Celiac disease is an immune reaction triggered by eating gluten (a protein found in barely, rye, and wheat).
For those with celiac disease, consuming gluten generates an immune response in your small intestine. This reaction damages the lining of your small intestine over time and prevents absorption of some nutrients – a condition called malabsorption. The intestinal damage often causes diarrhea, weight loss, fatigue, bloating and anemia, and can lead to severe health complications.
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Celiac disease has no cure, but for most people, observing a strict gluten-free diet can help manage symptoms and promote intestinal healing.
Symptoms of Celiac disease
The signs and symptoms of celiac disease can vary greatly and are different in children and adults. The most common signs for adults are:
Other symptoms not related to
- Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
- Anemia, usually resulting from iron deficiency
- Itchy, blistery skin rash (dermatitis herpetiformis)
- Damage to dental enamel
- Mouth ulcers
- Headaches and fatigue
- Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment
- Joint pain
- Reduced functioning of the spleen (hyposplenism)
- Acid reflux and heartburn
Symptoms in Children
In children under 2 years old, signs and symptoms of celiac disease include:
- Poor appetite
- Swollen belly
- Failure to thrive
- Muscle wasting
Older children may experience:
- Weight loss
- Short stature
- Delayed puberty
- Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination and seizures
When to see a doctor
A person should seek medical attention if they have diarrhea or digestive discomfort that lasts for more than two weeks. Consult your child’s doctor if your child is pale, irritable or failing to grow or has a potbelly and foul-smelling, bulky stools.
Consult your doctor before trying a gluten-free diet. If you stop or even reduce the amount of gluten you eat before you’re tested for celiac disease, you may change the test results.
Causes of Celiac disease
Celiac disease run in families. If someone in your family has the condition, endeavor to get tested. Celiac disease occurs from an interaction between genes, eating foods with gluten and other environmental factors, but the exact cause isn’t known. In some cases, Infant feeding practices, gastrointestinal infections and gut bacteria might contribute to developing celiac disease.
In some cases too, celiac disease becomes active for the first time after surgery, pregnancy, childbirth, or viral infection.
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When the immune system of the body overreacts to gluten in food, the reaction causes damage to the tiny, hair-like projections called villi that line the small intestine. Villi absorb vitamins, minerals and other nutrients from the food you eat. If your villi are impaired, you can’t get enough nutrients, even when you eat excessively.
Celiac disease can affect anyone. However, it tends to be more common in people who have:
- Type 1 diabetes
- A family member with celiac disease
- Rheumatoid arthritis
- Down syndrome or Turner syndrome
- Addison’s disease
- Autoimmune thyroid disease
- Microscopic colitis (lymphocytic or collagenous colitis)
If left untreated, celiac disease can result to:
- This may occur if your small intestine is unable to absorb enough nutrients. Malnutrition can lead to anemia and weight loss, it can cause slow growth in children.
- Untreated celiac disease can result to intestinal lymphoma and small bowel cancer in people who don’t maintain a gluten-free diet.
- Loss of calcium and bone density.Malabsorption of calcium and vitamin D may lead to a softening of the bone in children and a loss of bone density (osteoporosis) in adults.
- Infertility and miscarriage.Malabsorption of calcium and vitamin D can lead to infertility.
- Lactose intolerance.After consuming dairy products containing lactose, it can cause damage to your small intestine, leading to diarrhea and abdominal pain. However, some people continue to experience lactose intolerance in spite of successful management of celiac disease.
- Neurological problems.Some people with celiac disease may develop seizures or peripheral neuropathy.
Celiac disease in children can lead to delayed puberty, weight loss, anemia, epilepsy, arthritis, and irritability.
Nonresponsive celiac disease
Some people with celiac disease may not have a good response to a gluten-free diet. This condition, known as nonresponsive celiac disease, is often due to contamination of the diet with gluten. Therefore it’s important to work with a dietitian.
Refractory celiac disease
This form of celiac disease is rare, it occurs when the intestinal injury of celiac disease persists and leads to considerable malabsorption, even though you have observed a strict gluten-free diet. This combination is known as refractory celiac disease.
Doctors may order two blood tests to help diagnose celiac disease.
- Serology testingto check for antibodies in your blood. High levels of certain antibody proteins indicate an immune response to gluten.
- Genetic testingleukocyte antigens can be used to rule out celiac disease.
If the results of these tests indicate celiac disease, your doctor may order an endoscopy to view your small intestine and to take a small tissue sample to examine for damage to the villi.
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The only way to manage celiac disease is to be on strict, lifelong gluten-free diet. Foods that contain gluten include: wheat, rye, bulgur, durum, barely, semolina, farina, malt, and graham flour.
Your doctor may refer you to a dietitian, who can help you plan a healthy gluten-free diet.
Vitamin and mineral supplements
Your doctor or dietitian may recommend taking vitamin and mineral supplements if your nutritional deficiencies are severe. Supplements you may need include; calcium, folate, zinc, iron, vitamin B-12, vitamin D, and vitamin K
Vitamins and supplements are usually taken in pill form. If your digestive tract has trouble absorbing vitamins, your doctor may give them by injection.
Lifestyle and home remedies
You’ll need to avoid all foods that contain gluten. Here are foods that contain gluten and gluten-free foods that are considered safe to eat.
Always avoid foods and drinks that contains: barely, wheat, bulgur, farina, rye, malt, semolina, durum, graham flour, rye, and triticale.
Many basic foods are allowed in a gluten-free diet, including:
- fresh meats, fish and poultry that aren’t breaded, batter-coated or marinated
- most dairy products
- Wine and distilled liquors, ciders and spirits
Grains and starches allowed in a gluten-free diet include: corn, rice, cornmeal, quinoa, tapioca, amaranth, arrowroot, buckwheat, pure corn tortillas, gluten-free flours like corn, soy, potato, bean, and rice.