Despite the growing number of people who have been diagnosed, celiac disease can still be confusing for those who are affected and their friends and family members. Can you still go out to eat? What should you serve for dinner? Do you have to keep foods with gluten separate from other foods? These are all questions you may have asked or wanted to ask, but have felt uncomfortable doing so.

Here, Keith Laskin, MD, medical director of the Celiac Center at Paoli Hospital, answers some of the most common questions regarding a celiac disease diagnosis.

What is gluten and why can’t you eat it? Gluten is a protein that is found in foods that contain wheat, rye or barley. People with celiac disease develop an immune reaction to gluten, which results in damage to their intestinal tract and may interfere with their ability to absorb nutrients from their diet.

What kinds of foods can you eat and not eat? Anything containing wheat, rye or barley is dangerous, which means that foods like pizza, pasta, bread and beer are all off-limits for anyone with celiac disease. There are less obvious foods that they must also avoid, including croutons, some lunch meats, certain soups, salad dressings and cookies, crackers or cereal. Even communion wafers contain enough gluten to cause intestinal damage in people with celiac disease. Although it is a restrictive diet, more restaurants and food companies are coming out with gluten-free versions of these foods and more.

However, there are also many healthy and delicious foods that are already gluten-free. Fresh eggs, meat, poultry and fruits and vegetables are all safe to eat.

Can you cure celiac disease? There is no medical cure for celiac disease, but maintaining a gluten-free diet can keep the disease under control. New treatments may be on the horizon, however, as there is a tremendous amount of research being done.

Do gluten-free foods have to be prepared separately? Much like kosher foods or vegetarian foods, gluten-free foods should be prepared separately from regular foods. Cross-contamination can occur from something as simple as using the same utensils and can trigger a reaction from people with celiac disease.

Can someone with celiac disease have gluten if it’s just a small amount? No. Although some people with celiac disease have no symptoms when they consume a small amount of gluten, it is still harmful to their body. If you have celiac disease, gluten is always off-limits. Even a few crumbs is too much.

What are the symptoms of celiac disease? Celiac disease can present itself in a number of different ways, but many people who are diagnosed with it report gastrointestinal issues like bloating, upset stomach and abdominal pain. Non-gastrointestinal presentations are also common, and may include iron deficiency anemia, short stature, osteoporosis, infertility and chronic fatigue, to name just a few.

If you think you may have celiac disease, or if a relative was recently diagnosed with celiac disease, visit the Paoli Hospital Celiac Center or make an appointment with one of our gastroenterologists.