What is Celiac Disease?
For an excellent overview of Celiac disease and gluten intolerance, I recommend the book Dangerous Grains by James Braly M.D. and Ron Hoggan M.A.
What is Celiac Disease?
In people with Celiac disease, also called Celiac Sprue or gluten intolerance, the body’s immune system responds to the proteins that are referred to as ‘gluten’ in certain grains (wheat, rye, barley, spelt, kamut, triticale. See Foods Containing Gluten) by damaging the lining of the small intestine.
The lining of the small intestine contains small, finger-like growths called villi. The villi absorb nutrients from food, thus if the villi are damaged, the body’s ability to absorb nutrients is compromised.
Diagram of the small instestine including the finger-like villi which are damaged in Celiac disease
Symptoms
Symptoms of Celiac disease vary. Digestive symptoms are more common in infants and young children.
Common Symptoms in Children
- abdominal bloating and pain
- vomiting
- chronic diarrhea
- constipation
- pale, foul-smelling, or fatty stool
- weight loss
- delayed growth
- short stature
- delayed puberty
- dental enamel defects
- irritability
Adults are less likely to have digestive symptoms. Instead they may have one or more of the following, which doctors usually won’t associate with Celiac disease (which leads to misdiagnosis):
Common Symptoms in Adults
- unexplained iron-deficiency anemia
- low vitamin levels – especially iron, calcium and folate
- fatigue
- bone or joint pain
- arthritis
- bone loss or osteoporosis
- depression, anxiety, and mental illnesses like schizophrenia
- tingling numbness in the hands and feet
- seizures
- missed menstrual periods
- infertility or recurrent miscarriage
- frequent canker sores inside the mouth
- an itchy skin rash called dermatitis herpetiformis
Many people with Celiac disease have no apparent symptoms, but the long-term complications of Celiac disease include malnutrition, which can lead to many health problems and diseases. For example, thyroid disease and other autoimmune disorders, osteoporosis, and miscarriage are sometimes the result of the Celiac disease.
People with Celiac disease are also at an increased risk for cancers of the intestine and liver disease.
How Common is Celiac Disease?
1/3 – 1/2 of humans have the genes that can predispose them to Celiac, and approximately 1 out of every 250 people has Celiac disease. The numbers may be as high as 1 in 133 in the US.
The problem is that only 1 out of 10 people with Celiac disease are diagnosed and aware that they have Celiac.
Celiac affects whites more often than non-whites, and females more than males.
How is Celiac Disease Diagnosed?
The standard test for Celiac test is a blood test.
In full blown Celiac disease, a person will have higher than normal levels of certain autoantibodies in their blood. Autoantibodies are proteins that react against the body’s own cells and tissues. To diagnose Celiac disease, the blood is tested for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA).
In order to be tested by blood for Celiac disease, a person needs to be eating gluten. If a person stops eating foods with gluten before the test, the results may be negative even if the disease is present.
Please see Gluten Intolerance Testing: 6 Problems with Standard Tests and 2 Solutions
If blood tests are positive, a biopsy of the small intestine will be performed to confirm the disease. The doctor will remove tiny pieces of tissue from the small intestine to check for villi damage. The procedure is painless because anesthetic is used.
Note: if you live in Canada, you can order the Biocard home testing kit to test your blood for evidence of Celiac
Treatment
Celiac disease often goes untreated for many years because the symptoms of Celiac may not be present or they will seem to be symptoms of other diseases and disorders.
The only treatment for celiac disease is a gluten-free diet.
If gluten is eliminated from the diet, the small intestine will heal and symptoms will lessen or completely disappear. In children healing can be rapid, within 3-6 months, but in adults who have had Celiac for many years and thus may have experienced more damage, healing may take up to 2 years.
In rare cases damage to the villi will continue despite following a strict gluten-free diet. This is called refractory Celiac disease. People with this condition often need to receive nutrients directly into their bloodstream through a vein, or intravenously. Researchers are still evaluating drug treatments for refractory celiac disease.
But the good news is that for the majority of people, a gluten free diet is the solution and cure for the symptoms of Celiac and gluten intolerance. :)