1. Gainer, Cheryl L. MSN, CNM, RN

Article Content

Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications by C.J. Libonati (2007). Fort Washington, PA: Gluten Free Works Publishing.


This book is a first for author Cleo J. Libonati. A registered nurse with first-hand knowledge of celiac disease, Libonati takes the reader on a journey that educates and enlightens. This self-published book has a wealth of information useful for those afflicted with celiac disease as well as the healthcare professionals caring for them.


The topic of the book is important to all because of the prevalence of celiac disease in the United States. Prevalence studies conducted in the United States demonstrate that 1 in 133 Americans have celiac disease, amounting to a staggering 3 million Americans afflicted with the disorder, yet few are diagnosed. Complicating this picture is the lack of education and general knowledge of the disease among the public, health agencies, and healthcare professionals. In the introduction, Libonati notes that only 48 of the 6,276 papers published on celiac disease in the last 30 years were published in the United States.


The book reviews the pathophysiology, symptoms, manifestations, complications, associated disorders, diagnosis, and treatment of the disease. Written in clear concise language that both the layperson and health professional can understand, the book successfully integrates the research data on celiac disease into a useful resource. The print, format, tables, illustrations, and careful citation of research data along with the inclusion of the final statement from the June 2004 National Institutes of Health Consensus Development Conference on Celiac Disease make this text an easy to read resource for those wishing to further their education on celiac disease.


The message of the book is especially important for all health professionals specializing in gastroenterology. Although signs, symptoms, and presentation of celiac disease can be different in each individual afflicted, the common denominator is damage to the small bowel. This book provides a useful resource for every health professional associated with a gastroenterology practice and would be a valuable addition to office resources on celiac disease.


Recognizing Celiac Disease is very well organized and contains two sections. The first section of the book includes three chapters. Beginning with a discussion of gluten as the environmental trigger for celiac disease, the book takes the reader on a step-by-step journey into understanding the origin, pathophysiology, and symptoms of celiac disease. From definition of the disease to signs, symptoms, diagnostic criteria, and treatment of celiac disease, each chapter gives in-depth, up-to-date information on all aspects of each topic. Of particular interest to gastroenterology health professionals is an overview of the workings of the gastrointestinal tract along with the pathophysiology celiac disease inflicts on the gastrointestinal system. This section is written in a manner that will assist any reader in understanding the multiple presentations and physical manifestations of the disease. Also included in this section are three appendices; "Unsafe Foods and Ingredients," "Gluten-Free Diet Self-Management Three Step Process," and "Sample Foods Commonly Allowed and Not Allowed on a GF Diet." Each appendix is easy to read and understand. Although in-depth resources in themselves, the chapters and appendices include citations of research, articles, and resources utilized in creating each section of the book, providing the reader tools to further his or her knowledge if they so desire. This section also contains a glossary to assist readers unfamiliar with the terminology used in discussions of disease processes and their epidemiology.


The second section of the book is unique in that it contains two tables outlining an extensive literature review done by the author. An easy to read explanation on how to use this section of the book assists the reader to fully utilize the extensive amount of information presented in the tables. The first table lists nutritional deficiencies of celiac disease and the second table lists the signs, symptoms, associated disorders, and complications of celiac disease. Both tables are extremely helpful, providing extensive information on the typical and atypical signs and symptoms of the disease. Included in each table is information identifying associated disorders, complications, and whether these improve or do not improve on the gluten-free diet. The tables are a rich resource to understanding the nuances of celiac disease. Although the tables themselves provide a tremendous amount of information, the citations provided in the tables lead the reader to an even larger data base of information regarding all aspects of celiac disease.


Finally, the book contains an extensive reference list and index. The reference list is organized by the section of the book in which the sources are cited, and the index is well organized and easily assists readers in finding their desired topic.


Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications certainly lives up to the title. Libonati clearly outlines the extent of the disease and the need for recognizing, diagnosing, and treating celiac disease in the United States. Her book educates the reader not only about the disease process, but addresses treating and recognizing nutritional deficiencies, associated disorders, and the many complications of the disease. Recognizing Celiac Disease should be on the shelf of every family affected by celiac disease as well as the health professionals caring for them.