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What is celiac disease?
Celiac disease is a disorder that causes problems in your small intestine when you eat gluten, a protein found in wheat, rye, and barley. Gluten is poison to people who have celiac disease.
What does gluten do to people who have celiac disease?
In people who have celiac disease, gluten causes the immune system to attack the small intestine. This damages the small intestine and keeps your small intestine from taking in nutrients from the foods you eat. When this happens, your body doesn’t get the vitamins, calcium, protein, carbohydrates, fats and other important nutrients it needs. Your body can’t work well without these nutrients.
What are the symptoms of celiac disease?
Celiac disease can cause a wide range of symptoms, symptoms that change, or sometimes no symptoms at all.
Symptoms of celiac disease may include:
- Infants and young children who have celiac disease are more likely to have digestive symptoms, such as abdominal pain, vomiting, diarrhea (even bloody diarrhea) and constipation, and may fail to grow and gain weight. A child may also be irritable, fretful, emotionally withdrawn, or excessively dependent. If the child becomes malnourished, they may have a large tummy, thin thigh muscles, and flat buttocks. Many children who have celiac disease are overweight or obese.
- Teenagers may have digestive symptoms such as diarrhea and constipation. They may hit puberty late and be short. Celiac disease might cause some hair loss (a condition called alopecia areata) or dental problems.
- Adults are less likely to have digestive symptoms. Instead, they might have a general feeling of poor health, including fatigue, bone or joint pain, irritability, anxiety and depression, and missed menstrual periods in women. Some adults may have digestive symptoms such as diarrhea or constipation.
- Osteoporosis (loss of calcium from the bones) and anemia are common in adults who have celiac disease. A symptom of osteoporosis may be nighttime bone pain.
- Lactose intolerance (a problem digesting milk products) is common in patients of all ages who have celiac disease.
- Dermatitis herpetiformis (an itchy, blistery skin problem) and canker sores in the mouth are also common problems in people who have celiac disease.
CAUSES & RISK FACTORS
How did I get celiac disease?
Healthcare providers and researchers don’t know exactly what causes celiac disease. Celiac disease is more common in people who:
- Have a family member with celiac disease. If 1 member of your family has celiac disease, about 1 person out of 10 other members of your family is also likely to have it.
- Have an autoimmune disease, such as type 1 diabetes, rheumatoid arthritis, autoimmune thyroid or liver disease, Addison’s disease, or Sjogren’s syndrome.
- Have a genetic disorder such as Down syndrome or Turner’s syndrome.
If you have celiac disease, you probably won’t know it right away. You may have this disease for a while without getting sick. Then something like severe stress, physical injury, infection, childbirth, or surgery can trigger, or “turn on,” your celiac disease.
DIAGNOSIS & TESTS
How can I be sure I have celiac disease?
Blood tests can help your healthcare provider diagnose this disease. If you think you have celiac disease, contact your healthcare provider. Don’t stop eating gluten before you have a blood test. If you stop eating gluten before your blood test, it can mess up your results.
If your blood test indicates that you might have celiac disease, an intestinal biopsy (taking a small piece of tissue from your small intestine using a thin tube) or the diagnosis of dermatitis herpetiformis (a particular type of skin rash) will confirm that you have celiac disease.
Celiac disease sounds really serious. How can I control it?
Celiac disease is serious. Fortunately you can control celiac disease by following a gluten-free diet, meaning you don’t eat any gluten for the rest of your life. By following the right diet, you can reverse the damage caused by celiac disease and you’ll feel better. But if you “cheat” on your diet, the damage will come back, even if you don’t feel sick right away.
People who follow a gluten-free diet avoid all foods that contain wheat, barley, rye, spelt, and triticale products, including many breads, pastas, cereals and processed foods. Rice, corn, oats, quinoa, buckwheat, and millet do not contain gluten. Some people choose to avoid oats because some oat products can be contaminated with wheat gluten. Gluten also is sometimes used in medicines, so be sure to contact your healthcare provider or pharmacist before taking a new medicine.
Learning to be gluten-free may be difficult at first. It will take time for you and your family to learn how to avoid gluten. You’ll have to learn to read ingredient labels and identify the foods that contain gluten. You’ll have to be careful when you buy foods at the grocery store, or when you eat out. You’ll probably have to learn some new cooking recipes. For help, contact a celiac support group. These groups are excellent sources of information and advice. They’ll help you find gluten-free foods and good recipes, and can give you tips on successfully living with celiac disease.
What resources are there for people with celiac disease?
Many books and websites provide information, tips, and recipes for gluten-free living.
Your local celiac disease support group is a good source of information and support as you transition to gluten-free living.
You may also find it helpful to meet with a registered dietitian. A dietitian can help you learn what foods to avoid, how to read food labels, and how to make healthy substitutions for the foods you can no longer eat. Ask your healthcare provider for help finding a certified registered dietitian in your area.
Can I be sensitive to gluten without having celiac disease?
Yes, you can have gluten sensitivity without the immune system attack on the small intestine that gluten causes in celiac disease. Symptoms of gluten sensitivity are generally milder than those seen in celiac disease, but improve on a gluten-free or gluten-restricted diet. Contact your family healthcare provider to see if your symptoms could be due to gluten sensitivity.
QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER
- My mother had celiac disease. Am I at risk?
- I have celiac disease. Are my children at risk of having it too?
- What are the symptoms of celiac disease, and how are they different from other digestive problems?
- Is celiac disease a sign of another health problem? Does it put me at risk of other health problems?
- Can celiac disease be cured?
- Can you recommend a support group for people with celiac disease?
FOR MORE INFORMATION
Canadian Celiac Association
Toll Free 1-800-363-7296
Detecting Celiac Disease in Your Patients by HT Pruessner, M.D. (03/01/98, http://www.aafp.org/afp/980301ap/pruessn.html )