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Celiac disease is a chronic digestive and immune disorder that damages the small intestine. The damage can stop the body absorbing vitamins, minerals and other nutrients from food, which can lead to malnutrition and other serious problems.
What sets it off: gluten
The trigger is gluten, a protein in wheat, barley, rye and other grains. Gluten can also hide in things you swallow that aren't food:
- vitamins and supplements;
- toothpaste and mouthwash;
- lip balm.
Gluten in hair and skin products isn't absorbed through the skin, but swallowing some by accident could cause a reaction.
Not the same as wheat allergy or gluten sensitivity
| Celiac disease | Wheat allergy | Gluten sensitivity | |
|---|---|---|---|
| What happens | an immune reaction to gluten | an immune reaction to wheat — a type of food allergy | problems with gluten |
| Symptoms | see below | can differ, such as itchy eyes or trouble breathing | some overlap with celiac disease, such as belly pain and fatigue |
| Damages the small intestine? | yes | no lasting damage | no |
Some people with a wheat allergy also react to certain wheat proteins in cosmetics.
Causes and risk
The exact cause is not known. Research suggests celiac disease happens only in people who have certain genes and who eat food containing gluten; researchers are studying what else may play a part.
It's more common in people who:
- have a family member with it;
- have Down syndrome, Turner syndrome or Williams syndrome;
- are White;
- are female.
Symptoms
They vary from person to person, can come and go, can be mistaken for other conditions — and some people notice none. Digestive symptoms are more common in children than in adults.
| Digestive | Elsewhere in the body |
|---|---|
| bloating — a full or swollen belly | fatigue |
| long-term diarrhea, or greasy, bulky, unusually bad-smelling stool | depression and anxiety |
| constipation | irritability (in children) |
| gas | dermatitis herpetiformis, an itchy, blistering rash (mainly in adults) |
| lactose intolerance, from the intestinal damage | bone or joint pain |
| nausea and vomiting | mouth problems, such as canker sores or dry mouth |
| belly pain | |
| weight loss in adults; too little weight gain in children |
What it can lead to
Over time — especially untreated — celiac disease can cause:
- malnutrition;
- anemia, especially iron-deficiency anemia;
- bone loss;
- nervous system problems, such as headaches, balance problems or peripheral neuropathy;
- reproductive problems: missed periods and miscarriage in women, and infertility in both men and women.
Diagnosis
With symptoms that suggest celiac disease, your health care provider takes your medical and family history and does a physical exam, then orders tests. The usual ones are:
- Blood tests.
- A biopsy of the small intestine, taken during an upper gastrointestinal endoscopy — a flexible tube with a camera lets the provider see the lining of the esophagus, stomach and small intestine and take a tissue sample.
Treatment: gluten-free, for life
The treatment is a gluten-free diet for the rest of your life. Keeping to it treats or prevents many of the symptoms and complications, and in most cases heals the intestinal damage and prevents more.
- A registered dietitian can help you learn to eat a healthy diet without gluten.
- Avoid hidden gluten too — in some supplements, cosmetics, toothpaste and so on.
- Read labels. If a label doesn't list the ingredients, ask the manufacturer for them — and don't assume a product is gluten-free just because it doesn't mention gluten.
Sources
Based on the MedlinePlus health topic "Celiac Disease," National Library of Medicine, drawing on the National Institute of Diabetes and Digestive and Kidney Diseases; a work of the United States government in the public domain.
Лицензия: CC0 1.0 (общественное достояние) · По материалам medlineplus.gov
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