What is the celiac disease?
The gluten free diet has rapidly gained popularity over the last few decades but for most people it’s more than just a fad diet – it is a medical necessity. Celiac disease affects roughly 1 in 100 people worldwide including 2.5 million Americans. It is a hereditary condition that can manifest at any time and comes with a long list of potential symptoms which can make it difficult to diagnose.
Because celiac disease is tricky to diagnose, many people go untreated for years, or even decades. Over time, the disease causes damage to the small intestine, interfering with digestion and the absorption of nutrients which causes malnutrition and a long list of symptoms.
Celiac disease is a very manageable disease, but left untreated, it can have detrimental effects on the body. Read on to learn what causes celiac disease, the symptoms, and how it is diagnosed and treated.
What is Gluten, Anyway?
Gluten has become a buzz word in health and fitness communities. Due to its negative connection with celiac disease, many assume it should be avoided by everyone at all costs. However, it isn’t inherently bad. It’s simply a type of protein found in wheat, rye, barley, and triticale. Gluten is the substance that helps bind foods together and give them their shape – it’s what gives bread its elastic, spongy texture.
Though it is easy to identify sources of gluten that come from whole grains like wheat and barley, there are many hidden sources as well. Oats, for example, are often processed on shared equipment with gluten-containing grains and flour is used in many commercial foods. Even foods like soy sauce, imitation crab meat, and blue cheese can be hidden sources of gluten.
What Are the Symptoms of Celiac Disease?
When a person with celiac disease consumes gluten, their body identifies the protein as a foreign invader and mounts an immune response against it. During the response, toxins are created that damage the sensitive villi lining the small intestine. The villi play a major role in nutrient absorption so, when they are damaged, the body can’t properly absorb nutrients. Over time, malnutrition and other side effects of the autoimmune response produce symptoms.
Some of the most common symptoms of celiac disease include:
- Weight loss
- Chronic fatigue
- Gas and bloating
- Abdominal pain
- Nausea and vomiting
Though many symptoms related to celiac disease are digestive in nature, just as many aren’t. In fact, more than half of all adults with celiac disease display symptoms unrelated to the digestive system.
Here are some examples:
- Anemia, from iron deficiency
- Osteoporosis or loss of bone density
- Itchy, blistering skin rashes (dermatitis herpetiformis)
- Mouth ulcers
- Nervous system issues
- Joint pain
- Brain fog or confusion
Symptoms of celiac disease can also be different in children. Digestive problems like nausea, vomiting, diarrhea, constipation, and gas are most common in children. Long-term malnutrition can lead to additional symptoms like failure to thrive, weight loss, damage to the tooth enamel, stunted growth, delayed puberty, and even neurological symptoms.
How is it Diagnosed?
Celiac disease comes with a long list of potential symptoms and its underlying is cause (aside from being triggered by gluten consumption) is still up for debate. These factors make it difficult to diagnose the disease, but they aren’t the only challenges.
The road to diagnosing celiac disease begins with a physical examination and medical history. Symptoms will help your doctor rule out other potential conditions, but further testing is required to confirm a celiac disease diagnosis. Blood tests can help detect elevated levels of antiendomysium (EMA) and anti-tissue transglutaminase (tTGA) antibodies, but they are more reliable when gluten is still in the diet. If the blood tests are positive or inconclusive, an endoscopy can be performed to examine the small intestine for signs of damage to the villi.
As a hereditary autoimmune disease, celiac disease tends to run in families. People with a first-degree relative with celiac disease have a 1-in-10 chance of developing it themselves. Other risk factors for celiac disease include people with certain genetic disorders and those with other autoimmune diseases like lupus, rheumatoid arthritis, type 1 diabetes, Addison’s disease, and thyroid disease.
What Are the Treatment Options?
Because celiac disease is triggered by gluten consumption, the only treatment is to remove gluten from the diet entirely. Removing gluten will reduce the immune response damaging your small intestine and will give the villi time to heal. Eventually, you’ll be able to start digesting food and absorbing nutrients properly. In many cases, symptoms improve within days of starting the gluten-free diet, but it is important not to start the diet until the diagnosis has been confirmed and you’re sure you don’t require additional testing.
Once you’ve started the gluten free diet, you must stick to it if you hope to resolve your celiac disease symptoms and remain symptom-free. It can be tempted to “cheat” once in a while, thinking it won’t do you any harm, but it very well could. Each time you consume gluten, you set off an inflammatory reaction in your body that damages the villi in your intestine. It can take months for the villi to really heal and even one cheat day could compromise your recovery.
If you find yourself wondering whether you have some kind of gluten sensitivity, it’s worth asking your doctor to rule out underlying causes or to perform further testing.