Celiac Disease

Celiac Disease

A lot of people eat a gluten-free diet. For people with celiac disease, it's a must.

About 3 million Americans have celiac disease, an autoimmune disorder that's triggered when they eat gluten. Gluten is a protein found in wheat, barley, rye, and other grains. It is the protein that makes dough elastic and gives bread its chewy texture.

But when someone with celiac disease eats something with 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 can't properly absorb nutrients from food. Eventually, this can lead to malnourishment, as well as loss of bone density, miscarriages, infertility -- even to the start of neurological diseases, or certain cancers.

Symptoms

Celiac disease isn't the same thing as a food allergy, so the symptoms will differ.

If you're allergic to wheat, you may have itchy or watery eyes or a hard time breathing if you eat something that has wheat in it.

But if you have celiac disease and accidentally eat something with gluten in it, you may have intestinal problems (like diarrhea, gas, constipation) or any of the following symptoms:

• • Abdominal pain
  • Nausea
  • Anemia
  • Itchy blistery rash (doctors call this dermatitis herpetiformis)
  • Loss of bone density
  • Headaches or general fatigue
  • Bone or joint pain
  • Mouth ulcers
  • Weight loss
  • Heartburn

In children, intestinal problems are much more common than they are for adults. These symptoms include:

• • Nausea or vomiting
  • Bloating or a swelling in the belly
  • Diarrhea
  • Constipation
  • Pale, foul-smelling stool (steatorrhea)
  • Weight loss

Not everyone with celiac disease will have these symptoms. And some people have no problems at all, which makes diagnosis very difficult.

Diagnosis

Most people with celiac disease never know they have it. Researchers think as few as 20% of people with the disease ever get a proper diagnosis. The damage to the intestine is very slow, and symptoms are so varied, that it can be years before someone gets a diagnosis.

Doctors use two blood tests to help determine whether you have celiac disease:

• • Serology tests that look for certain antibodies
  • Genetic testing to look for human leukocyte antigens to rule out celiac disease

If you're already on a gluten-free diet, you'll need to come off it before having the antibody test so the results will be accurate.

If the blood test shows you might have celiac disease, you'll probably need to have endoscopy done. This is a procedure in which your doctor can look at your small intestine and take a little bit of tissue to see if it's damaged.

Treatment

There are no drugs that treat celiac disease. You'll need to go on a strict gluten-free diet. In addition to staying away from bread, cake, and other baked goods, you'll also need to avoid beer, pasta, cereals, and even some toothpastes, medications, and other products that contain gluten.

If you have a severe nutritional deficiency, your doctor may have you take gluten-free vitamins and mineral supplements and will prescribe medication if you have a skin rash.

After you've been on a gluten-free diet for a few weeks, you should start to feel better, as your small intestine begins to heal.

Who's at Risk?

Celiac disease tends to run in families, as it is a genetic disorder. If you have a parent, child, brother, or sister who has celiac disease, you have a 1 in 10 chance of getting it yourself. But having the genes for celiac disease doesn't automatically mean you'll get it.

Sometimes, a stressful event such as a viral infection, surgery, or some emotional trauma can trigger it. It could also happen after pregnancy. Of course, you would need to be eating foods with gluten for any harm to happen.

The disease is most common among Caucasians and people who have had other diseases like Down syndrome, type 1 diabetes, Turner syndrome (a condition where a female is missing an X chromosome), Addison's disease, or rheumatoid arthritis.