What is Celiac Disease?
March 9, 2024
Celiac disease is a serious autoimmune disease. It occurs in genetically predisposed people, where the ingestion of gluten leads to damage in the small intestine. Gluten is a protein found in wheat, rye and barley. When people with celiac disease consume gluten, their body has an immune response to attack the small intestine, damaging villi (small fingerlike projections that promote nutrient absorption). When villi become damaged, nutrients cannot be properly absorbed.
There are over 200 known symptoms of celiac disease. Symptoms can occur in the digestive system or other parts of the body such as joint pain. Some people with celiac disease have no symptoms at all. Some people may have a negative blood test and a positive intestinal biopsy. No matter what symptoms you experience or even if you don’t have symptoms people with celiac disease are at risk for long-term complications.
Most Common Symptoms in Infants & Children
Abdominal bloating and pain
Anxiety and depression
Attention-deficit/hyperactivity disorder (ADHD) and learning disabilities
Chronic diarrhea
Constipation
Damage to tooth enamel
Delayed puberty
Failure to thrive
Fatigue
Gas
Headaches
Iron-deficiency anemia
Irritability
Nausea and vomiting
Pale, foul-smelling stools
Seizures and lack of muscle coordination
Short stature
Weight loss
Most Common Symptoms in Adults
Abdominal pain
Bloating and gas
Cognitive impairment
Constipation
Diarrhea
Depression and anxiety
Fatigue
Headaches or migraines
Iron-deficiency anemia
Itchy, blistery skin rash (dermatitis herpetiformis)
Joint pain
Missed periods
Mouth ulcers and canker sores
Nausea and vomiting
Osteoporosis and osteomalacia
Peripheral neuropathy
Reduced functioning of the spleen (hyposplenism)
Weight loss
The only way to confirm a celiac disease diagnosis is by having an intestinal biopsy. An intestinal biopsy is considered the “gold standard” for diagnosis because it will determine if you have celiac disease and if your symptoms improve on a GF diet or if you have a different gastrointestinal disorder. For those with dermatitis herpetiformis (DH), a skin biopsy is sufficient for diagnosis of both DH and celiac disease.
Currently the only treatment is following a strict gluten free (GF) diet. All first-degree relatives should be screened, as there is a 1 in 10 risk of developing celiac disease, regardless of experiencing symptoms or not. Ventura et al, found that for people with celiac disease, the later the age of diagnosis, the greater chance of developing another autoimmune disorder.
Undiagnosed or Untreated Celiac Disease Can Lead to:
Early onset osteoporosis or osteopenia
Gall bladder malfunction
Heart disease
Infertility & miscarriage
Iron deficiency anemia
Lactose intolerance
Liver failure
Malnutrition
Small intestine cancer and non-Hodgkin lymphoma
Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), headaches, lack of muscle coordination, seizures, ataxia, dementia, neuropathy, myopathy & multifocal leucoencephalopathy
Pancreatic insufficiency
Vitamin & mineral deficiencies
Sources
Shah S, Akbari M, Vanga R, et al. Patient Perception of Treatment Burden is High in Celiac Disease Compared to Other Common Conditions. Am J Gastroenterol. 2014 Sept; 109(9): 1304-1311. doi: 10.1038/ajg.2014.29
Roy A, Minaya M, Monegro M, et al. Partner Burden: A Common Entity in Celiac Disease. Dig Dis Sci 61, 3451–3459 (2016). https://doi.org/10.1007/s10620-016-4175-5
Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders D, Cellier C, Mulder CJ, Lundin KAE. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019. Doi: 10.1177/2050640619844125
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