What is Celiac Disease?
Celiac disease is an autoimmune disease where gluten – a protein found in wheat, rye, and barley – attacks and damages the lining of the small intestine. For people with celiac disease, the breakdown of gluten creates toxins that destroy the villi. Villi are tiny, finger-like protrusions inside the small intestines. When villi become damaged, the body is unable to absorb nutrients from food, which leads to series health complications if untreated. Intestinal damage causes diarrhea, fatigue, weight loss, bloating, and anemia. It is estimated that 1 in 100 people worldwide are affected by Celiac disease, in two, and half Americans are undiagnosed.
Some individuals may experience gluten intolerance or sensitivity, which is a different diagnosis than celiac disease. Gluten intolerance can present itself with symptoms similar to celiac disease, but gluten intolerance is not an inflammatory condition of the small intestine. Rather, it is a food sensitivity. Special testing can differentiate celiac from gluten intolerance.
How is celiac disease diagnosed?
Celiac disease is hereditary, meaning it runs in families. Individuals with relatives diagnosed with celiac disease have a 1 in 10 chance of developing celiac disease.
Blood tests, including a complete blood count (CBC), liver function test, cholesterol test, alkaline phosphatase level test, and serum albumin test, can help make the diagnosis. People with celiac disease have high levels of anti-endomysial (EMA) and anti-tissue transglutaminase (tTGA) antibodies. Tests are most reliable when gluten is still in the diet. In cases where blood test results are inconclusive, an upper endoscopy can be performed to biopsy and analyze tissues.
Important: Since celiac disease is hereditary, it’s important first-degree relatives are tested, regardless if they have symptoms. Silent or asymptomatic celiac disease – meaning the typical symptoms of celiac disease are not experienced – is possible. Patients with asymptomatic celiac disease will still experience villous atrophy damage to their small intestine despite the physical symptoms.
What are the symptoms of Celiac Disease?
Celiac disease symptoms vary based on the individual and greatly differ between children and adults.
Digestive symptoms of celiac disease include:
Children’s symptoms include:
- Pale, foul-smelling, or fatty stool
- Iron-deficiency anemia
- Weight loss
- Irritability and behavioral issues
- Damage to tooth enamel
- Delayed growth and puberty
- Failure to thrive
- Short stature
- Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination, and seizures
Adult symptoms include:
- Iron-deficiency anemia
- Bone or joint pain
- Osteoporosis or osteopenia (bone loss)
- Seizures and migraines
- Liver and biliary tract infection, such as transaminitis, fatty liver, primary sclerosing, and cholangitis
- Peripheral neuropathy (tingling, numbness, or pain in the hands and feet)
- Tooth discoloration or enamel loss
- Canker sores inside the mouth
- Irregular menstrual periods
- Infertility and miscarriage
- Dermatitis herpetiformis (DH) – itchy skin rash made affecting 15-25% of people with celiac disease
How is Celiac Disease treated?
Since celiac is a chronic autoimmune disease, the only treatment is adherence to a strict gluten-free diet. A gluten-free diet heals the villous atrophy in the small intestine, eventually resolving symptoms and preventing future, potentially serious health conditions. A gastroenterologist often refers patients to a nutritionist to help walk you through a comprehensive gluten-free diet and inform you of hidden sources of gluten in medicines, supplements, products, and foods.
You should see a physician regularly after your initial diagnosis to identify nutritional deficiencies, address symptoms you might still be experiencing, and confirm your strict gluten-free diet is working. Based on your examination, gluten-free, age-appropriate supplements will be recommended.
Disclaimer: The information presented on this website is not intended to take the place of your personal physician’s advice and is not intended to diagnose, treat, cure or prevent any disease. Discuss this information with your healthcare provider to determine what is right for you. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical condition.
This website is owned and managed by Brian Cooley, MD. Any information, offers, or instruction as written, inferred, or implied is the sole responsibility of Brian Cooley, MD, and does not warrant claim or representation, inherent, or implied of DHAT, its subsidiaries, or employees.