DEAR DR. DONOHUE: My wife has been diagnosed with celiac disease. Since her diagnosis, she has adhered to a strict gluten-free diet and appears to be recovering nicely.

What can be expected if she were accidentally to consume a small amount of wheat from cross-contamination in a restaurant?

Is any effort being made to develop a medicine that could counteract the reaction to gluten? Please encourage food manufacturers to display “gluten-free” on their products when applicable. – J.B.

ANSWER: If you’re ever asked to name an illness that lived in quiet obscurity for decades and decades but has vaulted into the limelight in the past few years, the answer is celiac disease, a somewhat common disorder. It’s intolerance to gluten, a protein found in wheat, barley and rye. In susceptible people, gluten creates havoc in the digestive tract. It gives rise to diarrhea, stomach pain, bloating and weight loss. Often, the diagnosis isn’t made until people come down with another illness, like early-age onset for osteoporosis because their digestive tracts, damaged by gluten, can’t absorb calcium.

A diet that excludes gluten is the treatment for celiac disease. That’s somewhat of a tough diet to manage. Gluten is everywhere. It’s in places where you’d least expect. It can be a filler for some medicines.

Even communion wafers usually are made from wheat. So, small amounts of gluten have caused some celiac patients trouble, and I suppose cross-contamination with it in a restaurant is possible. The only way to know is to have your wife try eating in a restaurant and see what happens.

There are many efforts to find a control medicine for celiac patients. One effort focuses on finding an enzyme that digests gluten so it’s no longer a problem.

You and your wife might not know of a powerful ally, the Celiac Disease Foundation, which can be contacted at www.celiac.org or 818-990-2354. The foundation provides information for patients, fields their questions and puts them in touch with support groups.

DEAR DR. DONOHUE: Can cod liver oil cause a fatty liver? I was informed it’s not good for the liver. – L.R.

ANSWER: Excessive amounts of alcohol, obesity, some medicines, inflammatory bowel disease, diabetes and some rare illnesses cause fat to accumulate in the liver. Fat in the liver can harm it. Cod liver oil isn’t on most lists of fatty liver causes, but read on. Cod liver oil can cause liver damage.

Cod liver oil has gigantic amounts of vitamin A, close to 4,000 IU in a teaspoonful. The upper safe daily limit for vitamin A is 10,000 IU. The recommended daily intake is 3,000 IU (900 micrograms) for men and 2,333 IU (700 micrograms) for women.

Large doses of vitamin A cause headaches from brain swelling, can produce birth defects when taken during pregnancy, injure the liver and bring on osteoporosis and broken hips.

Check your total daily vitamin A intake. If you’re taking a multivitamin, note how much vitamin A is in it. You might be teetering on the edge of overdoing things.

Cod liver oil has some very good points. It’s an excellent source of omega-3 fatty acids – substances that prevent artery hardening and, therefore, heart attacks and strokes. Omega-3 fatty acids also lower blood cholesterol and triglycerides.