Living with celiac disease can require a radical shift in diet and careful inspection of food labels.

Starchy foods such as bread and pasta are obvious sources of gluten. But harmful quantities can be present in things as small as a Communion wafer or cracker crumbs.

There's debate about whether oats are safe for celiacs, but most dietitians recommend avoiding them.

Cathy Peterjohn, a registered dietitian and clinical nutrition/diabetes manager at Mary Washington Hospital in Fredericksburg, said she sees about six celiac patients a year. She tries to reassure them that celiac is a manageable disease, and she aims to provide them with the resources they need to live normal, healthy lives.

"Their attitude toward this is everything, because it is a major lifestyle change," Peterjohn said.

Maurer has been learning to read labels since she was diagnosed in March. For those who have lived with celiac longer, the hunt for gluten-free foods used to be even more difficult.

New federal labeling laws that took effect Jan. 1 require food allergens, including wheat, to be clearly identified on product labels.

Shelly Thompson of Spotsylvania County, who has celiac, says the law makes it easier to find gluten-free foods.

Thompson started a gluten-free support group in the area about four years ago.

"It's one of those diseases where if you know other people who have it, it really lightens your load," Thompson said.

The group Thompson formed meets at 9 a.m. on the third Saturday of every month at Salem Church Library in Spotsylvania.

At the meetings, group members bring gluten-free snacks and share recipes and news articles they have found in the past month.

The experiences of the group's members illustrate the many ways celiac can affect people.

Jodi Sullivan, 43, of Spotsylvania was sick for seven years before diagnosing herself with celiac disease and getting her doctor to confirm it through tests. Originally, she was diagnosed with chronic intestinal pseudo-obstruction.

Her son was tested for leukemia and clotting disorders, among other things, because of his frequent bloody noses and inability to clot properly. Sullivan later learned that those were symptoms of celiac, too. Jake Sullivan, 14, lives with both celiac and juvenile diabetes. It is common for people with one autoimmune disorder to develop another, as Jake did.