WHAT IS IT?
Celiac disease is an immune reaction to eating gluten, a protein found in wheat, barley, and rye.
Among people who have the disease, their immune systems react to gluten similarly to how they respond to a virus or bacteria — they try to attack and destroy the protein. This reaction inflames and damages the lining of the small intestine and prevents the absorption of essential nutrients.
Celiac disease tends to run in families. Certain gene changes (mutations) are associated with the development of the celiac disease. However, having one of these mutations doesn’t mean you’ll get the disease — just that you’re at increased risk.
Similar to many immune disorders, celiac disease is thought to result from an interplay between genetics and something in the environment that triggers its development. In some individuals, the celiac disease becomes active for the first time after a major event — such as surgery, pregnancy, childbirth, a serious viral infection, or severe emotional stress.
The signs and symptoms of celiac disease vary greatly. Classic signs and symptoms include belly pain, bloating, excessive gas, and very odorous mushy stools or diarrhea.
Some people experience fatigue due to anemia or headaches. Some lose weight while others gain weight. Some are bothered by an itchy, blistering rash. And some people don’t have any symptoms.
In children, celiac disease can affect growth and development.
WHAT TESTS TO EXPECT
A diagnosis of celiac disease generally involves ruling out other possible causes of your symptoms and a few tests and procedures:
- Blood tests. Elevated levels of certain substances in your blood (antibodies) indicate an immune reaction to gluten.
- Endoscopy. Your doctor may order this procedure if blood tests suggest possible celiac disease. During endoscopy, he or she can view the small intestine and take a sample of tissue (biopsy) to analyze for damage.
- Capsule endoscopy. This procedure uses a tiny wireless camera to take pictures of the small intestine.
The only way to treat celiac disease is to stop eating all foods that contain gluten. That means all foods made from wheat, barley, and rye. Because oats are often harvested and processed in the same places as wheat, barley, and rye, they generally are forbidden, too, because of worry of cross-contamination.
Gluten-containing grains are pervasive in many foods, such as bread, pasta, baked goods, and many processed products, such as chips, crackers, and cookies. Gluten is present in most beers and in many salad dressings, sauces, and seasonings. You can even find gluten in some luncheon meats and candies. Fortunately, more food processors are manufacturing gluten-free versions of their products.
Therefore, it’s important to work with a dietitian to learn which foods are safe to eat and which are not. A dietitian can teach you how to read food labels and what ingredients to look for on labels to alert you that the product contains gluten.
Once gluten is removed from the diet, inflammation of the small intestine begins to improve — often within days to weeks. However, complete healing may take several months to several years. Healing of the small intestine tends to occur more quickly in children than in adults.
In rare instances, the inflammation associated with celiac disease doesn’t respond to a gluten-free diet. This is known as refractory celiac disease. Further testing is often necessary. Other treatments may be prescribed to manage symptoms.
Left untreated, the disease can lead to a number of serious conditions, including osteoporosis, anemia, infertility, vitamin deficiencies, and cancer. That’s why it’s important for people with the disease who don’t experience symptoms to follow a gluten-free diet.
Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.