Celiac Disease

Definition

Celiac disease is an autoimmune disease of the digestive tract. In celiac disease, eating food with gluten damages little bulges in the small intestine. These bulges, called villi, absorb nutrients from foods. The condition affects the absorption of all nutrients. Untreated patients often become malnourished.

Cross Section of Small Intestine

Inner circle demonstrates little protrusions affected by Celiac disease.

Copyright © Nucleus Medical Media, Inc.

Causes

Doctors do not fully understand what causes celiac disease. Eating gluten seems to be involved. There is most likely a genetic factor. Patients with specific genes develop the disease after exposure to gluten. There is some evidence that earlier exposure in infancy can cause a more severe disease than later exposure.

Risk Factors

Risk factors that increase your chance of having celiac disease include:

• Family members with celiac disease
• History of another autoimmune disease, such as:
  • Type 1 diabetes
  • Autoimmune thyroid disease
  • Lupus
• Dermatitis herpetiformis—A skin condition associated with celiac disease
• Rheumatoid arthritis

Symptoms

Symptoms vary and may start in childhood or adulthood. Children often have different symptoms than adults. Symptoms may not develop if a large section of the intestine is undamaged. Malnutrition may produce the first signs of the condition, which are often the most serious.

Signs and symptoms may include:

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Symptoms are similar to those of other conditions. It may take a long time to get a diagnosis. Early diagnosis and treatment reduce the risk of complications.

Tests may include:

• Your bodily fluids and waste products may need to be tested for evidence of malabsorption. This can be done with:
  • Blood tests
  • Stool tests
• You may need to have a sample of tissue removed for testing. This can be done with biopsy.
• Your intestine may need to be examined. This can be done with endoscopy.

Treatment

A life-long, gluten-free diet is the only treatment for celiac disease. It is very effective. Symptoms usually go away within days of starting the diet. However, healing of the villi may take months or years. Additional intake of gluten can damage the intestine, even if you have no symptoms. Delayed growth and tooth discoloration may be permanent. Nutritional supplements, given through a vein, may be needed if the intestinal damage does not heal. Since gluten is added to many foods, the diet can be complicated and often frustrating. Some patients find support groups helpful.

Prevention

There are no guidelines for preventing celiac disease because the cause is not understood. If celiac disease runs in your family, ask your doctor about a screening test. The earlier you start the gluten-free diet, the less damage there will be to the intestine.