Celiac Disease

What is celiac disease?
For people with celiac disease, eating foods containing gluten causes damage to the lining of the small intestine. Gluten is a very common protein found in wheat, rye, and barley. The small intestine normally has many “finger-like” projections called villi where nutrients from food are absorbed into the body. When a person with celiac disease eats gluten, these villi are blunted or cut off. The body is then not able to absorb nutrients properly. This may lead to malnutrition.

Celiac disease is relatively common, especially in certain populations. It has a genetic component and can be seen in different members of the same family.

What are the symptoms of celiac disease?
The symptoms of celiac disease vary. The more “classic” signs include diarrhea, difficulty gaining weight or weight loss, abdominal pain or bloating, or other signs of malnutrition. There may also be signs in areas of the body other than the stomach and intestines. Since screening tests have become available, more people have been diagnosed without “classic” symptoms.

How is it diagnosed?
Blood tests can be used to screen for celiac disease and to monitor the results of a gluten-free diet. Results of the blood tests can vary, so your doctor will help interpret the findings. Since treatment requires a life-long dietary change, the diagnosis is not made from the blood tests alone but from an intestinal biopsy using an endoscope. During this procedure, a small tube is passed through the mouth and stomach, and then into the small intestine. Biopsies, or small scrapings of tissue, are removed from the small intestine and sent to a lab where they are examined under the microscope to see if the villi are damaged.

How is celiac disease treated?
The only treatment for celiac disease is a gluten-free diet. By following a strict gluten-free diet, the villi in the lining of the intestine will return to normal and will work properly to absorb nutrients. Since gluten is present in so many foods this diet can be challenging; however, it is also extremely effective in preventing problems associated with celiac disease.

What are the complications of celiac disease?
Short term, celiac disease may significantly affect childhood growth and development. Problems seen with malnutrition, such as anemia (low iron in the blood), can affect people of all ages. Long-term complications include osteoporosis (weakening of the bones), seizures and cancers of the intestine. Miscarriage or birth defects may be more common in women with untreated celiac disease.
Long-term, we suggest periodic monitoring of blood tests. High levels may indicate that gluten remains undetected in the diet. We also suggest periodic testing for signs of malnutrition.