An Overview of Celiac Disease

The original story can be found on the Verywell website. 

Celiac disease is an autoimmune disease in which eating foods that contain the protein gluten—found in wheat, barley, and rye—triggers your white blood cells to attack the lining of your small intestine, ultimately eroding it until it’s worn smooth. It has a wide range of potential symptoms, from abdominal pain to headaches. These can be addressed, and intestinal damage often largely reversed, once you’ve been diagnosed and begin following a gluten-free diet—the only current treatment for the condition.

People who have untreated celiac disease often cannot absorb nutrients from their food, and this can lead to serious health complications, such as malnutrition, osteoporosis, infertility, and even cancer.1

A study found that celiac disease affects approximately 1 in every 141 Americans. However, most people with the condition—80% or possibly more—don’t realize they have it.

There are more than 200 potential celiac disease symptoms. Though it originates in the digestive tract, the condition can affect all your body’s systems, impacting everything from your brain to your skin.

The most common symptoms include:
– Diarrhea and/or constipation (sometimes alternating)
– Bloating
– Abdominal pain
– Fatigue
– Headaches (including migraines)
– Skin conditions (including the so-called “gluten rash” dermatitis herpetiformis)

Some people with celiac disease may not even report any intestinal problems. They may, for example, only have joint pain and brain fog. They may also have depression and/or anxiety or tingling in their arms and legs (peripheral neuropathy), which involves nerve damage. In fact, there’s a huge variety of neurological symptoms associated with celiac disease, including alternations in your senses.

Symptoms can also vary depending on gender and age:

-Women with celiac disease often have symptoms related to their reproductive tracts; they may have irregular cycles or very painful periods.
– Men with celiac disease may be more likely to be underweight and suffer from reflux symptoms. They also seem to have more skin rashes than women.
– Children with celiac disease might have attention deficit-hyperactivity disorder or other behavioral issues and might also be “picky eaters.” Teens may battle with depression.
– Infants or toddlers with celiac disease may have a sore, swollen tummy or may not grow and develop as they should (failure to thrive).

Finally, it’s possible to have celiac disease without any symptoms at all. This is what’s known as silent celiac disease. People with this may feel fine, but they still have the intestinal damage that characterizes the condition.

The lining of your small intestine is made up of tiny, finger-like projections called villi, which help you digest food. The autoimmune reaction in celiac disease attacks these villi, which is what leads to symptoms and complications.

You need two things to have celiac disease: the genetic potential to develop it plus gluten in your diet. Without one or the other, you won’t develop the condition.

However, that’s far from the end of the story, since many people who have the genes for celiac never develop the condition. It’s not at all clear why some people with the so-called “celiac genes” wind up with celiac and others do not.

Some experts believe you also need some sort of “trigger” that causes you to develop celiac disease. There are people who believe a stressful period in their lives triggered their celiac disease. In addition, many women report the onset of symptoms after a pregnancy, another potential trigger. However, others who have celiac report a gradual onset of symptoms, so a trigger may not be essential.

Once thought to primarily affect children, it’s now clear that people of any age can be diagnosed with celiac. It’s not at all unusual to find it in people over age 65 whose possible symptoms include dementia. Women are more likely to be diagnosed than men.

Unfortunately, diagnosing celiac is not always straightforward. It usually takes multiple blood tests plus a procedure known as an endoscopy to determine if you have it. This process can take anywhere from several weeks to several months.

The blood tests, which usually represent the first step in the diagnosis process, screen your blood for high levels of antibodies associated with your body’s reaction to gluten in your diet. Because the tests look for the actual reaction to gluten, you must be eating a gluten-containing diet for them to be accurate.

If the blood tests come back positive, the next step, in most cases, is an endoscopy, in which a surgeon uses an instrument to look directly at your small intestine and take samples of your intestinal lining.

In order to be officially diagnosed with celiac disease, those samples of your intestinal lining must show the villous atrophy that’s found in the condition.9 However, it’s also possible to obtain a diagnosis through skin testing if you have an itchy, gluten-related rash known as dermatitis herpetiformis.

Some people may have celiac disease symptoms but have negative test results for the condition. In that case, they may be diagnosed with non-celiac gluten sensitivity, a recently recognized condition that’s not yet well defined. Not all physicians agree that gluten sensitivity exists, and there’s no accepted way to test for it yet.

Because celiac causes such a wide range of potential symptoms, it frequently is mistaken for other conditions as well. In some cases, it’s even overlooked entirely, although that’s less common than it was a few decades ago.

Once you suspect you might have the celiac disease, it can still take a long time to get a diagnosis. Studies have found the delay from the first doctor visit until the diagnosis was over five years, on average.

Although there are currently several potential drugs for celiac disease in development, there’s only one treatment you can use right now: the gluten-free diet.

To treat the damage caused by gluten, you need to eliminate gluten entirely. Once you do that, your intestinal lining will begin to heal and other complications from celiac disease (such as malnutrition) should begin to resolve.

This seems simple but it’s more difficult in practice. You must avoid every speck of gluten, which means replacing kitchen equipment, cleaning out your kitchen and your house, and adopting new rules for eating out (among other things).

Getting a gluten-free diet right takes a fair amount of research and practice. However, knowing that dedicating yourself to this change will likely have you feeling better rather quickly, your efforts are sure to seem worthwhile.

A Word From Verywell
Awareness of celiac disease is improving dramatically as more people speculate that gluten could be at the root of their health problems. Over the past few years, diagnosis of the condition has risen sharply as well. In addition, eating gluten-free has gotten easier as more food manufacturers produce products that are safe to eat.

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