Suppose you or a friend has frequent belly (abdominal) distress, bloating, and other symptoms that seem to puzzle healthcare providers.
Today, experts believe those healthcare providers should consider celiac disease. Also known as celiac sprue, this illness can cause a range of symptoms and problems.
Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. The culprit in celiac disease is gluten. This is a protein found in many grains, including wheat, rye, and barley. When a person with celiac disease eats gluten, the immune system responds by damaging the villi. This is the absorptive surface of the small intestine. This damage makes it difficult for the body to absorb nutrients the way it should.
In the past, healthcare providers didn’t often look for celiac disease. It was thought to be a rare childhood syndrome. Celiac disease is now known to be a common genetic disorder that tends to run in families. About 1 in 133 people have the disease.
About 1 in 20 first-degree relatives of a person with celiac disease will also have the disease. A first-degree relative is a parent, sibling, or child. Celiac disease is also seen more often in people with other health problems such as thyroid disease, Down syndrome, and irritable bowel syndrome.
Celiac disease can be triggered by surgery, pregnancy, childbirth, a viral infection, or severe emotional stress.
Symptoms happen at different times in different people. Sometimes they appear in childhood. But for other people, the symptoms appear when they are adults. And the symptoms aren’t always in the digestive system. Long-term or chronic diarrhea and recurrent abdominal pain are symptoms. But so are irritability and depression.
Other symptoms include:
Failure to thrive, in infants
Extreme tiredness (fatigue)
Missed menstrual periods
Pale, bad-smelling stool
Pale sores inside the mouth
Pain in joints
Painful skin rash
Recurring abdominal bloating
Tingling numbness in legs
Healthcare providers may have trouble diagnosing celiac disease because its symptoms are similar to other diseases. Diseases that share symptoms with celiac disease include irritable bowel syndrome, Crohn’s disease, ulcerative colitis, diverticulosis, chronic fatigue syndrome, and depression.
Recent research has found that people with celiac disease have higher than normal levels of certain antibodies. Tests can be given to measure these antibody levels. If the tests and symptoms point to celiac disease, your healthcare provider may confirm the diagnosis with a biopsy of the small intestine to check for villi damage.
Early diagnosis is important. The longer a person goes undiagnosed and untreated, the greater the chance of developing malnutrition and other problems.
First-degree relatives of people with celiac disease should speak with their healthcare provider about getting tested. A first-degree relative is a parent, sibling, or child. The condition is also more common in people with type 1 diabetes and Down syndrome.
Gluten does not harm the bowels of those who don't have celiac disease. But if you have the disease, there’s only one treatment: Don't eat any gluten for life.
For most people, following this diet will stop the symptoms, heal existing villi damage, and prevent further damage. The improvement begins almost immediately—within days of starting the diet. The small intestine is often completely healed, with the villi intact and working normally, in 3 to 6 months. The healing process may take up to 2 years for older adults.
A gluten-free diet bans all foods that contain wheat, rye, or barley. Most grains, pastas, cereals, and many processed foods fall into that category. You can eat breads and pastas made with potato, rice, soy, or bean flour. Gluten-free foods also are available from specialty food manufacturers. Other foods that are fine to include are meat, rice, fruits, and vegetables. Oats are fine as long as they aren’t contaminated with gluten, as some are.
You must be careful about:
What you buy for lunch at school or work
What you buy at the grocery store
What you eat at restaurants or parties
What you grab for a snack
U.S. law requires food labels to clearly identify wheat and other common food allergens in the list of ingredients. For more information, talk with your healthcare provider or see a nutritionist who knows about celiac.