Celiac Disease

People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins, and lip balms.

When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi—the tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats.

Risk Factors

As many as one in 141 Americans has celiac disease, although most remain undiagnosed. Celiac disease affects children and adults in all parts of the world and is more common in Caucasians and females.

Celiac disease is also more common among people with certain genetic diseases, including Down syndrome and Turner syndrome––a condition that affects girls’ development. Doctors and researchers don’t know exactly what causes celiac disease.

Causes

CELIAC DISEASE IS MORE COMMON IN PEOPLE WHO:

• Have a family member with celiac disease. If 1 member of your family has celiac disease, about 1 person out of 10 other members of your family is also likely to have it.
• Have an autoimmune disease, such as type 1 diabetes, rheumatoid arthritis, autoimmune thyroid or liver disease, Addison’s disease, or Sjogren’s syndrome.
• Have a genetic disorder such as Down syndrome or Turner’s syndrome.

If you have celiac disease, you probably won’t know it right away. You may have this disease for a while without getting sick. Then something like severe stress, physical injury, infection, childbirth, or surgery can trigger, or “turn on,” your celiac disease.

Symptoms

Celiac disease can cause a wide range of symptoms, symptoms that change, or sometimes no symptoms at all.

SYMPTOMS OF CELIAC DISEASE FOR INFANTS AND YOUNG CHILDREN MAY INCLUDE:

• Digestive symptoms, such as abdominal pain, vomiting, diarrhea (even bloody diarrhea) and constipation, and may fail to grow and gain weight.
• A child may also be irritable, fretful, emotionally withdrawn, or excessively dependent.
• If the child becomes malnourished, he or she may have a large tummy, thin thigh muscles, and flat buttocks. Many children who have celiac disease are overweight or obese.

TEENAGERS:

• Symptoms for adolescents include digestive issues such as diarrhea and constipation.
• They may hit puberty late and be short.
• Celiac disease might cause some hair loss (a condition called alopecia areata) or dental problems.

ADULTS ARE LESS LIKELY TO HAVE DIGESTIVE SYMPTOMS. INSTEAD, THEY MIGHT HAVE:

• A general feeling of poor health, including fatigue, bone or joint pain, irritability, anxiety and depression, and missed menstrual periods in women. Osteoporosis (loss of calcium from the bones) and anemia are common in adults who have celiac disease. A symptom of osteoporosis may be nighttime bone pain.
• Lactose intolerance (a problem digesting milk products) is common in patients of all ages who have celiac disease.
• Dermatitis herpetiformis (an itchy, blistery skin problem) and canker sores in the mouth are also common problems in people who have celiac disease.

Diagnosis

Blood tests can help your doctor diagnose this disease. If you think you have celiac disease, talk to your doctor. Don’t stop eating gluten before you have a blood test. If you stop eating gluten before your blood test, it can mess up your results. If your blood test indicates that you might have celiac disease, an intestinal biopsy (taking a small piece of tissue from your small intestine using a thin tube) or the diagnosis of dermatitis herpetiformis (a particular type of skin rash) will confirm that you have celiac disease.

Treatment

Fortunately you can control celiac disease by following a gluten-free diet, meaning you don’t eat any gluten for the rest of your life. By following the right diet, you can reverse the damage caused by celiac disease and you’ll feel better. But if you “cheat” on your diet, the damage will come back, even if you don’t feel sick right away.

People who follow a gluten-free diet avoid all foods that contain wheat, barley, rye, spelt, and triticale products, including many breads, pastas, cereals and processed foods. Rice, corn, oats, quinoa, buckwheat, and millet do not contain gluten. Some people choose to avoid oats because some oat products can be contaminated with wheat gluten. Gluten also is sometimes used in medicines, so be sure to talk to your doctor or pharmacist before taking a new medicine.

Learning to be gluten-free may be difficult at first. It will take time for you and your family to learn how to avoid gluten. You’ll have to learn to read ingredient labels and identify the foods that contain gluten. You’ll have to be careful when you buy foods at the grocery store, or when you eat out. You’ll probably have to learn some new cooking recipes. For help, contact one a celiac support group. These groups are excellent sources of information and advice. They’ll help you find gluten-free foods and good recipes, and can give you tips on successfully living with celiac disease.