What's Celiac Disease?

Celiac disease (CD) is also referred to as gluten sensitive enteropathy, gluten intolerance or celiac sprue. It is considered to be the most under-diagnosed common disease today, potentially affecting 1 in every 133 people in the USA. It is a chronic, inherited disease, and if untreated can ultimately lead to malnutrition.

Gluten intolerance is the result of an immune-mediated response to the ingestion of gluten (from wheat, rye, barley) that damages the small intestine. Nutrients are then quickly passes through the small intestine, rather than being absorbed.

To develop Celiac disease these three things must be present:

1. You must inherit the gene

2. You must consume gluten

3. You must have the gene triggered.

The disease is permanent and damage to the small intestine will occur every time you consume gluten, regardless if symptoms are present at the time.

Symptoms

Celiac disease was once thought of as a disease with only GI symptoms. It is now recognized that the disease is a multi-symptom (organ) disease. More often it presents with symptoms that can mimic other problems in the body.

Most physicians recognize the classic symptoms of celiac disease  as diarrhea, bloating, weight loss, anemia, chronic fatigue, weakness, bone pain and muscle cramps. Physicians may not be aware that celiac disease frequently presents with other symptoms that do not involve the small intestine.

Typically, 50% of patients who are diagnosed with celiac disease do not present with diarrhea. More often symptoms can include constipation, constipation alternating with diarrhea, or premature osteoporosis.

Overweight individuals may also have undiagnosed celiac disease. Children may have the disease and present with a variety of symptoms. On average patients experience symptoms 11 years before being diagnosed with celiac disease.

Green, PHR et al. Characteristics of Adult Celiac Disease in the USA: Results of a National Survey, Am J Gastroenterology. 2001;96(1):126-131).

Diagnosis

Initial screening for celiac disease is a blood test (serology) taken by your physician and sent to a lab for processing. In addition to a celiac panel a small intestine tissue biopsy may be preformed by a gastroenterologist. There are also celiac genetic tests available which help to identify celiac disease and stratify risk.

Treatment

If you are diagnosed with celiac disease strict adherence to a gluten free diet for life is the only treatment currently available. This involves the elimination of wheat, rye, barley and derivatives of these grains from your diet.