Celiac disease, also known as gluten-sensitive enteropathy, is an chronic digestive disorder caused by an immune reaction to eating gluten, which is a protein found naturally in wheat, barley and rye.
Celiac disease is sometimes passed down genetically and runs in families. According to the Celiac Disease Foundation, those with a parent, child or sibling with celiac disease have a 10% chance of having the disease themselves. It’s estimated that about 2 million people in the U.S. have celiac disease.
When those with celiac disease eat gluten, the protein triggers an immune response, causing the body’s infection defense mechanisms to attack the small intestine. Over time, this response can cause damage to the villi, which are small, finger-like projections that cover the internal lining of the small intestine and help the body absorb nutrients from food. Once the villi are damaged, it becomes harder for the body to absorb nutrients. This can cause a variety of symptoms and lead to serious complications if left untreated.
There is currently no cure for celiac disease, but symptoms can be reduced and damage to the intestine can often be healed if patients can adhere to a strict, gluten-free diet. This can be difficult, as gluten is found in many of the things we eat and products we use, including bread, pasta, prepackaged foods, cosmetics, personal care items like toothpaste, lipstick and other items.
It’s important to note that celiac disease is different from both wheat allergies and gluten sensitivity, which usually do not cause damage to the small intestine.
Why Hoag for Celiac Disease Diagnosis, Management and Care?
Hoag’s Margolis Family Inflammatory Bowel Disease (IBD) Program provides comprehensive, patient-first diagnosis and care for those living with chronic conditions of the bowel, including celiac disease, ulcerative colitis, Crohn’s disease, lymphocytic colitis, collagenous colitis and pouchitis.
Through a team-based, multidisciplinary approach that strives for whole-patient care, we work to help those with celiac disease find the accurate diagnosis, advanced treatment options and personalized recommendations and dietary advice that can help them return to an active lifestyle with less worry about their digestive health.
Symptoms of Celiac Disease
The symptoms of celiac disease can vary from patient to patient, but usually include digestive issues. Common digestive symptoms for adults include:
- Chronic diarrhea or constipation
- Uncontrolled weight loss due to malnutrition
- Pale, bad-smelling stools
- Bloating and gas
- Recurring abdominal pain
- Nausea and vomiting
Non-digestive symptoms may include:
- Anemia, which can cause fatigue
- Missed menstrual periods related to weight loss
- Loss of bone density or bone softening (AKA osteomalacia)
- Teeth changing color or losing enamel
- Bone pain, joint pain and muscle cramps
- Mouth ulcers
- Injury to the nervous system, which can cause:
- numbness and tingling in the feet and hands
- balance problems
- cognitive issues
- An itchy, painful skin rash (AKA dermatitis herpetiformis or DH)
Causes of Celiac Disease
Celiac disease is caused by a combination of genetics and eating foods containing gluten. When a person with celiac disease eats gluten, their immune system can attack the small intestine, damaging tiny projections called villi that line the small intestine and absorb nutrients. The exact cause of why some people who carry the gene for the condition develop symptomatic celiac disease while others do not is unknown.
While some people exhibit the symptoms of celiac disease as soon as they begin eating gluten-containing foods as infants, others only develop symptoms in adulthood. Some may have celiac disease and not know it because they don’t have any symptoms at all. Symptoms of celiac disease can be triggered by certain events, including infection, pregnancy, surgery, childbirth or severe emotional stress.
How is Celiac Disease Diagnosed?
Celiac disease can be difficult to diagnose because its symptoms can mimic those of several other gastrointestinal disorders, including:
If you visit the doctor with symptoms that might suggest celiac disease, your physician will likely talk to you about your medical history, including any relatives who might have celiac disease, and the symptoms you’re experiencing, followed by a thorough physical exam.
Depending on the outcome of the physical exam, you may be asked to submit to more tests, including:
- Blood work, to check for high levels of infection-fighting antibodies in your blood due to an overreaction by the immune system
- Biopsy, in which a small tissue sample is taken from the small intestine to be examined in a lab for damage to the villi. This is usually done via endoscopy, in which a long, flexible instrument called an endoscope is passed down the throat, through the stomach and into the small intestine.
Management and Treatment Options for Celiac Disease
There is currently no cure for celiac disease, but most people can manage their symptoms and heal damage to their intestine by following a strict gluten-free diet for the rest of their lives.
Next-Generation Treatment, Surveillance and Management Options for Chronic Bowel Disorders at Hoag.
Hoag is committed to offering the latest and most promising treatment and management options for those facing chronic issues involving the GI tract. Among the advanced techniques available at Hoag:
- Anorectal manometry (ARM)
- Capsule study
- Endoscopic ultrasound (EUS)
- Esophagogastroduodenoscopy (EGD)
- Single balloon enteroscopy
- Infusion Services
Ways to Reduce Your Risk of Developing Celiac Disease Symptoms
Celiac disease is a genetic condition that’s passed down through families, so there’s no known way to prevent yourself from developing the condition if you have a genetic predisposition to it. However, you can reduce your risk of developing symptoms by maintaining a healthy, balanced diet and strictly avoiding gluten.
As gluten can be found in unexpected places like condiments, certain cosmetics, toothpaste and more, you might be referred to a dietician who specializes in helping those with celiac disease avoid gluten.