Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, found in wheat, rye, and barley.
Celiac Disease and Gluten
Gluten is found mainly in foods, but it is also in products we use every day, such as stamp and envelope adhesive, medicines, and vitamins.
When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging the small intestine. The tiny, fingerlike protrusions lining the small intestine are damaged or destroyed. The protrusions, called villi, normally allow nutrients from food to be absorbed into the bloodstream. Without healthy villi, a person becomes malnourished, regardless of the quantity of food eaten.
Celiac disease research scientists are still trying to figure out the exact cause or causes of celiac disease. At this point, they believe that celiac disease is a type of
autoimmune disease and that certain genes and environmental factors play a role in a person developing the disease.
Celiac disease is a genetic disease, meaning it runs in families. Sometimes the disease is triggered -- or becomes active for the first time -- after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.
Celiac disease may affect different people in different ways. Celiac disease symptoms may occur in the
digestive system or in other parts of the body. For example, one person might have
diarrhea and abdominal pain (or stomach pain), while another person may be irritable or depressed. A person with celiac disease may even have no symptoms. Because there are so many possible symptoms of celiac disease, most people do not fit the profile of a "typical celiac patient."
Even people with the disease who exhibit no symptoms are still at risk for the complications of celiac disease, including:
Celiac Disease and Other Autoimmune Diseases
People with celiac disease tend to have other
autoimmune diseases. The connection between celiac disease and these diseases may be genetic. These diseases include (but are not limited to):
Diagnosing Celiac Disease
Making a celiac disease diagnosis can be difficult because some of its symptoms are similar to those of other diseases. If a doctor believes a person has celiac disease based on their symptoms and findings on a physical exam, he or she will usually test the person's blood to measure the levels of certain antibodies, including:
- IgA anti-tissue transglutaminase (tTGA)
- IgA anti-endomysium antibodies (AEA)
- IgA and IgG anti-gliadin antibodies (AGA).
Before being tested, one should continue to eat a regular diet that includes foods with gluten, such as breads and pastas. If a person stops eating foods with gluten before being tested, the results may be negative for celiac disease, even if the disease is actually present.
If the tests and symptoms suggest celiac disease, the doctor will perform a small bowel biopsy.
The only form of treatment for celiac disease involves following a gluten-free diet. A dietitian (a healthcare professional who specializes in food and nutrition) can create a gluten-free diet plan. Also, a dietitian can teach someone with celiac disease how to read ingredient lists and identify foods that contain gluten in order to make informed decisions at the grocery store and when eating out.
For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. In order to stay well, people with celiac disease must avoid gluten for the rest of their lives. Eating any gluten, no matter how small an amount, can damage the small intestine.
Some people with celiac disease show no improvement on the gluten-free diet. This condition is called unresponsive celiac disease.
Other Names for Celiac Disease
Other names for celiac disease include:
- Celiac sprue
- Nontropical sprue
- Gluten-sensitive enteropathy
- Gluten-induced enteropathy.
A Summary of Celiac Disease
Key points about celiac disease include the following:
- People with celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley.
- Celiac disease damages the small intestine and interferes with nutrient absorption.
- A person with celiac disease may or may not have symptoms. There are many possible symptoms of celiac disease, including diarrhea, abdominal pain (or stomach pain), and depression.
- Diagnosis of the disease involves blood tests and a biopsy of the small intestine.
- Since celiac disease is hereditary, family members of a person with the disease may wish to be tested.
- Celiac disease is treated by eliminating all gluten from the diet. A person with celiac disease must remain on this diet throughout his or her life.
- Without treatment, people with celiac disease can develop complications like cancer, osteoporosis, and anemia.
- A dietitian can teach a person with celiac disease proper food selection, label reading, and other strategies to help manage the disease.
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