Celiac disease is a chronic (long-term) digestive and immune disorder that damages the small intestine.

This damage may prevent your body from absorbing vitamins, minerals, and other nutrients from the food you eat, which can lead to malnutrition and other serious health problems.

When someone with celiac disease consumes something containing gluten, their body overreacts to the protein, damaging the villi—small, finger-like projections found along the wall of the small intestine.

When your villi are injured, your small intestine can’t properly absorb nutrients from food.

Over time, this can lead to malnutrition and potentially result in symptoms such as weakened bones, mood changes, and even miscarriage.

Most people with celiac disease are unaware they have it. Researchers believe that as few as 20% of people with the disease receive the correct diagnosis.

The damage to the intestine is very slow, and symptoms can vary widely from person to person.

Causes

Celiac disease is caused by an abnormal immune system response to gluten.

Genetic Factors:

Environmental Factors:

• Exposure to gluten, a protein found in wheat, barley, rye, and other grains
• Stress on your body and immune system
• Infections
• Trauma
• Surgery
• Pregnancy
• Obesity

Risk Factors

Celiac disease is more common among white people and females. It is also more prevalent in individuals with certain other conditions, including:

• Genetic factors
• Type 1 diabetes
• Lupus
• Thyroid disease
• Addison’s disease
• Down syndrome
• Autoimmune liver disease
• Rheumatoid arthritis
• Turner syndrome
• Intestinal lymphoma
• Intestinal cancer
• Psoriasis
• Scleroderma
• Chronic pancreatitis

Symptoms

Symptoms in Adults:

• Constipation
• Joint pain and stiffness
• Diarrhea
• Weakness
• Iron deficiency anemia
• Skin disorders
• Fatigue
• Headaches
• Depression and anxiety
• Weight loss
• Numbness and tingling in your hands and feet
• Seizures
• Nausea and vomiting
• Irregular menstrual periods
• Infertility
• Pale sores inside your mouth
• Loss of enamel and tooth discoloration

Symptoms in Children: Children with celiac disease may feel tired and irritable, and may experience:

• Abdominal pain
• Weight loss
• Vomiting
• Abdominal bloating
• Persistent diarrhea or constipation
• Pale, fatty, foul-smelling stools

Diagnosis

Diagnosis starts with a physical examination and a review of medical history. Doctors will test the blood for the presence of antibodies commonly found in people with celiac disease: anti-tissue transglutaminase and anti-endomysial antibodies.

They may also order a human leukocyte antigen (HLA) test. HLAs are proteins found on white blood cells, some types of which are associated with celiac disease.

Common Blood Tests:

• Liver function test
• Cholesterol test
• Complete blood count (CBC)
• Alkaline phosphatase level test
• Serum albumin test

Endoscopy and Biopsy: In some cases, a biopsy of the small intestine may be needed to confirm the diagnosis.

Treatment

The most important treatment for celiac disease is adopting a gluten-free diet for life. After a few weeks on the diet, your small intestine should begin to heal, and you will start to feel better.

Celiac Disease Diet: Even small amounts of gluten can be harmful, so you will need to avoid all foods and beverages that contain or are made with wheat, rye, or barley.

• Choose fresh, frozen, or canned fruits and vegetables without breading or sauces.
• Avoid dairy products that contain gluten.
• Choose meat, fish, and poultry without added ingredients, instead of deli meats or sausages.

Celiac Disease Medications: Doctors may also prescribe:

• Vitamin or mineral supplements if you have anemia or serious nutritional deficiencies
• Corticosteroids to treat any inflammation that remains after cutting gluten from your diet or for refractory celiac disease
• Medications such as dapsone to treat the rash that may result from celiac disease

Complications

Untreated celiac disease can cause a variety of complications, including:

• Delayed growth and development in children
• Problems with coordination and balance
• Nerve tingling and numbness
• Learning and attention issues
• Chronic inflammation leading to:
  • Scarring of the intestine
  • Liver disease
  • Autoimmune disorders
  • In rare cases, cancer

Prevention

While there is no cure for celiac disease, you can reduce the risk of complications by:

• Reducing stress
• Eating a gluten-free diet
• Preventing cross-contamination of gluten-free foods
• Reading food labels carefully
• Exercising regularly
• Screening for early signs of the disease
• Maintaining a healthy weight
• Avoiding smoking
• Limiting radiation exposure
• Avoiding spicy or oily foods
• Avoiding excessive iodine intake from foods or supplements