Celiac Disease Can Harm Digestion
Suppose you or a friend has frequent abdominal distress, bloating, and other symptoms
that seem to puzzle doctors.
Today, experts believe those doctors should consider celiac disease. Also known as
celiac sprue, this illness can cause a range of symptoms and problems. Among them:
diarrhea, constipation, bloating, abdominal pain, fatigue, irritability, infertility
in women, depression, and anemia.
Celiac disease is a digestive disease that damages the small intestine and interferes
with absorption of nutrients from food, according to the National Institute of Diabetes
and Digestive and Kidney Diseases (NIDDK). The culprit in celiac disease is gluten,
a protein found in many grains, including wheat, rye, and barley. When a person with
celiac disease eats gluten, the immune system responds by damaging the villi, the
absorptive surface of the small intestine. This damage makes it difficult for the
body to absorb nutrients the way it should.
In the past, U.S. doctors didn't often look for celiac disease — it was thought to be a rare childhood syndrome. Celiac disease is now known to be
a common genetic disorder that tends to run in families. More than 2 million people
in the U.S., or about 1 in 133, have the disease.
About 5% of the first-degree relatives of a person with celiac disease will also have
the disease. A first-degree relative is a parent, sibling, or child.
Celiac disease can be triggered by surgery, pregnancy, childbirth, a viral infection,
or severe emotional stress, the NIDDK says.
What are the symptoms?
Symptoms occur at different times in different people. Sometimes they appear in childhood,
but for other people, the symptoms appear when they are adults. Symptoms aren't always
in the digestive system, the NIDDK says. Although chronic diarrhea and recurrent abdominal
pain are symptoms, irritability and depression also can be symptoms.
Other symptoms, from the NIDDK:
Recurring abdominal bloating
Pale, foul-smelling stool
Failure to thrive (infants)
Pain in joints
Tingling numbness in legs
Pale sores inside the mouth
Painful skin rash
Missed menstrual periods
How is celiac diagnosed?
Doctors may have difficulty diagnosing celiac disease because its symptoms are similar
to other diseases, the NIDDK says. Diseases that share symptoms with celiac disease
include irritable bowel syndrome, Crohn's disease, ulcerative colitis, diverticulosis,
chronic fatigue syndrome, and depression.
Recent research has found that people with celiac disease have higher than normal
levels of antibodies to endomysium and tissue transglutaminase. Tests can be given
to measure these antibody levels. If the tests and symptoms indicate celiac disease,
your doctor may confirm the diagnosis with a biopsy of the small intestine, to check
for villi damage.
Early diagnosis is important. The longer a person goes undiagnosed and untreated,
the greater the chance of developing malnutrition and other complications, the NIDDK
How is celiac treated?
Gluten does not harm the bowels of those who don't have celiac disease. But if you
have the disease, there's only one treatment: Avoid gluten for life.
For most people, following this diet will halt the symptoms, heal existing villi damage,
and prevent further damage, the NIDDK says. The improvement begins almost immediately
— within days of starting the diet. The small intestine is usually completely healed,
with the villi intact and working normally, in 3 to 6 months. (The healing process
may take up to 2 years for older adults.)
A gluten-free diet bans all foods that contain wheat, rye, or barley. Most grains,
pastas, cereals, and many processed foods fall into that category. You can eat breads
and pastas made with potato, rice, soy, or bean flour, however, the NIDDK says. Gluten-free
foods also are available from specialty food manufacturers. Other foods that are fine
to include are meat, rice, fruits, and vegetables.
You must be cautious about what you buy for lunch at school or work, what you purchase
at the grocery store, what you eat at restaurants or parties, and what you grab for
a snack. According to the NIDDK, U.S. law requires food labels to clearly identify
wheat and other common food allergens in the list of ingredients. For more information,
talk with your health care provider or see a nutritionist who knows about celiac.