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Recurring upset stomach? Battling a bloated gut all too often? Diarrhea affecting daily life? Celiac disease could be the cause. An estimated 2 million people in the U.S. live with this chronic digestive and immune disorder, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Celiac disease is triggered by the protein gluten found in grains such as wheat. The disease sparks an autoimmune response, causing the body to attack nutrient-absorbing structures in the small intestine called villi. Left untreated, this damage can contribute to conditions including:
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Anemia (low red blood cells)
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Fertility issues in women of childbearing age
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Nutritional deficiencies
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Osteoporosis (bone weakness)
For some people, treatment for celiac disease can be simple and effective: adoption of a gluten-free lifestyle. As with any change in routine, going gluten free can be an adjustment, but learning something new is usually well worth the effort when it comes to feeling better. Note that not everyone who goes gluten-free is relieved of all symptoms.
Know the symptoms of celiac disease.
Celiac disease can develop at any age and symptoms can differ from person to person. In general, some common signs to look for include regular bouts of:
Lesser-known celiac disease symptoms can include:
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Brain fog
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Dermatitis herpetiformis—an itchy vascular rash
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Fatigue
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Mental health changes
On rare occasions, a person may have celiac disease without symptoms. This phenomenon is called silent celiac. It’s usually discovered when routine lab testing shows unexplained vitamin deficiencies. Symptoms may eventually appear as the body continues to attack the small intestine.
Talk with your doctor about diagnosis.
Because the signs of celiac disease vary, talk with your doctor to get to the root of any GI concerns. And be sure to discuss symptoms before cutting gluten out of your diet. This way, any diagnostic blood test the provider might suggest will be as accurate as possible.
Related reading: Think You Have Celiac Disease? Don’t Go Gluten-Free Just Yet.
In addition to assessing symptoms, your doctor can talk with you about family history and genetics that could play a role. For example, people with a parent, sibling, or even a child with celiac disease – you may be at higher risk. Also, those with a wheat-heavy heritage—such as those from the the global “Wheat Belt” or with an Italian lineage—may be more susceptible to celiac disease.
If diagnostic testing is the way to go, the first step is a simple blood test to check for antibodies in the blood that indicate a reaction to gluten. The presence of these antibodies could suggest celiac.
The second step is an upper endoscopy. During this safe outpatient procedure, a gastroenterologist slides a slender tube down your throat to take a look at the small intestine. They’ll examine tissue lining the small intestine and take a tiny sample to test for damage.
Gluten sensitivity and celiac disease are different.
If testing rules out celiac disease, a wheat allergy or gluten sensitivity may be to blame for your symptoms. In this case, providers might recommend a gluten challenge—monitoring the grains within your diet and tracking symptoms to pinpoint a connection.
Gluten intolerance, allergies, or sensitivities share many of the same signs and symptoms of celiac disease, however, these conditions don’t damage the small intestine. That injury aspect is the main difference between celiac disease and gluten reactions.
Celiac disease can be managed with a gluten-free diet.
If you’re diagnosed with celiac disease, it’s time to make dietary changes. There’s no medication to treat celiac disease today, but it can be successfully managed with a gluten-free diet. No gluten in the body means no harmful reaction in the gut and no symptom flareups.
Some common gluten-heavy foods to avoid are:
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Bread
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Cake
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Crackers
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Pasta
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Soup
Understanding how to approach a gluten-free diet isn’t something you need to figure out on your own; a registered dietitian can help you tailor a plan that’s works with your life.
Related reading: Celiac Disease: Why Gluten-Free is Still Mission-Critical.
As awareness of celiac disease grows, so do gluten-free food options in grocery stores and restaurants. This empowers patients to continue enjoying foods and the socialization of going out to eat. But, of course, there’s always a risk of cross contamination, especially at a restaurant. We often advise patients to consider cooking at home while getting used to gluten-free eating.
Keep in mind that gluten may be an ingredient in things we consume beyond food, like some vitamins and medications. To help ingest as little gluten as possible, patients can tap into resources like the National Library of Medicine’s database to identify medications with gluten.
We typically re-test for gluten antibodies after three to six months of following a gluten-free diet. Those antibodies usually disappear around six months if a gluten-free lifestyle is in place, which means the small intestine is no longer being injured and symptoms are likely under control.
Talk with your doctor about symptoms.
If you suspect celiac disease is the culprit of unpleasant gut problems, speak with your doctor right away.
Remember you’re not alone if you’re diagnosed with celiac disease. Your family and friends, primary care provider, gastroenterologist, and nutritionist can provide holistic support along your gluten-free journey.
