Health Education: Celiac Disease

Celiac disease is a digestive disorder 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.

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 called villi. They normally allow nutrients from food to be absorbed into the bloodstream. If these villi are damaged or destroyed a person becomes malnourished, regardless of the quantity of food eaten.

Because the body’s own immune system causes the damage, celiac disease is considered an autoimmune disorder. It is a genetic disease, meaning it runs in families. Sometimes the disease is triggered, or it becomes active for the first time, after surgery, pregnancy, viral infection or severe emotional stress.

Celiac disease affects people differently. Symptoms may occur in the digestive system or in other parts of the body. For example, one person might have diarrhea and abdominal pain, while another person may be irritable or depressed. In fact, irritability is one of the most common symptoms in children.

Symptoms may include:

  • Gas
  • Recurring abdominal bloating
  • Chronic diarrhea
  • Constipation
  • Pale, foul-smelling or fatty stool
  • Weight loss/Weight gain
  • Fatigue
  • Unexplained anemia
  • Bone or joint pain
  • Behavioral changes
  • Tingling numbness in the legs
  • Delayed growth
  • Failure to thrive in infants
  • Mouth ulcers
  • Dermatitis

Diagnosis of Celiac Disease

To diagnose celiac disease, physicians will usually test blood to measure levels of:

  • Immunoglobulin A (IgA)
  • Anti-tissue transglutaminase (tTGA)
  • IgA anti-endomysium antibodies (AEA)

Endoscopic biopsy of the villi of the small intestine remains the gold standard in the diagnosis of Celiac disease.

Celiac Disease Treatment

The only treatment for celiac disease is to follow a gluten-free diet. When a person is first diagnosed with celiac disease, the doctor usually will ask the person to work with a dietician on a gluten-free diet plan.

For most people, following this diet will stop symptoms, heal existing intestinal damage and prevent further damage. Improvements begin within days of starting the diet. The small intestine is usually healed in 3-6 months in children and younger adults and within 2 years for older adults. Healed means a person now has villi that can absorb nutrients from food into the bloodstream.

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.

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