Celiac Disease
What Is Celiac Disease?
Celiac disease is an immune reaction to eating gluten. Gluten is a protein found in wheat, barley and rye. When a person with celiac disease eats something containing gluten, their body overreacts to the protein and damages their villi, which are very small finger-like projections found along the wall of the small intestine. When the villi are injured, the small intestine cannot properly absorb nutrients from food.
What Causes Celiac Disease?
It is believed that celiac disease is caused by a combination of factors including genetic disposition, eating foods with gluten and other environmental factors, but the precise cause is unknown. Infant feeding practices, gastrointestinal infections and gut bacteria may also contribute to developing celiac disease.
Celiac disease can sometimes be triggered or become active for the first time after surgery, pregnancy, childbirth, viral infection or severe emotional stress. Some gene variations also increase the risk of developing the disease, but having those gene variants does not mean you will get celiac disease. This suggests that additional factors are involved.
What Are The Symptoms of Celiac Disease?
The signs and symptoms of celiac disease can vary greatly and are different in children and adults. The most common symptoms for adults include diarrhea, fatigue and weight loss. Adults may also experience bloating, gas, abdominal pain, nausea, constipation, and vomiting.
More than half of adults with celiac disease have signs and symptoms that are not related to the digestive system, including:
- Anemia
- Loss of bone density
- Itchy, blistery skin rash
- Damage to dental enamel
- Mouth ulcers
- Headaches and fatigue
- Nervous system injury, including numbness and tingling in the feet and hands, problems with balance, and cognitive impairment
- Joint pain
- Kidney disease
- Acid reflux or heartburn
How Is Celiac Disease Diagnosed?
To diagnose celiac disease, a gastroenterologist can conduct different blood tests. There are several serum antibody tests that aid in the diagnosis of celiac disease. There is also a genetic test to look for human leukocyte antigens. In order to get accurate results from the antibody test, patients must refrain from a gluten-free diet for 6-8 weeks.
If the blood test shows signs of celiac disease, an endoscopy may need to be performed. During this procedure, a gastroenterologist will examine the small intestine and take a sample of the tissue to see if it has been damaged.
What Treatments Are Available?
The only treatment for celiac disease is lifelong adherence to a strict gluten-free diet. People living gluten-free must avoid foods with wheat, rye and barley. Patients with celiac disease should also be tested for nutritional deficiencies and evaluated for bone loss. Dietary supplements may be recommended for bone loss treatment.
Once gluten is removed from the diet, inflammation in the small intestine generally begins to lessen, usually within several weeks. Some patients start to feel better in just a few days. Complete healing and regrowth of the villi can take several months to several years.