What is it?
Celiac disease is a digestive disease that damages the small intestine and prevents nutrients in food from being absorbed. People who have this disease cannot tolerate gluten, which is a protein found in wheat, rye, barley, and perhaps oats. If someone with celiac eats something that has gluten, their immune system responds by causing damage to the small intestine. Specifically, tiny finger-like protrusions, called villi, on the lining of the small intestine are lost. Villi are important because they absorb nutrients from food we eat. If someone has no villi, they become malnourished, even though they may eat a great deal of food.
Celiac disease is considered an autoimmune disorder because damage is caused by the body’s immune system. It is also considered a malabsorption disease because nutrients are not absorbed.
Who's at Risk?
Celiac disease is hereditary. First-degree relatives (parents, siblings, children) of those who have been diagnosed with celiac disease should be tested since around 10 percent of their first-degree relatives will also have the disease.
Celiac disease can first occur after having a viral infection, severe emotional stress, surgery, becoming pregnant, or giving birth. Whether a person was breastfed, and if so, how long, may play a role in how and at what age celiac disease develops. The longer someone was breastfed, the longer it takes for disease symptoms to appear – and the more atypical those symptoms are.
Celiac disease affects people differently. One person might have diarrhea and abdominal pain, while another person may be irritable or depressed. (Children most often have irritability.) Some people with celiac disease have no symptoms because the part of the small intestine that is not damaged is still able to absorb enough nutrients to prevent symptoms.
Celiac symptoms may include one or more of the following:
- Behavior changes
- Bone pain
- Chronic diarrhea
- Delayed growth
- Enamel loss or tooth discoloration
- Failure to thrive in infants
- Leg tingling or numbness (from nerve damage)
- Missed menstrual periods (from excessive weight loss)
- Mouth sores
- Muscle cramps
- Painful joints
- Pale, foul-smelling bowel movements
- Skin rash
Diagnosing celiac can be difficult because some of its symptoms mimic those of other diseases, such as Crohn’s disease, chronic fatigue syndrome, depression, irritable bowel syndrome, and ulcerative colitis.
People who have celiac disease have higher than normal levels of certain antibodies in their blood. The immune system produces antibodies in response to substances that are perceived as threatening by the body. Therefore, physicians perform blood tests to measure levels of antibodies to gluten. If the tests and patient symptoms suggest celiac disease, a small tissue sample from the small intestine may be removed to be analyzed for damage to the villi. Biopsy of the small intestine is the best way to diagnose celiac disease.