According to researchers at the University of Chicago Celiac Disease Center, celiac disease is four times as common as it was 50 years ago. The center’s director, Stefano Guandalin, MD, further reports that only about 5% of people with celiac disease know that they have it.
Understanding Celiac Disease
Celiac disease is a digestive disorder caused by an abnormal reaction to gluten, the protein in wheat, rye, and barley. Although celiac disease runs in families, the disorder may not emerge until later in life. Often it’s triggered or initially becomes active after surgery, pregnancy, childbirth, infection, or severe emotional stress. Studies on breastfeeding show that the longer a child is breastfed, the later in life celiac disease may develop. Recent studies suggest that celiac disease is not an autoimmune disorder although it has the same symptoms and is mediated by an abnormal immune response.
In celiac disease, the immune system produces antibodies that destroy villi, the tiny, fingerlike projections lining the small intestine that absorb nutrients. Without healthy villi, affected individuals become malnourished even when their intake of food is adequate.
Who is Affected?
More than 2 million people in the United States, or about one in every 133 people, have celiac disease. Among people with a first-degree relative affected by celiac disease, the incidence rises to one in every 22 people.
Symptoms and Complications
Celiac disease can cause a broad array of symptoms and complications, including:
- Diarrhea
- Bloating
- Infertility
- Abdominal discomfort
- Osteoporosis
- Nutrient malabsorption
- Weight loss
- Weight gain
- Vomiting
- Pale, foul-smelling, or fatty stool
Symptoms of celiac disease vary from one individual to another. Symptoms may occur in the digestive system or in other parts of the body. Atypical symptoms in celiac disease include rashes, joint pain, arthritis, iron-deficiency anemia, depression, anxiety, seizures, missed menstrual periods, dental enamel defects, recurrent miscarriage, and canker sores inside the mouth.
Symptoms depend on a person’s age and the degree of intestinal damage he has when symptoms present. The longer a person goes before he's diagnosed and treated, the greater the chance of developing long-term complications, including lymphoma. Diagnosis is often delayed because celiac disease has such a wide array of symptoms. It’s often confused with irritable bowel syndrome, inflammatory bowel disease, diverticulitis, intestinal infections and chronic fatigue syndrome.
Diagnosis
Diagnosis is made with blood tests for tissue transglutaminase, endomysial, and gliadin antibodies. If test results are negative but celiac disease is suspected, additional blood tests such as immunoglobulin levels may be needed. A biopsy of the small intestine is used to confirm diagnosis when presumptive blood tests suggest celiac disease. Patients should continue to eat gluten before having blood tests for celiac disease or their results may be falsely negative.
People with elevated antibodies but no evidence of celiac disease may be gluten intolerant. This means that the body is unable to break down gluten. Unlike people with celiac disease, people with gluten sensitivity usually do not have malabsorption of nutrients. People with gluten intolerance may want to eat an 80 to 90 percent gluten-free diet depending on their symptoms. By reducing or eliminating gluten, they can reduce their digestive symptoms in a timeframe ranging from several weeks to one year.
Treatment
Treatment consists of a gluten-free diet. The small intestine usually heals in 3 to 6 months in children although it may take several years for the intestines to heal in adults. Besides obvious sources such as breads, gluten is present in many preservatives and food additives. Processed foods that may contain gluten include potato chips, gravy mixes, soups, soy sauces, matzo, rice mixes, candy, cold cuts, hot dogs, salami, sausage, communion wafers, imitation fish and French fries.
Resources:
Celiac disease on the rise: What you need to know, Foodconsumer.org, March 7, 2007..
Good Medicine: Celiac Disease, Natural Health, July/August 2009.
Elaine Moore - I'm a retired medical technologist and medical writer with more than 30 years experience working in hospital laboratories. Currently, I ...
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