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Q&A On Celiac Concerns

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Navigating through a sea of information can be tricky. This is especially true when it comes to celiac disease, where there seems to be a constant flow of new studies and research. To help you with the latest developments, we've answered some common and not-so-common queries.

Q: I was recently diagnosed with celiac disease. Do I need to worry about gluten-containing ingredients in the body care and makeup products that I use?

A: Research has shown that gluten molecules are too large to penetrate intact skin. However, there are some people with celiac or gluten sensitivities who avoid any skin care items or makeup products that contain gluten on the chance that it may irritate their skin or accidentally be swallowed. (This is a particular concern with lip balms, lip glosses, and lipsticks.) Fortunately, there are many natural skin care and makeup manufacturers that avoid gluten as well as other common allergens in their product lines. Be sure to check labels every time before purchasing, as formulations may change.

Q: If I have celiac disease, do I need to worry about feeding gluten to my baby girl? Will her avoiding it help prevent the disease?

A: It was believed that if gluten was introduced later on in a genetically susceptible child, the risk of developing the disease could be reduced. However, new data from randomized clinical trials shows that children who are genetically susceptible to celiac disease who were introduced to gluten later on simply developed the disease later on.

Michelle Pietzak, MD, a pediatric gastroenterologist at Children's Hospital of Los Angeles, advises that genetic testing be considered before introducing gluten to infants with a celiac sibling or parent. While not all experts agree on delaying gluten if the baby has a high genetic risk, you may want to wait to introduce it--or avoid it altogether. Delaying gluten until the child is 2 won't prevent the disease, but it will delay its onset during important growth periods. 

It's interesting to note that if a baby has high-risk genes for celiac disease, breastfeeding won't protect her. It can help protect against a wheat allergy, however, as babies who are breastfed tend to have fewer allergies.

Q: Are there new tests coming out to determine if someone has celiac disease? What about testing for non-celiac gluten sensitivity?

A: There's a new blood test being developed at Norway's University of Oslo for celiac disease. It will work even when individuals are on a gluten-free diet by detecting special gluten-reactive T-cells in the body. Those with celiac disease have greater numbers of these T-cells, even when they eat gluten free. Later this year a preliminary clinical trial on the testing should be complete.

Researchers are getting closer to identifying markers for gluten sensitivity in the body. A study from the University of Bologna in Italy indicates that those who are gluten-sensitive may have high levels of zonulin--a molecule linked to inflammation. Preliminary results find that levels of zonulin in gluten-sensitive individuals nearly match those who have celiac disease. This is a promising start for developing tests to diagnose non-celiac gluten sensitivity in the future.  

Q: Should I be taking probiotics if I have celiac disease? Which ones would work best?

A: When unresolved issues are present (abdominal discomfort, bloating, occasional constipation or diarrhea), a probiotic may help, according to Stefano Guandalini, MD, an expert in celiac disease and founder and medical director of the University of Chicago Celiac Disease Center. Research suggests that the strain Bifidobacterium breve may reduce inflammatory markers in children with celiac disease. Bifidobacterium infantis may lessen some symptoms of the disease in adults. 

Carefully read labels or contact the manufacturer, as not every product is gluten- or allergen-free. Inquire with the manufacturer whether any of the bacterial strains in the probiotic supplement were grown on a gluten-containing grain such as wheat or barley. Instead of--or in addition to--probiotics, you may also want to consume fermented foods containing live cultures (yogurt, kefir, miso, sauerkraut, kombucha, and kimchi). These items can be good gluten-free sources of probiotics.

Click to See Our Sources

"A Closer Look at Probiotics," 10-11/15; "Gluten & Your Baby," 2-3/16; "Research Roundup: New Celiac Test," 2-3/16, by Christine Boyd, Gluten Free & More

"A Protein in the Gut May Explain Why Some Can't Stomach Gluten" by Jill Neimark,, 12/9/15