What Is Celiac Disease?

Medical illustration showing intestinal damage caused by Celiac disease. When people with celiac disease ingest gluten, their immune system responds by attacking the small intestine. Within the lining of the small intestines are villi, which help absorb nutrients. When these become damaged from an immune attack, the body cannot properly take in nutrients. This can lead to nutritional deficiencies and other serious health problems.

Celiac disease is an autoimmune disorder that can develop at any point in life, from infancy to adulthood. It’s different from gluten intolerance, which is a sensitivity to foods with gluten. Celiac disease and gluten intolerance symptoms may both involve digestive discomfort, such as bloating or diarrhea. However, gluten sensitivity won’t cause your body to attack itself.

If you have celiac disease, it’s important to eat a gluten-free diet and avoid accidental ingestion of foods or products with gluten. Gluten is a type of protein commonly found in grains, such as wheat, barley, rye, and, sometimes, oats. Sometimes it’s also an unexpected added ingredient in certain medications and makeup. Eliminating gluten will improve your symptoms and lower your risk of additional health complications.

Click to enlarge illustration

Celiac disease signs and symptoms

Celiac disease symptoms can be different for each person, which makes diagnosing the chronic condition very complicated. These may include gastrointestinal changes, such as:

Abdominal pain
Anemia
Bloating
Gas
Indigestion
Changes in appetite
Lactose intolerance
Diarrhea, constipation, fatty or foul-smelling stools
Nausea or vomiting
Unexplained weight loss (although people can be overweight or of normal weight)

Because the intestines do not absorb enough vitamins, minerals, and other nutrients, the following symptoms of malnutrition may appear over time:

Bruising easily
Depression or anxiety
Fatigue
Hair loss
Itchy skin
Missed menstrual periods

What are the signs of celiac disease in children?

Children with celiac disease may have many of the same general symptoms that adults with celiac disease have. In addition, children and adolescents may experience:

Defects in the tooth enamel and changes in tooth color
Delayed puberty
Irritable and fussy behavior
Poor weight gain
Slowed growth and shorter-than-normal height for their age

Risk factors and celiac disease causes

Celiac disease is an inherited disorder, which means a parent can pass down certain gene changes that predispose someone to the condition. Other factors can cause celiac disease, which is triggered by eating gluten.

Diagnosis

It can be tempting to begin eliminating gluten from your diet before an official diagnosis, but doing so can affect testing for the disease. We want to see how gluten affects your body so we can accurately diagnose your condition and recommend the appropriate next steps for healing. As a result, it’s important to seek care before starting a gluten-free lifestyle.

Celiac disease shares similar symptoms with inflammatory bowel diseases, so it’s important to get a thorough evaluation from an experienced gastroenterologist. Blood tests can detect celiac disease antibodies, indicating that your immune system is reacting to gluten and may cause damage to the small intestines. If these tests are positive, your provider may also perform an upper endoscopy. This outpatient test allows your doctor to visualize the inside of the small intestine and take a small tissue sample, or biopsy, for further analysis.

Celiac disease treatment

The best celiac disease treatment is to completely remove gluten from your diet. This allows your body and your small intestine to heal so that it can properly absorb nutrients. While you may notice improved symptoms within a few days of eating gluten-free, it’s important to stick with your diet changes long-term. It can take several months or longer for your digestive system to normalize. Just one accidental gluten contamination can trigger an immune response that causes damage. Untreated inflammation may increase your risk of small bowel cancer, so it’s important to avoid gluten, whenever possible.

Foods to avoid with celiac disease

We often recommend our patients meet with a dietitian. Someone trained in nutrition can help you understand what foods you should avoid, how to read ingredients on labels, and where you can find gluten-free alternatives.

Unless it is labeled “gluten-free,” gluten is commonly found in the following products which should be avoided:

Beer
Bread
Cakes
Cereal
Cookies
Crackers
Dressings and sauces
Oats
Pastas
Soups

Fortunately, many stores now carry “gluten-free” products, labeled prominently for convenience. Eating gluten-free may seem challenging at first, but over time it will become second nature.