Celiac Disease

Celiac disease also knows as gluten-sensitive enteropathy or celiac sprue is a medical condition triggered by the consumption of gluten, a protein found in various grains including barley, wheat and rye. The body is no longer able to absorb nutrients because of the damage caused to the small intestine’s lining. This represents an abnormal immune response that requires immediate treatment because it can lead to anemia, osteoporosis and lymphoma. Children with celiac disease can experience a slow growth and development, apart from common symptoms like weakness and diarrhea, fatigue and weight loss. Seeking medical attention as soon as possible becomes imperative in order to prevent potential complications.


Types of Celiac Disease

Silent celiac disease or asymptomatic celiac disease does not cause any common gastrointestinal symptoms like abdominal pain, diarrhea or constipation. People with this type of condition may experience other symptoms including fatigue and neurological problems or they may not experience symptoms at all. Because of this, doctors can discover it only when examining the patient for a completely different disease because then he acquires details regarding the family and medical history, among others. The lack of noticeable symptoms is not necessarily a good thing considering that it impedes people from receiving a proper diagnosis on time, which may lead to serious complications on the long term. Until they find out, they will continue to eat gluten foods and damage their small intestine. The bright side is that, thanks to the awareness growth of celiac disease nowadays, doctors who identify this condition to a certain person, recommend performing screening to close relatives in order to discover other potential cases.

Latent celiac disease refers specifically to those people who clearly have inherited the genes for this condition but they have not experienced notable signs. Even though many people confuse latent celiac disease with silent celiac disease, there is a clear difference. On one hand, silent celiac disease presents damage to the villi or small intestine’s lining and no symptoms. On the other hand, with latent celiac disease, the visual examination at the doctor’s office does not reveal damage to the villi, but the blood tests’ results usually come out positive. Doctors can establish a diagnosis under specific circumstances:

  • The patient had celiac disease during childhood that practically disappeared on its own without any intervention. If he experiences gastrointestinal issues in the future, he must go through several tests that have the purpose to exclude the condition.
  • The patient had a beginning of celiac disease in childhood but adopted a gluten-free diet in order to treat it. Similar to the first situation, if any problems arise later in life, testing represents the best way to count out the disease.

Even if the doctor establishes a diagnosis for celiac disease, it will not affect the patient and he will not have to change his diet at this point. Nevertheless, periodic follow-ups are necessary to notice and control progression or manifestation of the condition.

Refractory celiac disease refers specifically to those people who despite following a strict gluten-free diet as part of the treatment for the condition, the small intestine does not heal. Most of the time, patients notice a significant change a few weeks after starting the diet. However, there are cases when symptoms recur after a while and doctors immediately consider refractory celiac disease. Even though the odds of developing this condition are small, it can lead to severe complications. Sometimes, doctors explain it through the existence of microscopic amounts of gluten ingested by the patient accidentally that cause the symptoms to continue. If the patient observes the diet sacredly but his state does not improve, the doctor will investigate the problem carefully to find a relevant and logical explanation. If he ends up establishing a diagnosis for celiac disease, he will explore the available treatments immediately in order to help the patient.  In a few cases, the doctor will inform the patient that he actually does not have celiac disease. Only middle-aged or older people can have this type of condition and they present various symptoms including weight loss and diarrhea, malnutrition and vitamin deficiencies.


Celiac Disease


Causes of Celiac Disease

Even though specialists do not know the precise cause of celiac disease, one thing is for sure: a combination between genes, foods with gluten and environmental factors make possible its development. Bacteria in the stomach, gastrointestinal infections and infant feeding are other factors that contribute significantly to this condition. Severe emotional stress, viral infection, childbirth and surgery represent triggers that can activate celiac disease for the first time. Apparently, some gene variations can increase the chances of developing the condition but this affirmation is not set in stone meaning that having certain genes is not a safe recipe for disaster, unless it comes associated with additional factors including type 1 diabetes, lactose intolerance, rheumatoid arthritis, thyroid disease, lupus, Down and Turner syndrome, intestinal lymphoma and cancer.


Symptoms of Celiac Disease

Usually, people with this condition start to notice the first signs, which include stomach problems, more exactly gas and diarrhea several days in a row. In addition, they feel apathetic, tired and achy. Obviously, eating certain foods that contain gluten, such as bread and pasta will inevitably worsen the symptoms. The inexplicable loss of weight represents another clue that makes celiac disease a possibility, taking into account that it usually manifests by attacking the small intestine and making it impossible to absorb the needed nutrients for the body. With the passage of time, if left untreated, this disease can provoke other serious health problems like permanent intestinal damage. Celiac disease can affect people at any point in their life, regardless of the age. However, the symptoms are different.

Celiac disease symptoms in children and teens cause digestive problems, irritability and tiredness. In addition, delayed puberty and abnormal weight is present. Other symptoms include abdominal pain and bloating, constipation and chronic diarrhea, vomiting and improper growth.

Celiac disease symptoms in adults involve the digestive system, but also other parts of the body. Common symptoms include iron deficiency and joint pain, stiffness and fatigue, arthritis and seizures, anxiety or depression, skin disorders and tooth discoloration, numbness and tingling in the extremities, mouth sores and irregular menstrual periods, miscarriage and infertility.

The symptoms of celiac disease vary from person to person, according to several factors:

  • the extent of intestinal damage
  • the amount of gluten ingested
  • the length of time the body was exposed to gluten foods

Surprisingly, other people do not experience any type of symptoms related to celiac disease but they are prone to developing complications on the long term. Anyone who has even the slightest suspicion in relation to the condition must schedule an appointment to the doctor’s office in order to receive the adequate diagnosis, followed by treatment. Waiting is the enemy in this unfortunate case, as well as gluten foods. Reading the labels carefully in order to discover hidden gluten must become a habit. Nevertheless, people with celiac disease can still eat unprocessed meats, fresh foods and vegetables, eggs and dairy products, alcohol drinks like cider, wine and liquor.


Diagnosis for Celiac Disease

Unfortunately, studies show that approximately 20% of people receive diagnosis for celiac disease. This happens because the intestinal damage is very slow and symptoms vary, so it may take a few years for a doctor to establish a diagnosis and prescribe a proper treatment. On the other hand, for patients who do experience specific symptoms caused by this condition, doctors require information concerning medical history and perform a detailed physical examination. Generally, the person comes to the cabinet several times complaining of recurring pain in the abdominal area, joint aches and chronic anemia that do not show response to iron treatment, which makes the doctor to suspect the possibility of celiac disease. Consequently, he proceeds by using different methods and procedure to confirm his suspicion.

  • Blood tests are more efficient and provide results that are more accurate when the patient still consumes gluten foods because it can prove or rule out the existence of antibodies. Moreover, the doctor has the possibility to examine human leukocyte antigens.
  • Skin biopsy represents another procedure that can help doctors establish a proper diagnosis and avoid the necessity of internal biopsy, which refers to the analysis of a tissue sample from the intestines. It consists in closely examining pieces of skin tissue under a microscope.
  • Endoscopy becomes an option when both of the methods mentioned above, namely blood test and biopsy are inconclusive. During this procedure, the doctor examines the intestines and the severity of damage by using a thin tube known as endoscope with a small camera attached to it. He slowly introduces it through the mouth, esophagus and stomach into the duodenum.


Treatment for Celiac Disease

Celiac disease can be easily mistaken for other problems including food intolerance and irritable bowel syndrome. If the patient presents one of these two conditions, the doctor will give priority and treat it first. The treatment for celiac disease is quite simple: a strict lifelong gluten-free diet. Nevertheless, for some people this represents a drastic change regarding the way they eat. For this reason, working with a knowledgeable and experienced dietitian will considerably facilitate the process. He will provide clear instructions regarding food and product labels. Furthermore, he will help the person with celiac disease discover gluten-free foods that are among her preferences. After the patient eliminates gluten from his diet, the results will speak for themselves. Within a few days, his overall state will improve visibly and after several weeks, the inflammation in the small intestine reduces. However, complete healing may last up until several years. In comparison to adults, children experience a quicker recovery.

If the patient happens to eat a product without realizing that it contains gluten, he will experience abdominal pain and diarrhea. Even though this incident does not cause visible symptoms of celiac disease to everyone, it does not mean that it is not damaging. Even consuming scarcely detectable amounts of gluten can be harmful. Because of this, paying close attention not only to foods, but also to medications and other products is very important. Some of them include mouthwash and toothpaste, lipstick, over-the-counter medications, preservatives and food stabilizers, nutritional and mineral supplements, among others.


Myths about Celiac Disease

  1. Gluten sensitivity and celiac disease are the same thing

People seem to mistake celiac disease for gluten sensitivity and the other way around because both of them involve abnormal reactions to gluten, a protein found in various grains and they often provoke similar gastrointestinal symptoms. However, the main difference is that the first one represents an autoimmune disease and makes the absorption of nutrients impossible by causing damage to the small intestine. Celiac disease runs in the family because people have a gene for the condition from birth and they trigger it by eating gluten.  Food intolerance or non-allergic food sensitivity, on the other hand, refers to the difficulty of digesting specific foods.

  1. Only the gastrointestinal tracts is affected by the celiac disease

Indeed, some of the most common manifestations of celiac disease such as bloating, diarrhea and abdominal pain, affect the gut. However, the immune cells leave the gastrointestinal tract when the gluten comes through in order to fight against the body. This causes other symptoms including headaches, anemia, joint pain, skin rashes, fatigue as well as weight loss, miscarriage, irregular periods and even infertility. In addition, celiac disease works in relation with other autoimmune diseases like thyroid disorder or diabetes. In severe cases, doctors will resort to surgery to remove the small intestines.

  1. Celiac disease is harmless and it just presents some unpleasant symptoms

If a person with celiac disease does not take the condition seriously and avoids seeking medical attention, she will not receive a proper diagnosis and treatment. This means that the chances of developing complications including severe infections, thyroid disorders, neurological problems and even osteoporosis increase significantly. Nevertheless, one of the most dangerous complications remains cancer and sometimes, embracing a gluten-free diet does not help to control the condition.


Last updated on March 2nd, 2018

Chris Riley

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