac Sprue Association states that 'pure oats may be included as part of a gluten-free diet,' but then goes on to suggest that people on a gluten free diet avoid oats anyway because 'uncontaminated oat sources are not readily available.' Oats can be contaminated if they are processed in the same mill where they process wheat. Gluten Free Medications It is easy to understand why gluten is found in many foods, such as bread, pasta, and cereals, since wheat, barley, and rye, are popular grains. But why is gluten in other products and foods? Gluten is used as a 'filler' in these products and in medications, it is often an inactive ingredient. Unfortunately, even when you look at the package insert for the medication, it can be hard to know if the drug contains gluten, since it typically won't list gluten or wheat, but will instead list the name of some cryptic filler. The words 'starch' or 'stabilizer' in the inactive ingredients can be clues to the presence of gluten, in addition to other inactive ingredients. Your pharmacist or the drug's manufacturer should be able to help you figure out if the drug is gluten free too. Fortunately, many common childhood medications, including antibiotics, seem to be gluten free. Be aware that some generic medications have more than one manufacturer, so in addition to the brand name medication, you have to may have to make sure the specific generic drug your pharmacist dispenses is also gluten free. Even easier, you can find many lists of gluten free medications from celiac disease support groups, such as the Wheaton Gluten Free Support Group. Just because a medication isn't on the list, doesn't mean it isn't gluten free though. Prevacid, for example, is not on the list. It also has starch as an inactive ingredient, which makes it suspicious for being a medication with gluten, but a call to the manufacturer confirmed that all forms of Prevacid are in fact gluten free and that the starch is corn starch.