Celiac (SEE-lee-ak) disease is a digestive condition triggered by consumption of the protein gluten, which is primarily found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye. People with celiac disease who eat foods containing gluten experience an immune reaction in their small intestines, causing damage to the inner surface of the small intestine and an inability to absorb certain nutrients.
Celiac disease can cause abdominal pain and diarrhea. Eventually, the decreased absorption of nutrients (malabsorption) that occurs with celiac disease can cause vitamin deficiencies that deprive your brain, peripheral nervous system, bones, liver and other organs of vital nourishment.
No treatment can cure celiac disease. However, you can effectively manage celiac disease by changing your diet.
- Intermittent diarrhea
- Abdominal pain
Celiac disease may also present itself in less obvious ways, including:
- Irritability or depression
- Stomach upset
- Joint pain
- Muscle cramps
- Skin rash
- Mouth sores
- Dental and bone disorders (such as osteoporosis)
- Tingling in the legs and feet (neuropathy)
- Weight loss
- Abdominal cramps, gas and bloating
- General weakness and fatigue
- Foul-smelling or grayish stools that may be fatty or oily
- Stunted growth (in children)
Dermatitis herpetiformis is an itchy, blistering skin disease that also stems from gluten intolerance. The rash usually occurs on the torso, scalp and buttocks. Dermatitis herpetiformis can cause changes to the lining of the small intestine similar to that of celiac disease. However, it may not produce noticeable digestive symptoms. This disease is treated with a gluten-free diet, in addition to medication to control the rash.
Tests and diagnosis
- Blood tests. Blood tests can detect higher than normal levels of certain antibodies (anti-endomysium and anti-tissue transglutaminase) in people with celiac disease. Antibodies are specialized proteins that are part of your immune system and work to eliminate foreign substances in your body. In people with celiac disease, their immune systems may be recognizing gluten as a foreign substance and producing elevated levels of antibodies to get rid of it.
- Collecting a sample of small intestine for testing. To confirm the diagnosis, your doctor may want to examine a small portion of intestinal tissue to check for damage to the villi. To do this, your doctor inserts a thin, flexible tube (endoscope) through your mouth, esophagus and stomach into your small intestine and takes a sample of intestinal tissue to examine under a microscope.
- Swallowing a camera pill that collects pictures of the small intestine. In some cases your doctor may want to examine the entire small intestine with a capsule endoscopy. This procedure involves swallowing a pill-sized capsule that contains a tiny camera. As the camera travels through your digestive tract, it takes thousands of images and sends them to a recorder you wear on a belt. Your doctor reviews the pictures to see the inside of your small intestine. The capsule leaves your body in your stool and can be flushed down the toilet.
Some people try a gluten-free diet on their own, to see if that helps relieve their signs and symptoms. But doing so may change the results of blood tests so that they appear to be normal. So see your doctor for testing first, before you try a gluten-free diet.
University of Chicago at celiacdisease.net:
What is the difference between celiac disease, gluten intolerance, wheat allergy and gluten
Gluten intolerance is a generic term encompassing any adverse reaction to gluten ingestion,
regardless of the mechanism involved: it includes celiac disease, wheat allergy, and “gluten
Wheat allergy is an allergic reaction to gluten ingestion, mediated by specific immune
mechanisms that are common to other food allergies (e.g. milk, nuts…) and is totally different
from celiac disease.
The last term, gluten sensitivity, is the most difficult to define, as it implies adverse reactions
caused by gluten ingestion that do not fall into the two known and well characterized entities
outlined above. Some individuals indeed manifest symptoms to gluten and yet no tests can
identify a specific pathology in them. Research is active on this topic, including bench
investigations carried out at The University of Chicago Celiac Center.
A CHILD WILL ON AVERAGE VISIT 8 PEDIATRICIANS BEFORE BEING DIAGNOSED.
UNDIAGNOSED CELIAC PATIENTS ARE AT GREATER RISK OF OTHER SERIOUS ILLNESSES.
97% OF PEOPLE WITH CELIAC DISEASE HAVE NOT BEEN DIAGNOSED.
(University of Chicago Celiac Center, www.celiacdisease.net)