6 Minute Read
Reviewed By: Dr. Natasha Mendez
Celiac disease is a condition that affects about 1% of the population, or roughly two million people. Let's take a deeper look at this condition, including what it is, its symptoms and how you can get diagnosed and treated for it.
What is Celiac Disease?
Celiac disease is an autoimmune disease that occurs when your body reacts to the presence of gluten in your digestive system. Gluten is a protein found in barley, rye and wheat that gives dough its sticky, elastic texture. It’s present in a variety of foods, including breads, baked goods and pasta.
While gluten isn’t harmful to the average person, when it’s consumed by people with celiac disease, it triggers an immune response in which the immune system attacks the lining of the small intestine, causing a range of gastrointestinal symptoms like bloating and constipation. Over time, celiac disease can cause permanent damage to the intestines.
Is Celiac Disease the Same as Gluten Sensitivity or Wheat Allergy?
Celiac disease is different from gluten sensitivity and wheat allergy. Gluten sensitivity, also known as non-celiac gluten sensitivity (NCGS) or gluten intolerance, causes the same symptoms as celiac disease, but it’s a digestive disorder rather than an immune system disorder and doesn’t damage your small intestine.
Like celiac disease, a wheat allergy is an immune system reaction to this grain, causing symptoms that can range from a headache or hives to anaphylaxis, a life-threatening condition that causes swelling and difficulty breathing. But unlike celiac disease, a wheat allergy commonly goes away by the age of 12, while people who have celiac disease don’t outgrow it.
Who Gets Celiac Disease?
Research has found that celiac disease is largely genetic and runs in families. Most people who develop the disease have DQ2 and DQ8 variations in their genes. If you have a close relative with celiac disease, you’re more likely to develop it as well. There is also evidence that consuming large amounts of gluten in childhood can make a person who is genetically predisposed to celiac disease more likely to experience symptoms later in life.
Celiac disease symptoms may start in infancy, childhood, adolescence or adulthood. Research shows that some genetic and chronic health conditions may also raise the risk for celiac disease. These include:
- Type 1 diabetes
- Down syndrome
- William syndrome
- Turner syndrome
- Certain types of thyroid disease
- Addison’s disease
What Are the Symptoms of Celiac Disease?
Symptoms of celiac disease can vary from person to person, and some people don’t experience any symptoms at all — it’s possible to have celiac disease for years and not know it. For these individuals, subtle abnormalities in blood work, like anemia or elevated liver enzymes, may lead to a diagnosis.
In some cases, celiac disease causes obvious digestive symptoms, such as abdominal pain, bloating, constipation, diarrhea and vomiting. In other cases, it can cause less-obvious symptoms such as:
- Anxiety or depression
- Balance problems
- Canker sores
- Dry mouth
- Fatigue or difficulty concentrating
- Fertility problems in men and women
- Headaches
- Irregular menstrual periods
- Joint, bone or nerve pain
Children with celiac disease may grow more slowly or have difficulty putting on weight. In some cases, the disease may delay puberty.
Around two to three percent of children and 20 percent of adults with celiac disease develop a skin rash called dermatitis herpetiformis, or DH, which usually takes the form of blisters that may cause moderate to severe itching. Although DH can occur anywhere on the body, it’s most common on the back, buttocks, elbows, knees and scalp. Usually, the rash goes away on its own with treatments for celiac disease, but in some cases, doctors may prescribe medications for it.
What Are the Long-Term Risks of Celiac Disease?
Without treatment, celiac disease can lead to other health problems, such as:
- Lactose intolerance: Damage to the small intestines associated with celiac disease can lead to an inability to digest lactose, a sugar found in milk and dairy products.
- Nutritional deficiencies: Celiac disease can interfere with the body’s ability to absorb and use nutrients, posing a risk for malnutrition or deficiencies of certain vitamins and minerals.
- Loss of bone density: When celiac disease leads to deficiencies of calcium or vitamin D, bone loss may occur, potentially leading to osteoporosis.
- Cancer: There is some evidence to suggest that uncontrolled celiac disease may increase the risk for cancers that affect the digestive system, such as intestinal lymphoma and small bowel cancer.
Fortunately, managing celiac disease with a treatment plan developed by your doctor can lower the likelihood of these complications.
How Do You Know If You Have Celiac Disease?
Many health conditions can cause symptoms similar to those of celiac disease, and the only way to know for sure what’s causing your symptoms is to get tested. But tests for celiac disease only work if you have been eating gluten — cutting it out of your diet without a diagnosis can backfire, since the disease can cause serious damage to your intestines.
If you think you or someone you love may have celiac disease, gluten insensitivity or a wheat allergy, discuss your concerns with your healthcare provider, who can order screening tests to check for celiac disease. Based on the screening results, your physician may order additional tests, such as a biopsy of the lining of the small intestine.
Since celiac disease has a strong genetic component and may not always cause symptoms, if someone is diagnosed with the condition, the rest of their family should be screened as well.
Treating Celiac Disease
Celiac disease is a chronic, or lifelong, condition, but with the right diagnosis and treatment, those affected can manage their symptoms and live a healthy life. Treatment centers on adopting a strict gluten-free diet — even trace amounts of gluten can damage your intestines, even if you have no symptoms. Since gluten may be present in dietary supplements, prescription and over-the-counter medications, beauty products, toiletries and even items like communion wafers and envelope glue, it’s important to work with your healthcare team to plan a gluten-free lifestyle.
If celiac disease has caused nutritional deficiencies, your doctor may prescribe supplements like copper, folic acid or iron. In cases where the small intestine is severely damaged, medications may be prescribed to control inflammation.
In most cases, a gluten-free diet allows the small intestine to heal. For children, healing may take up to six months, and for adults, it can take a few years. In some cases, the small intestine doesn’t heal, a condition known as refractory celiac disease. Refractory celiac disease requires specialized treatment.
If you think you may have a gluten sensitivity, wheat allergy or celiac disease, talk to your healthcare provider. Celiac disease is a serious condition, but with the right diagnosis and treatment, you can live a long, healthy life. To schedule an appointment with a provider at Broward Health, call 954.832.0332.