About celiac disease
What is celiac disease?
Celiac disease, sometimes called celiac sprue or gluten-sensitive enteropathy, is an immune reaction to eating gluten, a protein found in wheat, barley and rye.
If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine's lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.
In children, malabsorption can affect growth and development, besides causing the symptoms seen in adults.
There's no cure for celiac disease — but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing.
What are the symptoms for celiac disease?
The signs and symptoms of celiac disease can vary greatly and are different in children and adults. The most common signs for adults are Diarrhea, Fatigue and Weight loss. Adults may also experience Bloating and gas, Abdominal pain, Nausea, Constipation, and Vomiting.
However, more than half of adults with celiac disease have signs and symptoms that are not related to the digestive system, including:
- Anemia, usually resulting from iron deficiency
- Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
- Itchy, blistery skin rash (dermatitis herpetiformis)
- Damage to dental enamel
- Mouth ulcers
- Headaches and Fatigue
- Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment
- Joint pain
- Reduced functioning of the spleen (hyposplenism)
- Acid reflux and Heartburn
In children under 2 years old, typical signs and symptoms of celiac disease include:
- Chronic Diarrhea
- Swollen belly
- Failure to thrive
- Poor appetite
- Muscle wasting
Older children may experience:
- Weight loss
- Short stature
- Delayed puberty
- Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, Headaches, lack of muscle coordination and Seizures
Dermatitis herpetiformis is an itchy, blistering skin disease that stems from intestinal gluten intolerance. The rash usually occurs on the elbows, knees, torso, scalp and buttocks.
Dermatitis herpetiformis is often associated with changes to the lining of the small intestine identical to those of celiac disease, but the disease may not produce noticeable digestive symptoms.
Doctors treat dermatitis herpetiformis with a gluten-free diet or medication, or both, to control the rash.
When to see a doctor
Consult your doctor if you have Diarrhea or digestive discomfort that lasts for more than two weeks. Consult your child's doctor if your child is pale, irritable or failing to grow or has a potbelly and foul-smelling, bulky stools.
Be sure to consult your doctor before trying a gluten-free diet. If you stop or even reduce the amount of gluten you eat before you're tested for celiac disease, you may change the test results.
Celiac disease tends to run in families. If someone in your family has the condition, ask your doctor if you should be tested. Also ask your doctor about testing if you or someone in your family has a risk factor for celiac disease, such as type 1 diabetes.
What are the causes for celiac disease?
Celiac disease occurs from an interaction between genes, eating foods with gluten and other environmental factors, but the precise cause isn't known. Infant feeding practices, gastrointestinal infections and gut bacteria might contribute to developing celiac disease.
Sometimes celiac disease is triggered — or becomes active for the first time — after surgery, pregnancy, childbirth, viral infection or severe emotional stress.
When the body's immune system overreacts to gluten in food, the reaction damages the tiny, hair-like projections (villi) that line the small intestine. Villi absorb vitamins, minerals and other nutrients from the food you eat. If your villi are damaged, you can't get enough nutrients, no matter how much you eat.
Some gene variations appear to increase the risk of developing the disease. But having those gene variants doesn't mean you'll get celiac disease, which suggests that additional factors must be involved.
The rate of celiac disease in Western countries is estimated at about 1 percent of the population. Celiac disease is most common in Caucasians; however, it is now being diagnosed among many ethnic groups and is being found globally.
What are the treatments for celiac disease?
A strict, lifelong gluten-free diet is the only way to manage celiac disease. Besides wheat, foods that contain gluten include:
- Graham flour
- Spelt (a form of wheat)
A dietitian who works with people with celiac disease can help you plan a healthy gluten-free diet. Even trace amounts of gluten in your diet can be damaging, even if they don't cause signs or symptoms.
Gluten can be hidden in foods, medications and nonfood products, including:
- Modified food starch, preservatives and food stabilizers
- Prescription and over-the-counter medications
- Vitamin and mineral supplements
- Herbal and nutritional supplements
- Lipstick products
- Toothpaste and mouthwash
- Communion wafers
- Envelope and stamp glue
- Play dough
Removing gluten from your diet will gradually reduce inflammation in your small intestine, causing you to feel better and eventually heal. Children tend to heal more quickly than adults.
Vitamin and mineral supplements
If your anemia or nutritional deficiencies are severe, your doctor or dietitian might recommend that you take supplements, including:
- Vitamin B-12
- Vitamin D
- Vitamin K
Vitamins and supplements are usually taken in pill form. If your digestive tract has trouble absorbing vitamins, your doctor might give them by injection.
Medical follow-up at regular intervals can ensure that your symptoms have responded to a gluten-free diet. Your doctor will monitor your response with blood tests.
For most people with celiac disease, a gluten-free diet will allow the small intestine to heal. For children, that usually takes three to six months. For adults, complete healing might take several years.
If you continue to have symptoms or if symptoms recur, you might need an endoscopy with biopsies to determine whether your intestine has healed.
Medications to control intestinal inflammation
If your small intestine is severely damaged or you have refractory celiac disease, your doctor might recommend steroids to control inflammation. Steroids can ease severe signs and symptoms of celiac disease while the intestine heals.
Other drugs, such as azathioprine (Azasan, Imuran) or budesonide (Entocort EC, Uceris), might be used.
Treating dermatitis herpetiformis
If you have this skin rash, your doctor might recommend a medication such as dapsone, taken by mouth, as well as a gluten-free diet. If you take dapsone, you'll need regular blood tests to check for side effects.
Refractory celiac disease
If you have refractory celiac disease, your small intestine won't heal. Then you'll likely need to be evaluated in a specialized center. Refractory celiac disease can be quite serious, and there is currently no proven treatment.
What are the risk factors for celiac disease?
Celiac disease can affect anyone. However, it tends to be more common in people who have:
- A family member with celiac disease or dermatitis herpetiformis
- Type 1 diabetes
- Down syndrome or Turner syndrome
- Autoimmune thyroid disease
- Microscopic colitis (lymphocytic or collagenous colitis)
- Addison's disease
- Rheumatoid arthritis
Is there a cure/medications for celiac disease?
Celiac disease, also known as celiac sprue, non-tropical sprue, or gluten-sensitive enteropathy, is a digestive and auto-immune disease that damages the small intestine.
- The condition is generally triggered by the protein known as gluten. Gluten is found in wheat, and barley triggers the immune response in patients and makes them intolerant to other gluten-containing products.
- The intestines have vill, a thin-finger-like structure on the surface that helps in the absorption of the digested food. However due to the auto-immune attack, caused by the gluten, these villi get flattened, affecting the ability to absorb. In the long term, it will result in malnourishment, diabetes, and thyroid disorders.
- Celiac disease is a serious ailment, where affected individuals might develop deficiencies in various nutrients from anemic, from iron deficiency to easy bleeding or bruising due to Vitamin K deficiency. Unfortunately, there is no cure or specific medications to treat Celiac disease.
- The condition can only be treated by following by healthy and strict gluten-free diet. The patients will also prescribe nutritional supplements to treat the deficiencies of nutrients, caused by the disease.
- In rare cases, steroids will be given to reduce the immune activity, while a drug named dapsone will treat dermatitis herpetiformis.
Dermatitis herpetiformis,Peripheral neuropathy,Malnutrition,Iron deficiency anemia,Infertility,Behavioral problems,Osteoporosis,Small bowel ulcers,Rheumatoid arthritis,Lupus,Type 1 diabetes
Azathioprine (Azasan, Imuran),Budesonide (Entocort EC, uceris)
Diarrhea,Bloating,Abdominal pain,Frothy stools due to unabsorbed fats,Sudden weight loss,Skin rashes,Depression,Brittle bones,Fatigue,Mouth ulcers,Bone and joint pain,Tingling or numbness in hands and feet