What is Celiac Disease?
Celiac disease is an autoimmune reaction from eating gluten. Your body responds by attacking the small intestine. Overtime this condition has a severe impact upon absorption of nutrients.
Experts are yet to pinpoint a definitive cause. However, they have established a number of underlying factors: other autoimmune diseases, viruses, infant nursing methods and even traumatic periods in life can trigger it.
Celiac disease is also a hereditary condition. This means it runs in families. If you have a parent or sibling with the disease there is a 1 in 10 chance of developing it.(1)
This condition is also known as sprue or coeliac.
Lining the small intestine you have small finger like projections. These are called villi and they help the body absorb all the essential goodness from your food. When they are damaged, nutrients cannot be absorbed properly into the body.
Gluten is the name for the protein found in grains. People with celiac disease only react to the form of gluten found in wheat, barley, and rye.
When someone with celiac disease eats anything containing this protein,it damages the villi. This causes a drastic chain of events within your digestive system and your body.
Celiac disease can be suffered both in childhood or as an adult, yet once you have it, it stays with you for life.
This condition is divided into three types: classical, non- classical and silent.(2)
People can have signs and symptoms of malabsorption. This means the small intestine is not absorbing enough nutrients and fluids.
They may also have diarrhea or pale, foul-smelling, fatty stools. They experience weight loss.
Edema is another indication associated with classic celiac disease. This means that excess fluid build up in body tissues. It causes swelling usually in the feet, legs or hands.(3)
Children have growth failure and can be irritable or unhappy.
This is associated with milder signs and symptoms of stomach and intestinal issues.
There can be unexplained anemia due to iron deficiency.
They may have just one of the other symptoms of the disease, or many. The symptoms will be classified as mild.
Sometimes people have the disease but display none of the symptoms. The disease usually shows up if they are screened for damage to the intestines.
It is thought that between 50% and 90% of people that have celiac disease are not diagnosed.(4)
The symptoms for celiac disease can vary from one person to another. Adults and children also display contrasting signs. Even infants under 2 can experience different symptoms to that of older children.(5)
Common signs of celiac for infants include: vomiting, chronic diarrhea and swollen bellies. They can also have a poor appetite.
Their stools will be pale and smell foul and they may fail to thrive and have muscle wastage.
Older Children Symptoms
Older children will also experience diarrhea or constipation. Pale, nasty smelling stools and weight loss are also indications of this condition.
As they develop they could be shorter than other children of the same age and puberty might also be delayed.
Behavioral issues and irritability are not uncommon. There are also neurological symptoms.These include attention deficit hyperactivity disorder (ADHD) and learning disabilities.
Children also experience headaches, lack of muscle coordination and seizures.
The most common symptoms for adults are diarrhea, fatigue and weight loss.
They will experience bloating and gas and abdominal pain as well as nausea, vomiting or constipation.
Celiac disease can prevent the body from absorbing enough iron, this means anemia can occur.
Mouth ulcers or damage to dental enamel on the teeth is another sign to look out for.
It can cause headaches and also affect the nervous system. The result is numbness and tingling in the feet and hands. Impaired balance is another sign.
Problems with memory, thinking, language and judgement are also possible.
Your spleen can be damaged. The spleen helps fight infection and keep your blood cells healthy.
Unexplained infertility or recurrent miscarriages are also be indications of this disease.
The rash normally appears on the elbows, knees, torso, scalp and buttocks. It is an indication of gluten intolerance.
If you are tested for celiac disease via a blood test or genetic screening your doctor may ask you to have an endoscopy. This is the gold standard test for this condition.
This is an outpatient procedure where a scope is placed through your mouth to allow a view of the small intestine.
A biopsy or sample of the small intestine can be taken at the same time. The results of the biopsy will show how much damage there is to the villi.
This damage falls into four types.(10)
This shows no damage to the villi. The intestinal lining is normal and it is unlikely that you have celiac disease.
This shows no damage to the villi. It is a result that is expected if you have been following a gluten free diet. It may also be the result expected from family members of someone with the disease.
This type is rare. The villi are normal and the only symptom you have is the skin rash dermatitis herpetiformis
This shows the villi are shorter than they should be or not present at all. This is the result when you are experiencing symptoms of the disease.
The only successful treatment for Celiac disease is following a gluten free diet. This is a lifelong commitment.
A referral to a dietitian can help you plan your diet.
Following a gluten free diet will help the small intestine to heal.
Information surrounding gluten-free foods are now widely available. The internet provides a wealth of information explaining the grains you can eat.
Fresh foods like fruits, vegetables, meat, poultry, fish, dairy, beans, legumes, and nuts are gluten-free options.(11)
Foods Containing Gluten
Wheat is the main source of gluten.
It can also be found in many other grains and foods. These include: barley, bulgur, durum, farina, graham flour, malt, rye, semolina, spelt and triticale.
Many foods are now clearly labelled if they are gluten free. Be aware there may be hidden gluten in some products. These include modified food starch, preservatives and food stabilizers.
There are other items that contain gluten which you will need to consider. These include prescription and over-the-counter medications.
Some vitamin and mineral supplements or herbal and nutritional supplements can contain gluten. Other items include: lipstick, toothpaste, mouthwash, envelope and stamp glue.
Vitamins and Dietary Supplements
Many people with celiac disease are deficient in some types of vitamins and minerals. If this is the case taking a gluten free multivitamin pill will help.(12)
When you are diagnosed you may be screened to check your bone health. The disease can make your bones thinner. You will possibly be prescribed medication or advised to take a dietary supplement.(13)
Your doctor will perform tests to check the damage to your small intestine. If it is severely inflamed or damaged they can prescribe steroids to help it heal.
Corticosteroids or autoimmune medications are considered if you have refractory Celiac disease.(14)
This means a gluten free diet alone does not relieve the symptoms. The damage to the villi in the small intestine does not heal with a gluten free diet alone.
Endoscopy, Biopsy and Blood Tests
Your physician can refer you for blood tests. This will check for levels of antibodies that attack an enzyme called tissue transglutaminase. The antibodies attack this enzyme mistaking it for gluten.(15)
You can also be referred for an endoscopy. This allows a doctor to look at the small intestine for signs of damage. They are also able to take tissue samples or a biopsy during this medical process.(16)
When performing these tests you need to continue eating gluten or the tests will not give a true result.
What is celiac disease? Celiac disease is an autoimmune reaction from eating gluten, a protein found in barley, wheat and rye.
What are the signs of celiac disease? Typical signs of this disease are digestive issues. These include diarrhea, vomiting, abdominal pain and constipation. An itchy skin rash is common in people of all ages. You may feel very tired or irritable. Sometimes there are no signs at all.
How do you develop celiac disease? Celiac disease is hereditary. This means it could be in your genes. People who suffer with other autoimmune diseases, such as type 1 diabetes or rheumatoid arthritis will often have celiac disease. However, the precise cause isn’t known.
How are you diagnosed for celiac disease? Your doctor may take blood tests. The tests will look for raised levels of certain antibodies in your blood. They can also refer you for an endoscopy or biopsy. This will help the doctor identify whether there is damage to the small intestine. Some people don’t have symptoms of the disease and only these tests will reveal if they have it.
What is the best treatment for celiac disease? The only current treatment for this disease is to follow a strict gluten free diet. The diet must be followed for life. Accidentally eating gluten could trigger the symptoms again.
What are the long term complications of celiac disease? This disease can lead to additional serious health problems if not treated. These include the development of other autoimmune disorders like type I diabetes and multiple sclerosis. Other complications are osteoporosis, infertility and miscarriage. It can cause neurological conditions like epilepsy and migraines. It can stunt growth. It can also contribute to intestinal cancers.
Is celiac disease considered a disability? Celiac disease does not appear to be considered a disability. You may get certain social security benefits to help you if the condition is severe.(17)
Is there a cure for celiac disease? There is no cure for this condition. It can only be managed by following a gluten free diet. Many stores and restaurants now have foods suitable for people with celiac disease.
Is celiac disease life threatening? Celiac disease is not life threatening. However, there are some serious conditions associated with the disease. These include diabetes, cancer and liver problems.(18)
Celiac disease affects the autoimmune system. Eating gluten causes it to attack and damage the small intestine. This leaves the body lacking in nutrients.
It’s a lifelong disease which has to be carefully managed otherwise it can seriously impact upon quality of life.
The disease is caused by an intolerance to gluten which is a protein found in grains.
There is no known cure at the present time however, it can be controlled by following a gluten free diet. Getting used to this type of diet may be difficult and you may need the help of a dietitian.
Thankfully this condition has been acknowledged as a real problem which affects so many lives. This is why you can now find many food products available in stores geared for a gluten-free diet.