Celiac Disease

OVERVIEW - WHAT IS CELIAC DISEASE?

 Also referred to as celiac sprue, a celiac disease definition is when a person’s immune system reacts negatively to consuming gluten, commonly found in wheat, rye, and barley.

A person with celiac disease will have difficulty absorbing vital nutrients because the consumption of gluten triggers a response within their small intestine, often causing diarrhea. After a while, the lining in the small intestine could be damaged, preventing the nutrients from being absorbed. This leads to malabsorption.

In addition to the discomfort of the disease, it can also have a negative impact on growth and development in children. Other complications will be discussed later in the article.

COMMON SYMPTOMS OF CELIAC DISEASE

While the symptoms can vary between people, the most common symptoms are easy to spot. Digestive symptoms could include the following:

• Diarrhea
• Bloating and Gas
• Abdominal Pain
• Constipation
• Nausea and Vomiting

Other common and non-digestive symptoms may include:

• Weight Loss
• Fatigue
• Iron-Deficiency Anemia
• Celiac Disease Rash
• Osteoporosis or Osteomalacia
• Headaches
• Mouth Ulcers
• Joint Pain

The nervous system could also be affected. So, you might experience a loss of balance, tingling in the hands and feet, and cognitive impairment.

And, “celiac eyes” is a term used when people with celiac disease also have Sjogren’s syndrome, a condition that dries out the eyes and mouth. 

WHAT CAUSES CELIAC DISEASE?

 Even though the exact cause is unknown, a person’s genes combined with a high gluten diet are thought to be contributing factors to the disease. Other celiac disease causes could include excessive gut bacteria, gastrointestinal infections, surgeries, pregnancies, severe long-term stress, and viral infections.

If the immune system overreacts to gluten, the villi (small hair-like projections) found in the small intestines can be damaged. Villi helps to absorb nutrients from foods that are consumed. But, if the villi is damaged, they can’t grab onto the nutrients and this will lead to malabsorption.

Celiac disease seems to be more common in people who have the following:

• Down Syndrome
• Addison’s Disease
• Microscopic Colitis
• Type 1 Diabetes
• Autoimmune Thyroid Disease

It also tends to be hereditary. If you have any of the above conditions or diseases, and have some of the symptoms, you should consult a physician regarding a possible celiac disease diagnosis.

HOW IS CELIAC DISEASE DIAGNOSED?

 The majority of people don’t know they have celiac disease. But, if you consistently have the symptoms, your doctor will help determine if you have the disease.

One of the two available blood tests is a good place to start. Those blood tests are:

• Serology testing will search for certain antibodies within the blood. When the antibody proteins are elevated, it’s an indicator of an unfavorable reaction to gluten.
• Genetic testing can look for human leukocyte antigens, which can help rule out the disease.

However, testing should be done before you make changes to your diet. If you remove gluten prior to testing, the test won’t reflect celiac disease, even if you have it.

If either of these blood test results indicate the possibility of celiac disease, an endoscopy or capsule endoscopy will most likely be ordered for confirmation.

POSSIBLE COMPLICATIONS FROM UNCONTROLLED CELIAC DISEASE

There are a few serious complications that can arise when celiac disease is not controlled. Some of these include: 

• Weakened Bones - If your body is unable to absorb vitamin D and calcium, it could lead to rickets or osteomalacia. This will result in softening of the bones in children, and bone disease such as osteoporosis in adults.
• Malnutrition - If your small intestine is not absorbing necessary nutrients, it can lead to malnutrition, unwanted weight loss, and anemia. Malnutrition in adolescents could cause slow growth.
• Issues with Reproduction - Miscarriages and infertility are common problems that come with malabsorption of both vitamin D and calcium.
• Attack on the Nervous  System - Problems with the nervous system, such as seizures are sometimes linked to celiac disease. Neuropathy is another disease of the nervous system that has been discovered in people with celiac disease.
• Lactose Intolerance - Ongoing celiac disease, without attempts to control it, can lead to lactose intolerance. This means that if there is damage to the small intestine, you could develop abdominal pain and diarrhea after consuming dairy products that contains lactose. It’s possible to reverse this if you follow a reasonable celiac diet and allow your intestine to heal.
• Cancer - If you have celiac disease and don’t remove gluten from your diet, the risk of cancer increases, for several types of cancer such as small bowel cancer or intestinal lymphoma.

Even though the risks and complications can be severe, the good news is that your risk significantly decreases if you follow a celiac diet.

WHAT FOODS TRIGGER CELIAC DISEASE?

Even though there is no cure, a celiac disease diet will help manage the symptoms. Avoiding gluten as much as possible will help relieve symptoms. Foods with gluten that will trigger celiac Include:

• Wheat
• Rye
• Barley
• Bulgur
• Malt
• Semolina
• Triticale
• Spelt
• Farina
• Graham Flour
• Durum

Because these foods can be found within other foods, as well as non-foods such as medications, toothpaste, and even glue on an envelope, it can be overwhelming to start a gluten-free diet on your own. A dietician is trained to help with specialized diets.

You will likely be placed on supplements to help with nutritional deficiencies. These might include:

• Vitamins B-12, D, and K
• Folate
• Zinc
• Iron
• Copper

If you have not been tested, but have the symptoms, make sure to talk to your doctor about your concerns. As mentioned above, celiac disease can lead to a lot of unnecessary damage if not treated with proper diet.

Once you adjust your lifestyle to a Gluten free diet and take supplements recommended by your physician, your digestive system should start to recover to some normalcy. This would include the ability to absorb much needed nutrients once again. It could take up to a few weeks to see real significant improvement. But, many people notice a positive difference in just a few days.