What is Celiac Disease?

Celiac disease is a condition in which a protein found in certain foods – gluten – causes the immune system to damage the small intestine. The small intestine is responsible for absorbing food and nutrients. However, when the lining of the small intestine is damaged this can cause problems with absorbing nutrients which is referred to as malabsorption. Gluten is found in wheat, barley, rye and several condiments, sauces and spreads. It is not clear what exactly causes celiac disease, but there is a combination of environmental and genetic factors. Celiac disease can affect both male and females of any age. Although there is no cure for celiac disease, avoiding gluten can stop the damage to the lining of the small intestine.

What are the common symptoms?

The symptoms of celiac disease can vary from person to person. Some people may have no symptoms, yet exhibit signs of malabsorption detected on blood tests. Others can develop a variety of gastrointestinal complaints. The most common symptoms experienced are abdominal discomfort, diarrhea, bloating, weight loss and decreased energy. There can also be other signs and symptoms of vitamin and nutrient deficiencies that can cause anemia, bone loss, nervous system disorders and skin rash. Children with celiac disease can have a poor appetite, slow growth and have difficulty gaining weight.

How is Celiac Disease Diagnosed?

Celiac disease can be difficult to diagnose because its signs and symptoms can resemble other conditions. However, there are blood tests available which can help make the diagnosis. These blood tests look for proteins (antibodies) that can become elevated in people with celiac disease. It is important to continue eating gluten while being tested because avoiding it can cause these proteins to become normal. If the blood test is positive for celiac disease, the diagnosis is confirmed by obtaining a sample of the small intestine. The sample (known as a biopsy) is obtained by performing an upper endoscopy and the sample is viewed under a microscope to see if there has been any damage to the lining of the small intestine. An upper endoscopy is a procedure performed by a gastroenterologist during which a small flexible tube with a camera is introduced through the mouth and a small piece of tissue from the small intestine is removed.

How is Celiac Disease Treated?

The cornerstone of treatment for celiac disease is elimination of gluten from the diet.  This can be overwhelming initially because many foods that we eat and even condiments that we cook with contain gluten. Therefore, consulting with an experienced dietician can help you learn how to eat, shop and prepare a gluten-free diet.  Most patients will notice an improvement in their symptoms within two weeks. Rarely, patients fail to have improvement in symptoms despite adherence to a gluten-free diet. This is considered refractory celiac disease and requires medications which suppress the immune system (like steroids). It is important to remain on a strict gluten-free diet despite feeling well to prevent nutritional deficiencies and certain types of gastrointestinal cancer. Families should be aware of their increased risk of developing celiac disease and anyone with symptoms should be tested. Various local and national support groups help increase awareness and make living a gluten-free lifestyle achievable.