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Celiac Disease

What is Celiac Disease?

Celiac disease is an autoimmune disease involving the small intestine in which people cannot tolerate a protein called gluten. Gluten is found primarily in wheat, barley, and rye, but may also be in products we use every day, including some medicines and vitamins and even in stamp and envelope glue.

Many people living with celiac disease are undiagnosed for a number of reasons:

  • The symptoms associated with celiac disease are often attributed to other problems.
  • While many health-care providers have learned about the disease, they may not think first about celiac disease as a potential diagnosis when presented with the list of symptoms.


What Are The Causes of Celiac Disease?

Celiac disease occurs from an interaction between genes, eating foods with gluten and environmental factors. We do not yet know what causes this disease. Sometimes Celiac disease is triggered or becomes active after surgery, pregnancy, childbirth, viral infection or severe emotional stress.


What Are The Signs And Symptoms of Celiac Disease?

Celiac disease affects people differently and the symptoms are wide and varied. Experiencing these symptoms does not mean a person has celiac disease, just as some patients with the disease may not show any symptoms.

Symptoms of celiac disease include:

  • Gas, recurring abdominal bloating and pain
  • Chronic diarrhea or constipation; pale, foul-smelling or fatty stool
  • Weight loss/weight gain
  • Fatigue
  • Unexplained anemia (a low count of red blood cells causing fatigue)
  • Behavioral changes; irritability is common in children
  • Tingling numbness in the legs (from nerve damage)
  • Bone or joint pain
  • Muscle cramps
  • Delayed growth in children or failure to thrive in infants
  • Pale sores inside the mouth, called aphthous ulcers
  • Itchy skin rash called dermatitis herpetiformis


What Are The Risk Factors of Celiac Disease?

Celiac disease was, until recently, thought to be a rare disease. However, as many as 2 million people in the U.S. may have celiac disease. It is very common among first-degree relatives who have celiac disease. Celiac disease is diagnosed in both children and adults and many people do not have any symptoms. In some patients with the genetic predisposition, the disease reveals itself after an event such as surgery, pregnancy, viral infections or severe emotional stress.


How is Celiac Disease Diagnosed?

The symptoms of celiac disease often mimic other diseases, such as irritable bowel syndrome and Crohn’s disease. A blood test is often the first test your doctor will order. This test checks for high levels of autoantibodies associated with celiac disease. If the blood test comes back positive, an upper endoscopy is often recommended to obtain a sample of the tissue (biopsy) from your small intestine to test the damage to the villi. Upper endoscopy involves passing a long, thin, flexible tube with a tiny video camera and light on the end through the mouth and into the small intestine. Tiny instruments are passed through an opening in the endoscope to obtain tissue samples for the biopsy. Before you undergo any test to determine whether you have celiac disease, it is important that you continue a diet consisting of gluten-containing food so the results are accurate.


What Are Possible Treatments For Celiac Disease?

The primary treatment for celiac disease is the strict following of a gluten-free diet. A life-long gluten-free diet will help protect your small intestine. In many patients with celiac disease, even a small amount of gluten is enough to cause intestinal damage, even though you may not be experiencing symptoms. While you may be tempted to cheat, and may not notice much of a problem when you do, it is important to remember that you may run the risk of long-term problems. While you will never be completely cured of celiac disease, after adopting a gluten-free diet your small intestine should heal in about two years for adults and within a few months in children and young adults.

Being healed from celiac disease means that your small intestine returns to normal function and can begin absorbing nutrients properly; however, it does not mean that you can stop eating gluten-free products. Some patients with Celiac disease may experience symptoms if the same cookware is used to cook their food and food containing gluten.


Are There Preventative Steps to Help With Celiac Disease?

A Gluten-Free Diet is the best was to prevent Celiac from getting worse. Grains, including wheat products, are a major source of nutrients in the basic American diet. The U.S. Department of Agriculture recommends individuals eat between 3 and 8 ounces of grains a day depending on age and activity level. For instance, this is one slice of bread, 1 cup of ready-to-eat cereal, or a half a cup of cooked rice, cooked pasta or cooked cereal.

Once you are diagnosed with celiac disease, you should consult with a nutritionist who will work with you to help develop a diet program that will be free of gluten-containing products, but still ensures you are receiving the correct balance of nutrients. You will need to learn how to read nutrition labels to ensure that the products do not contain gluten or other ingredients that may affect you. While the introduction of a gluten-free diet can seem overwhelming, especially for a child, there are many foods that can be substituted for traditional wheat-based foods.


What Are The Risks If Celiac Disease Is Left Untreated?

  • Due to damage to the small intestine and nutrient absorption problems, people with celiac disease are at increased risk of developing malnutrition, anemia, and other diseases and health problems.
  • After years of being undiagnosed, some adults may experience “refractory” celiac disease, which means that the body does not respond to a gluten-free diet and that symptoms continue and can lead to intestinal damage.
  • Patients with celiac disease may develop osteoporosis (weak and brittle bones) or short stature in children. This is due to the lack of nutritional absorption.
  • Patients may experience an increased risk of lymphoma and intestinal cancers.
  • Some patients with celiac disease may have other autoimmune disorders including type 1 diabetes, thyroid disease, rheumatoid arthritis, and liver disease, among others.

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Meet Jennifer Bonheur, MD

Dr. Jennifer Bonheur is a board-certified gastroenterologist who loves her work and values her relationships with her patients. As a female gastroenterologist, she strives to connect and treat the patient and not simply the illness. Dr. Bonheur offers specialized care in gastroenterology and therapeutic endoscopy. Together with her staff, she is committed to providing the highest quality medical care in a comfortable, professional and personalized environment. Learn More »