What is Celiac Disease?
Celiac disease is an autoimmune disease that occurs when eating gluten causes damage to the small intestine. Gluten is a protein found in wheat, rye, and barley. It may also be found in some vitamins and supplements, hair and skincare products, toothpastes, and lip balm.
When someone with celiac disease eats gluten, their immune system attacks the small intestine and damages the villi, which are small finger-like projections along the wall of the small intestine. When villi are damaged, the small intestine cannot absorb nutrients from food properly, which may lead to health problems such as malnourishment, loss of bone density, miscarriage, infertility, neurological diseases, or certain cancers.
Symptoms
Celiac disease symptoms vary widely. Some people have no symptoms at all, while others have digestive issues or problems in other parts of the body. There are more than 200 known symptoms associated with celiac disease.
Symptoms typically improve or disappear after a person begins eating a gluten-free diet. However, consuming even small amounts of gluten can cause the symptoms to return.
Common symptoms of celiac disease in adults include:
- Abdominal pain
- Anemia
- Bloating and gas
- Bone or joint pain
- Constipation
- Depression and anxiety
- Diarrhea
- Fatigue
- Headaches
- Heartburn
- Itchy, blistery rash (called dermatitis herpetiformis)
- Missed periods
- Mouth ulcers and canker sores
- Nausea and vomiting
- Nervous system injury, including numb or tingling hands or feet, balance problems, or changes in awareness
- Osteoporosis and osteomalacia
- Weight loss
Common symptoms in children include:
- Abdominal bloating and pain
- Anemia
- Attention deficit hyperactivity disorder (ADHD) and learning disabilities
- Constipation
- Crankiness or mood changes
- Damaged tooth enamel
- Delayed puberty
- Depression and anxiety
- Diarrhea
- Failure to thrive, in infants
- Fatigue
- Headaches
- Nausea and vomiting
- Pale, foul-smelling poop
- Seizures and lack of muscle coordination
- Slow growth and short height
- Weight loss
Treatment Options
There are no medications that treat celiac disease. The only treatment is to follow a strict gluten-free diet for life. It is crucial to read all food labels and check ingredients in other products like vitamins and supplements, hair and skincare products, cosmetics, toothpaste, and lip balm.
Commonly, people diagnosed with celiac disease have deficiencies in certain vitamins and minerals because their body has challenges absorbing nutrients. In these cases, a doctor may recommend supplements.
Diagnosis
Most people with celiac disease do not know they have it. It is estimated to affect 1 in 100 people worldwide, but researchers believe that only about 20-30% are properly diagnosed.
Diagnosing celiac disease involves blood tests and a biopsy of the small intestine. Blood tests that check for specific antibodies are usually the first step in testing. People with celiac disease who eat gluten have higher than normal levels of these antibodies; however, the test will only work if you are eating a diet that contains gluten.
If blood tests show that you may have celiac disease, your doctor will probably order an endoscopy to confirm the diagnosis. An endoscopy is a procedure that examines the inside of your small intestine, and a small tissue sample will be taken and tested for any damage.
If you have a rash, doctors will take a small sample of your skin to look for signs that it is caused by celiac disease.
Causes and Risk Factors
The exact causes of celiac disease are unknown, but it tends to run in families and might be linked to certain genes. If one of your close family members (i.e. a parent, child, or sibling) has celiac disease, you have a 1 in 10 risk of developing it as well.
Celiac disease can develop at any age after you start eating gluten. Stressful medical events such as a viral infection, surgery, emotional trauma, or pregnancy can trigger it.
Celiac disease is most common among Caucasians and people who have other diseases, including certain autoimmune diseases, genetic disorders, and conditions affecting the intestines, kidneys, liver or pancreas.
References
Celiac Disease Foundation. What is Celiac Disease? 2023. Accessed July 9, 2023. https://celiac.org/about-celiac-disease/what-is-celiac-disease/
MedlinePlus. Celiac Disease. 2018. Accessed July 9, 2023. https://medlineplus.gov/celiacdisease.html
NIH National Institute of Diabetes and Digestive and Kidney Diseases. Celiac Disease Tests. 2021. Accessed July 9, 2023. https://www.niddk.nih.gov/health-information/professionals/clinical-tools-patient-management/digestive-diseases/celiac-disease-health-care-professionals
WebMD. Celiac Disease. 2022. Accessed July 9, 2023. https://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease