Celiac disease is an inherited autoimmune disorder that causes a reaction in your body to the protein, gluten. Gluten in your digestive system triggers your immune system to produce antibodies against it. These antibodies damage the lining of your small intestine (the mucosa). Damage to the mucosa in your small intestine impairs its ability to absorb nutrients from your food, causing nutritional deficiencies.
Gluten is a protein found in grains — particularly wheat, barley and rye. These grains, especially wheat, make up many of the staple foods of the standard Western diet, from breads and cereals to pasta and baked goods. Besides that, gluten often appears as an additive in food products where you wouldn’t expect to find it, such as sauces, soups and packaged foods. Beer is usually made from barley or rye.
What are the symptoms of celiac disease?
Symptoms of celiac disease vary widely among people, which can make it hard to recognize. Some people don’t notice any symptoms at all. Some experience indigestion and other gastrointestinal (GI) symptoms after eating gluten. Some only have vague symptoms of nutritional deficiencies later on, when real damage has been done. In these people, symptoms of anemia may be the first to present.
Mood changes, most commonly irritability in children and depression in adults.
Dermatitis herpetiformis: About 15% of people with celiac disease develop this chronic skin condition as a side effect. Also called the “gluten rash” or the “celiac rash,” the same gluten antibodies that damage your small intestine in celiac disease cause this condition. Dermatitis herpetiformis manifests as an itchy rash that looks like clusters of bumps or blisters. It typically affects your elbows, knees, buttocks or scalp.
How do you treat celiac disease?
The first and most important step in treating celiac disease is to stop eating gluten. You can’t change the way your body reacts to gluten, but you can prevent gluten from triggering that reaction. When you stop eating gluten, your small intestine will begin to heal and will soon be able to absorb nutrients again. You have to maintain a strict gluten-free diet for life, though, to avoid hurting your small intestine again.
Additional treatment may include:
Nutritional supplements to replace any serious deficiencies.
Specific medications to treat dermatitis herpetiformis, such as dapsone.
Corticosteroids for severe inflammation that’s not responding fast enough to the diet.
Continuous follow-up care, including regular testing to make sure the disease is controlled.
How long does the treatment take to work?
Most people find their symptoms begin to improve almost immediately after starting a gluten-free diet. It may take several weeks to replace your nutritional deficiencies and several months for your gut to fully heal. It can take longer in some cases, depending on the extent of the damage and how long it’s been going on. You can also prevent your body from healing if you aren’t strict with your diet.
How do you know if you have celiac disease?
You might suspect you have celiac disease if you have gastrointestinal symptoms after eating gluten. Many people appear to have a sensitivity to gluten or wheat products in their diet. Food intolerances can cause uncomfortable symptoms after eating, but they don’t damage your intestines the way celiac disease does. To diagnose celiac disease, healthcare providers will look for evidence of this damage.
It’s important to get tested for celiac disease before you try a gluten-free diet, so the tests can reveal how gluten actually affects your body. Once you begin avoiding gluten, your gut will begin to heal. Healing is good, but it’ll erase the evidence of celiac disease. You and your healthcare provider need to know for sure if you have it in order to know what kind of care you’ll need going forward.
How do healthcare providers test for celiac disease?
Healthcare providers use two methods of testing for celiac disease. They prefer to use both together to confirm the diagnosis. The first method is blood testing. Providers test a sample of your blood for the gluten antibodies that damage your intestines. Then, they’ll look for the damage itself. This requires taking a small tissue sample from your small intestine (biopsy) to examine under a microscope.
To take the sample, a gastroenterologist will perform an endoscopic exam of your small intestine. Endoscopic procedures involve passing a tiny camera through your body on the end of a long, thin catheter. An upper endoscopy passes the endoscope down your throat into the first part of your small intestine. Guided by the camera, the endoscopist can pass tools through the catheter to take a biopsy.
Additional tests
After confirming celiac disease, your provider will want to test your blood for specific vitamin and mineral deficiencies. Severe deficiencies can have wide-ranging effects on your body and may need to be treated directly with supplements. Common findings include iron-deficiency anemia, vitamin-deficiency anemia and vitamin D deficiency. You may also be low in electrolytes, such as calcium.
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