What is celiac disease?

April 18, 2016 Leslie H. Price, MD


Celiac disease is an autoimmune disorder that damages the small intestine and prevents the absorption of nutrients. This disease occurs in genetically predisposed people and can be diagnosed at any age. Worldwide, an estimated 1 in 100 people have celiac disease.

What celiac does to the body

People with celiac disease cannot tolerate gluten, a name for the proteins found in wheat, barley and rye. Gluten breaks down into the peptide gliadin, which interacts with the immune system and causes the body to attack itself. When this happens, the villi – small hair-like projections that line the small intestine -- flatten and become inflamed, blocking the absorption of nutrients.

Symptoms to watch for

Patients with celiac disease can have a myriad of gastrointestinal and systemic health problems, although some people have no symptoms. Possible symptoms include:

  • Abdominal bloat, gas and pain
  • Diarrhea
  • Constipation
  • Weight loss
  • Fatigue
  • Weak bone such as osteopenia or osteoporosis
  • Iron deficiency anemia
  • A rash known as dermatitis herpetiformis

Celiac disease is associated with Down syndrome, microscopic colitis and other autoimmune conditions, including insulin dependent diabetes mellitus, Sjogren’s syndrome and thyroid diseases.

How is celiac disease diagnosed?

Diagnosis is based on symptoms, positive serologic blood testing and an upper endoscopy. During this procedure, a thin, flexible tube with a camera is used to evaluate your small intestine, and tissue is taken from the lining of your small intestine for a biopsy.

Treating celiac disease

There’s no cure for celiac disease, so patients must remain on a gluten-free diet for life. They also will need to consult with a dietician and have blood work done to check for nutritional and mineral deficiencies. Patients should avoid lactose when they are first diagnosed because the enzyme lactase, needed to break down lactose, is found in the villi but cannot do its job when the lining of the small intestine is damaged. As the small intestine heals, dairy products are better tolerated.

Further tests to maintain health

Patients will need to have intermittent celiac panel and blood work done. People with celiac disease also can develop hyposplenism, which impedes spleen function and leaves patients vulnerable to infectious diseases. For this reason, patients should receive pneumococcal vaccines. All patients also should have a bone mineral density scan to check for osteopenia or osteoporosis.

Finally, a patient’s close family members, including parents, siblings and children, should have blood work to check for celiac disease.

If you are concerned that you may have celiac disease, talk to your doctor and consider asking for a referral to the Swedish Digestive Health Network, or call 1-855-411-MYGI (6944).

For more information about celiac disease, visit the Celiac Disease Foundation website. For more dietary information, visit the National Celiac Association.


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