Celiac Disease

Celiac Disease (CD) can also be referred to as gluten sensitive enteropathy (GSE), gluten intolerance, or celiac sprue. It is considered to be the most under-diagnosed common disease today, potentially affecting 1 in every 133 people in the USA. It is a chronic, inherited, autoimmune intestinal disorder where the ingestion of gluten interferes with the proper absorption of nutrients in the small intestines. The disease is permanent and can lead to serious health problems if left undiagnosed or untreated.

Celiac Disease differs from other food allergies in that a specific food component, gluten, triggers an autoimmune reaction. Gluten is a cereal grain based protein found in all forms of wheat (including durum, semolina, spelt, kamut, einkorn, and faro), and related grains, such as rye, barley, and sometimes oats. The immune system response to the gluten protein damages the walls of the small intestines gradually over time. Symptoms vary widely based on the individual, frrom diarrhea and abdominal pain to irritability or depression. Some people have no symptoms.

Celiac disease is genetic and highly heritable to children. Doctors can diagnose the disease using a combination of blood tests and elimination diets, as well as taking a biopsy of the small intestines. The only known treatment for the disease is strict adherence to a gluten free diet.

** Implications for Teachers**

While Celiac Disease is not a disability that requires educational assistance, it can definitely impact a student's ability to learn in the classroom if undiagnosed or not treated properly. Students with undiagnosed Celiac Disease, or students who have accidentally ingested gluten, may experience symptoms, such as depression, fatigue, and lack of concentration, that directly impact concentration and ability to learn.

In elementary school settings where teachers provide snacks in the classrooms, schools are required to provide gluten free snacks for students with Celiac Disease (see below).

**Implications for Students **

Federal law (Section 504 of the Rehabilitation Act of 1973) mandates that public schools must provide a free and appropriate public education and not discriminate against disabled students. The law recognizes that accommodations for special diet may be required in order to ensure that a student receives an appropriate education. Students cannot be excluded from eating in the cafeteria or eating hot lunch because of food allergies.

The USDA Child Nutrition Division requires that public school food service provides substitute meals to food allergic students. In order for the student to recieve this aide, they must have a physician certify in writing and provide instructions about the child's disability and what foods must be avoided to ensure the child's safety. Schools that do not comply with these requests may lose federal funding.

The attached document from the USDA provides additional information on special dietary needs requirements in public schools.

**This section was contributed by: Allison Aboud