Celiac Disease: An Introduction

Reviewed by Jill Kohn, MS, RDN, LDN
Gluten-free and Celiac Disease

In the United States, approximately 1 in 141 individuals is diagnosed with celiac disease — a lifelong condition — which damages the lining of the small intestine and prevents it from absorbing parts of food that are important for health. The damage is due to a reaction from eating gluten, a protein found in wheat, barley, rye and possibly oats. The lining of the intestines contains areas called villi, which help absorb nutrients. When people with celiac disease eat foods or products that contain gluten, their immune system reacts by creating substances that cause damage to the villi. This results in an inability of the body to absorb nutrients properly. Individuals then become malnourished despite how much food they may eat.

Celiac disease can develop at any point in life, from infancy to late adulthood, with more women than men being diagnosed. And, interestingly, 83 percent of those with celiac disease have not been diagnosed, partly because there are many symptoms that vary from person to person. For example, one person may have constipation, the second may have diarrhea and a third may have no trouble at all with stools.

Risk and Symptoms

The risk of developing celiac disease is greater for people who have a family member with celiac disease. More common in Caucasians and people of European ancestry, people with celiac disease may experience any or all of the following gastrointestinal symptoms, including abdominal pain, bloating, gas or indigestion, constipation, decreased appetite (may also be increased or unchanged), diarrhea, lactose intolerance, nausea and vomiting, abnormal stools (floating, foul-smelling, bloody or "fatty") and unexplained weight loss (although people can be overweight or normal weight).

Additional symptoms may start over time and may include bruising easily, depression or anxiety, fatigue, growth delay in children, hair loss, itchy skin (dermatitis herpetiformis), missed menstrual periods, mouth ulcers, muscle cramps and joint pain, nosebleeds, seizures, tingling or numbness in the hands or feet and unexplained short height.

Children with celiac disease may have defects in tooth enamel and changes in tooth color, delayed puberty, diarrhea, constipation, fatty or foul-smelling stools, nausea or vomiting, irritable and fussy behavior, poor weight gain and slowed growth or shorter than normal height for their age.

Diagnosis

The diagnosis of celiac disease requires a physician to assess symptoms, medical history and perform an exam. If celiac disease is suspected, blood and biopsy tests will be done to confirm the diagnosis.

Some individuals are sensitive or intolerant to gluten, but do not have celiac disease. Symptoms include, but are not limited to, abdominal pain and bloating, diarrhea, joint pain, reflux, bloating and fatigue. Unlike celiac disease, gluten sensitivity does not cause atrophy, or deterioration, of the intestinal villi.

A gluten-free diet is the primary treatment for celiac disease and gluten sensitivity. Help from a registered dietitian nutritionist can ensure the dietary changes you make will be successful.

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