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).
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.
Celiac disease can leave the patient vulnerable to other health problems, including:
Osteoporosis, a disease that weakens bones and leads to fractures. This occurs because the person has trouble absorbing enough calcium and vitamin D.
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.
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.