Celiac Disease

Celiac disease (also known as celiac sprue or gluten-sensitive enteropathy) is a digestive and multisystem disorder. Multisystem means that it may affect several organs. Celiac disease is a complex immune-mediated disorder, one in which the immune system causes damage to the small bowel when affected people eat gluten


  • Normally, the body’s immune system is designed to protect it from foreign invaders.

  • When people with celiac disease eat foods that contain gluten, their immune systems attack the lining of the intestine.

  • This causes inflammation (swelling) in the intestines and damages the villi, the hair-like structures on the lining of the small intestine.

  • Nutrients from food are absorbed by the villi.

  • If the villi are damaged, the person cannot absorb nutrients and ends up malnourished, no matter how much he or she eats.


Symptoms of celiac disease vary among sufferers and include:

No symptoms at all (like some family members of celiac patients).

  • Digestive problems (abdominal bloating, pain, gas, constipation, diarrhea, pale stools and weight loss).

  • A severe blistering skin rash called dermatitis herpetiformis and sores in the mouth (called aphthous ulcers).

  • Unexplained anemia (low blood count) or hepatitis (inflammation of the liver).

  • Musculoskeletal problems (muscle cramps, joint and bone pain) and defects in dental enamel.

  • Growth problems and failure to thrive (in children). This is because they cannot absorb the nutrients.

  • Tingling sensation in the legs (caused by nerve damage and low calcium).

  • Depression.


  • If your healthcare provider thinks you might have celiac disease, they will perform a careful physical examination and discuss your medical history with you.

  • The provider may also perform a blood test to measure levels of antibodies to gluten. People with celiac disease have higher levels of certain antibodies in their blood.

  • Sometimes having a genetic test for celiac disease in the blood may be necessary.

  • Your provider may perform other tests to look for nutritional shortages, such as a blood test to detect iron levels. A low level of iron (which can cause anemia) can occur with celiac disease.

  • Your provider may take a biopsy from your small intestine to check for damage to the villi.

  • In a biopsy, the doctor inserts an endoscope (a thin, hollow tube) through your mouth and into the small intestine and takes a sample of the small intestine with an instrument.

  • This is done with sedation or anesthesia to avoid any discomfort during the procedure.

Risk factors

Celiac disease can leave the patient vulnerable to other health problems, including:

  • Malnutrition.

  • Osteoporosis, a disease that weakens bones and leads to fractures. This occurs because the person has trouble absorbing enough calcium and vitamin D.

  • Infertility.

  • Cancer of the intestine (very rare).

People who have celiac disease may have other autoimmune diseases, including:

  • Thyroid disease or liver disease.

  • Type 1 diabetes.

  • Lupus.

  • Rheumatoid arthritis.

  • Sjogren’s syndrome (a disorder that causes insufficient moisture production by the glands).

  • Autoimmune liver disorders.


  • If you have celiac disease, you can’t eat any foods that contain gluten (including wheat, rye and barley).
  • You will be encouraged to visit with a dietitian for formal diet instruction.
  • Dropping gluten from your diet usually improves the condition within a few days and eventually ends the symptoms of the disease. However, the villi usually require months to years to complete healing.
  • It might take two to three years for the intestines to heal in an adult, compared to about six months for a child.
  • You’ll need regular medical follow-up visits (usually at 3 months, 6 months, and then every year) and have to remain on this diet for the rest of your life.

  • Eating even a small amount of gluten can damage your intestine and restart the problem.

  • Following a gluten-free diet means you cannot eat many staples, including pasta, cereals and many processed foods that contain gluten.

  • There may also be gluten in ingredients added to food to improve texture or flavor and in some medicines.

  • Some less obvious sources of gluten may include ice cream and salad dressing.

  • Cross-contamination is another common source of gluten which happens when gluten-free foods come accidentally into contact with gluten.

  • If you have celiac disease, you can still eat a well-balanced diet.

  • For instance, bread and pasta made from other types of flour (potato, rice, corn, or soy) are available.

  • Food companies and some grocery stores also carry gluten-free bread and products.

  • You can also eat fresh foods that have not been artificially processed, such as fruits, vegetables, meats and fish, since these do not contain gluten.


  • Celiac disease cannot be prevented. However, early detection and management of celiac disease may prevent severe complications.

  • Therefore, it is very important to check for celiac disease in persons at higher risk for having the condition, such as first-degree family members of patients with celiac disease.

diseases treatment health prevention celiac-disease digestive-system disorders

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