Celiac disease is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. It is estimated to affect 1 in 100 people worldwide, but only about 30% are properly diagnosed.
When people with celiac disease eat gluten (a protein found in wheat, rye, and barley), their body mounts an immune response that attacks the small intestine. These attacks lead to damage on the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.
Celiac disease is hereditary, meaning that it runs in families. People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease.
Celiac disease can develop at any age after people start consuming gluten. Left untreated, celiac disease can lead to additional serious health problems.
Long-Term Health Effects
People with celiac disease have a 2x greater risk of developing coronary artery disease, and a 4x greater risk of developing small bowel cancers.
The treatment burden of celiac disease is comparable to end-stage renal disease, and the partner burden is comparable to caring for a patient with cancer. 1 2
Untreated celiac disease can lead to the development of other autoimmune disorders like type 1 diabetes and multiple sclerosis (MS), and many other conditions, including dermatitis herpetiformis (an itchy skin rash), anemia, osteoporosis, infertility and miscarriage, neurological conditions like epilepsy and migraines, short stature, heart disease, and intestinal cancers.
Treatment
Currently, the only treatment for celiac disease is lifelong adherence to a strict gluten-free diet. People living gluten-free must avoid foods with wheat, rye, and barley, such as bread and beer.
Ingesting small amounts of gluten, like crumbs from a cutting board or toaster, can trigger small intestine damage.
Does Gluten or Gluten Intolerance Cause Weight Gain?
Celiac disease is also known as coeliac disease, celiac sprue, non-tropical sprue, and gluten sensitive enteropathy.
| Early Diagnosis Lowers Chance of Developing Another Condition | |
|---|---|
| AGE OF DIAGNOSIS | CHANCE OF DEVELOPING ANOTHER AUTOIMMUNE CONDITION |
| 2-4 | 10.5% |
| 4-12 | 16.7% |
| 12-20 | 27% |
| Over 20 | 34% |
Undiagnosed or Untreated Celiac Disease Can Lead to:
Long-Term Health Conditions
- Early onset osteoporosis or osteopenia
- Gall bladder malfunction
- Heart disease
- Infertility and miscarriage
- Iron deficiency anemia
- Lactose intolerance
- Liver failure
- Malnutrition
- Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), headaches, lack of muscle coordination, seizures, ataxia, dementia, neuropathy, myopathy, and multifocal leucoencephalopathy
- Pancreatic insufficiency
- Small intestine cancer and non-Hodgkin lymphoma
- Vitamin and mineral deficiencies
Other Autoimmune Disorders
In a 1999 study, Ventura, et al. found that for people with celiac disease, the later the age of diagnosis, the greater the chance of developing another autoimmune disorder.
Celiac disease can be difficult to diagnose because it affects people differently. There are more than 200 known celiac disease symptoms which may occur in the digestive system or other parts of the body. Some people develop celiac disease as a child, others as an adult. The reason for this is still unknown.
Some people with celiac disease have no symptoms at all, but still test positive on the celiac disease blood test. Others may have a negative blood test, but have a positive intestinal biopsy. However, all people with celiac disease are at risk for long-term complications, whether or not they display any symptoms.
Digestive symptoms are more common in infants and children. Here are the most common symptoms found in children:
Abdominal bloating and pain
Anxiety and depression
Attention-deficit/hyperactivity disorder (ADHD) and learning disabilities
Chronic diarrhea
Constipation
Damage to tooth enamel
Delayed puberty
Failure to thrive
Fatigue
Gas
Headaches
Iron-deficiency anemia
Irritability
Nausea and vomiting
Pale, foul-smelling stools
Seizures and lack of muscle coordination
Short stature
Weight loss
Do You Have Celiac Disease?
The most common symptoms in adults include:
Abdominal pain
Bloating and gas
Cognitive impairment
Constipation
Diarrhea
Depression and anxiety
Fatigue
Headaches or migraines
Iron-deficiency anemia
Itchy, blistery skin rash (dermatitis herpetiformis)
Joint pain
Missed periods
Mouth ulcers and canker sores
Nausea and vomiting
Osteoporosis and osteomalacia
Peripheral neuropathy
Reduced functioning of the spleen (hyposplenism)
Weight loss
Classical, Non-classical, and Silent Celiac Disease
According to the World Gastroenterology Organization, celiac disease may be divided into two types: classical and non-classical.
In classical celiac disease, patients have signs and symptoms of malabsorption, including diarrhea, steatorrhea (pale, foul-smelling, fatty stools), and weight loss or growth failure in children.
In non-classical celiac disease, patients may have mild gastrointestinal symptoms without clear signs of malabsorption or may have seemingly unrelated symptoms. They may suffer from abdominal distention and pain, and/or other symptoms such as: iron-deficiency anemia, chronic fatigue, chronic migraine, peripheral neuropathy (tingling, numbness, or pain in hands or feet), unexplained chronic hypertransaminasemia (elevated liver enzymes), reduced bone mass and bone fractures, and vitamin deficiency (folic acid and B12), difficulty losing weight, late menarche/early menopause and unexplained infertility, dental enamel defects, depression and anxiety, dermatitis herpetiformis (itchy skin rash), etc.
First-degree relatives should always be screened, since there is a 1 in 10 risk of developing celiac disease.
Silent celiac disease is also known as asymptomatic celiac disease. Patients do not complain of any symptoms, but still experience villous atrophy damage to their small intestine. Studies show that even though patients thought they had no symptoms, after going on a strict gluten-free diet, they report better health and a reduction in acid reflux, abdominal bloating, and distention and flatulence.
First-degree relatives, whether or not experiencing symptoms, should always be screened, since there is a 1 in 10 risk of developing celiac disease. Second-degree relatives also have an increased risk of developing the disease. 1
The number of ways celiac disease can affect patients, combined with a lack of training in medical schools and primary care residency programs, contributes to the poor diagnosis rate in the United States. Currently, it is estimated that 80% of the celiac disease population remains undiagnosed.
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