Celiac disease is a digestive disease that inhibits the small intestine’s ability to absorb nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is commonly found in wheat, rye and barley. It is most often found in food, although it is also used as a binding agent in some medications and other everyday products.
Celiac disease causes an immune system result that damages the villi. These tiny, fingerlike protrusions line the small intestine and allow nutrients from food to be absorbed into the bloodstream. Without healthy villi, a person becomes malnourished, regardless of the quantity of food eaten.
Since the body’s immune response is responsible for the damage, celiac disease is classified as an autoimmune disorder. It is also considered a malabsorption disease, since it prevents nutrients from being absorbed. Other names for celiac disease include gluten-sensitive enteropathy, celiac sprue and nontropical sprue.
Celiac disease is a genetic disease; most people who have it have at least one blood relative with the disease. The disease often becomes active after pregnancy, childbirth, surgery, viral infection or severe emotional stress.
If you or your child is currently experiencing the symptoms of celiac disease, schedule a consultation with Dr. Tabib today. He is extremely experienced in the detection and treatment of this often misdiagnosed disease.
Symptoms of Celiac Disease
There is no single symptom of celiac disease and it affects each person differently. Symptoms can occur in many parts of the body, not just the digestive system. For example, one person might have diarrhea and abdominal pain, while another person may be irritable or depressed. In fact, irritability is one of the most common symptoms in children.
Symptoms of celiac disease may include one or more of the following conditions:
- recurring abdominal bloating and pain
- chronic diarrhea
- pale, foul-smelling, or fatty stool
- weight loss / weight gain
- muscle cramps
- unexplained anemia (a low count of red blood cells causing fatigue)
- bone or joint pain
- osteoporosis, osteopenia
- tooth discoloration or loss of enamel
- pale sores inside the mouth, called aphthous ulcers
- behavioral changes
- tingling numbness in the legs (from nerve damage)
- itchy skin rash called dermatitis herpetiformis
- missed menstrual periods (often because of excessive weight loss)
- infertility, recurrent miscarriage
- delayed growth
- failure to thrive in infants
Celiac disease is often asymptomatic. However, people without symptoms are still at risk for complications from celiac disease, including malnutrition. The longer it goes undiagnosed and untreated, the greater the chance of malnutrition and other complications. This condition can be extremely serious in children, as malnutrition can cause delayed growth and other development problems.
Researchers are studying the reasons that symptoms of celiac disease vary so widely.The length of time a person is breastfed, the age a person started eating gluten-containing foods, and the amount of gluten-containing foods you eat are three factors thought to play a role in the presentation of celiac. According to studies, the longer a person was breastfed, the later the symptoms of celiac disease appear and the more uncommon the symptoms.
Diagnosis of Celiac Disease
The easiest way to test for celiac disease is through a blood test. Research has shown that people with celiac disease have above average levels of certain autoantibodies in the blood. These protective proteins are usually produced to shield the body from perceived threats. But, in patients with celiac disease, they instead attack their own villi.
Since celiac disease is hereditary, family members, particularly first degree relatives such as parents, siblings or children of people who have been diagnosed may wish to be tested for the disease. About 5 to 15 percent of an affected person’s immediate family will also have the disease. About 3 to 8 percent of people with type 1 diabetes will have biopsy-confirmed celiac disease, and 5 to 10 percent of people with Down syndrome will be diagnosed with celiac disease.
Before testing is performed, you should not alter your diet. Restricting your gluten intake can produce a false negative result in the blood test. In fact, gluten needs to be present in your system in order for your body to produce the offending autoantibodies in most cases.
If the tests and symptoms suggest celiac disease, Dr. Tabib will perform a small bowel biopsy. During the biopsy, he removes a tiny piece of tissue from the small intestine to check for damage to the villi. The sample is taken using a long, thin tube called an endoscope.To get tested, contact us to make an appointment with Dr. Tabib today. Early detection and treatment is the key to avoiding possible complications, including malnutrition, down the road.
Treatment of Celiac Disease
The only treatment currently available for celiac disease is to follow a gluten-free diet. Follow diagnosis, most patients meet with a professional dietician to learn about how to avoid gluten. This may include avoiding certain foods and knowing what to look for on labels, as many processed foods contain gluten.
For most people, the gluten-free diet will stop symptoms, heal existing intestinal damage, and prevent further complications. Most people experience some immediate improvements once they eliminate gluten from their diets. It usually takes 3 to 6 months in children and younger adults and 2 years for older adults to be completely healed, meaning the villi are healthy enough to absorb nutrients from food into the bloodstream.
Complications of Celiac Disease
Malabsorption issues put a patient with celiac disease at risk for malnutrition and anemia, among other health problems.
- Cancer can develop in the intestine, including lymphoma and adenocarcinoma.
- Poor calcium absorption contributes to osteoporosis, which makes the bones weak, brittle and prone to breaking.
- Birth defects and miscarriage are risks for pregnant women with untreated celiac disease.
- Malnutrition can adversely affect a child’s normal growth and development. Children who are diagnosed and treated before their growth stops may have a catch-up period.
- A lack of folic acid causes calcium deposits to form in the brain, which in turn cause seizures.
Dermatitis herpetiformis (DH) is a severe itching, blistering skin condition found in people with celiac disease. The rash usually occurs on the knees, elbows, and buttocks. About 20 percent of people with DH also have intestinal symptoms of celiac disease. Like celiac, DH is diagnosed using a blood test and a biopsy, this time on the patient’s skin. Fortunately, DH improves in response to a gluten-free diet, much like celiac disease.