Celiac disease is a condition where the immune system reacts negatively to gluten, a protein identified in barley, rye, and wheat. When individuals with celiac disease consume gluten, their immune system mistakenly triggers the small intestine’s inner lining, causing inflammation and discomfort.
This inflammation can lead to damage in the small intestine over time, making it difficult for the body to absorb essential nutrients and minerals from food. This can result in various health problems, including nutrient deficiencies and digestive issues. It’s important for individuals with celiac disease to avoid gluten to prevent these symptoms and complications.
What is it?
Celiac disease is a condition where the immune system has a negative reaction to gluten, a protein identified in barley, rye, and wheat. When someone with celiac disease eats gluten, their immune system mistakenly attacks the small intestine.
The damage from this immune response affects the tiny, finger-like structures in the intestine known as villi. These villi are responsible for absorbing nutrients from food. When they are damaged, the body can’t absorb nutrients as well, which can cause various health problems, including nutrient deficiencies and digestive issues.
Common symptoms of celiac disease include discomfort in the stomach and intestines after consuming gluten. However, not everyone with the disease experiences obvious symptoms, which is why many individuals may have it without knowing.
It affects about 1% of people globally. In the United States alone, an estimated 2.5 million individuals may have celiac disease without being diagnosed. The only effective treatment is to completely eliminate gluten from the diet to prevent symptoms and intestinal damage.
Symptoms
Celiac disease signs can vary widely, ranging from mild to serious, and may change over time. Some individuals experience no symptoms, while others may only notice them at another time in life, often when an anemia or nutrient deficiency is detected. Kids are more likely to have digestive signs than adults. Common digestive symptoms in children include bloating, gas, abdominal pain, chronic diarrhea, vomiting, nausea, and foul-smelling, pale, or fatty stools. Non-digestive symptoms can also occur, such as weight loss, extreme tiredness, anxiety or depression, mouth sores, joint pain, a skin rash termed as dermatitis herpetiformis, and peripheral neuropathy, which causes tingling in the feet and legs.
Symptoms in Children
In children, celiac disease can lead to developmental and growth problems if the body cannot absorb nutrients properly. This may result in failure to thrive in infants, delayed development, short stature, loss of weight, damaged tooth coating, mood swings like irritability or impatience, and lower stomach pain or diarrhea. Over time, some children might face an automatic remission of symptoms, remaining symptom-free until another time in life.
Causes and Risk Factors
Celiac disease can affect anyone, but it is more common among white Americans and women. It also tends to be inherited in families, with a person having a 1 in 10 chance of developing celiac disease if a parent or sibling has the condition.
Certain conditions are associated with a higher risk of celiac disease, including Turner syndrome, Down syndrome, type 1 diabetes, and autoimmune thyroid diseases like Hashimoto’s. Research has identified a few other potential risk elements, although more evidence is needed to confirm them. These include early contact with the gluten, facing multiple viral infections while infancy, and having specific genetic markers linked to celiac disease.
Tests and Diagnosis
To diagnose celiac disease, a healthcare provider will typically review the medical histories of the patient and their family and may order various tests, including biopsies, genetic tests, and blood tests.
Blood tests are commonly used to find particular antibodies linked with celiac disease, like anti-endomysial and anti-tissue transglutaminase antibodies. A human leukocyte antigen test may also be conducted, as certain HLA types are linked to celiac disease.
If these tests suggest the presence of celiac disease, the healthcare provider may perform a biopsy. This involves utilizing an endoscope to take small tissue samples from the lining of the small intestine. Multiple samples are usually taken to ensure accurate results.
Determining celiac disease can be challenging because its symptoms often resemble those of other conditions, like Crohn’s disease, irritable bowel syndrome, Whipple’s disease, giardiasis, and small intestinal bacterial growth. Additionally, some medicines, like nonsteroidal anti-inflammatory drugs, can cause similar symptoms, complicating the diagnosis.
What is the Treatment for Celiac Disease?
The primary intervention to this disease is to eliminate gluten in the foods. Most individuals find that avoiding gluten greatly enhances their symptoms and allows their intestines to cure.
For those with a skin rash known as dermatitis herpetiformis, medicines like diamino diphenyl sulfone can help decrease signs. However, these medications do not heal the intestines, so maintaining a strict gluten-free food is essential.
Individuals alongside celiac disease might also need to take mineral and vitamin supplements to address or prevent deficiencies, as the disease can interfere with nutrient absorption.
Scientists are actively exploring drug therapies to make managing celiac disease easier and enhance long-term outcomes.
What Can Celiac Disease Lead To?
In individuals alongside celiac disease, consuming gluten can repeatedly damage the lining of the small intestine. This damage can lead to nutrient deficiencies, which may cause various health problems, like:
- Anemia: A situation where the body without enough healthy cells of red blood to carry sufficient oxygen to soft tissues, leading to fatigue and weakness.
- Hair Loss: Due to nutrient deficiencies, hair may become thin or fall out.
- Osteoporosis: A condition where bones become weak and brittle due to insufficient calcium and vitamin D absorption.
- Small Bowel Ulcers: Sores can form in the lining of the small intestine, causing pain and discomfort
There is also a rare association between certain kinds of cancer, like lymphoma, and celiac disease which affects cells of white blood. However, most individuals alongside celiac disease do not develop cancer. Adhering to a strict gluten-free diet may help decrease the chance of these complications.
Some individuals alongside celiac disease may develop a condition called refractory celiac disease, where their body does not respond to a gluten-free diet even after one year. This is a rare condition, affecting about 1 to 2 percent of those alongside celiac disease, and typically occurs in individuals aged 50.
Summary
Celiac disease is an immune condition where the immune system responds negatively to gluten, destroying the small intestine and leading to nutrient deficiencies. Symptoms vary widely and can include digestive issues, anemia, and osteoporosis. A strict gluten-free diet is the primary treatment, improving symptoms and allowing intestinal healing. In rare cases, untreated celiac disease can lead to complications like refractory celiac disease or certain cancers. Managing the condition involves avoiding gluten-containing foods and products, and many gluten-free options are now available. Consulting a dietitian can help ensure proper nutrition.
