Celiac Disease

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Introduction

What is celiac disease?

Celiac disease is a genetic disorder that affects your digestive system and damages your small intestines. If you have celiac disease, your body is sensitive to gluten and your immune system reacts abnormally to foods you eat that contain gluten. Gluten is a protein found in foods and products that contain certain grains, such as wheat, oats, barley and rye.

The lining of your intestines is made of many small fingerlike bumps, called villi, that are responsible for digesting and absorbing nutrients. In celiac disease, the villi flatten out and are damaged or destroyed when exposed to gluten. This decreases the amount of surface area that is available to digest and absorb nutrients in the small intestine.

The symptoms of celiac disease vary among individuals and depend on the amount of gluten a person consumes. Symptoms can affect the digestive tract as well as other parts of the body. Common symptoms include excessive gas, abdominal bloating, diarrhea, weight loss, and fatigue. Some people who have celiac disease may have no symptoms.

Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is far more common than once believed. According to the National Institutes of Health, more than two million people in the United States are affected by celiac disease. It commonly runs in families and in populations with other autoimmune diseases and genetic disorders (Source: NIDDK).

What’s the difference between celiac disease and gluten intolerance?

Celiac disease is a serious form of gluten intolerance in which the body reacts to gluten by damaging the small intestine. Although the symptoms can be similar, celiac disease symptoms are generally more severe and long-lasting compared to the symptoms of milder forms of gluten intolerance. Most importantly, celiac disease causes actual damage to the small intestine and can cause complications in other body systems, such as anemia and osteoporosis. These problems are generally not seen in milder forms of gluten intolerance.

Left untreated, celiac disease can result in serious complications, such as malnutrition, small intestine cancer, and anemia. Seek prompt medical care if you have symptoms of celiac disease, such as excessive abdominal bloating, diarrhea or weight loss.

Symptoms

What are the symptoms of celiac disease?

The symptoms of celiac disease can be vague and similar to other conditions that affect the digestive system, such as diverticulosis or irritable bowel syndrome. Your symptoms may be mild or severe, and they may vary depending on the amount of gluten you eat. Symptoms of celiac disease affect your small intestines and can affect other parts of your body. Some people with celiac disease experience no symptoms.

Symptoms of celiac disease can include:

  • Abdominal bloating

  • Abnormally foul-smelling stools

  • Chronic or persistent diarrhea

  • Excessive gas

  • Fatigue

  • Irritability in children

  • Pale feces

  • Tooth discoloration, including white, yellow or brown spots, may be the first symptoms of celiac disease, especially in young children; permanent tooth problems can cause serious health issues

Serious symptoms that might indicate a life-threatening condition

Celiac disease can lead to serious complications, such as anemia, miscarriage, birth defects, malnutrition, or osteoporosis. Symptoms that might indicate a serious or life-threatening condition include:

  • Bone and joint pain, sometimes related to rheumatoid arthritis

  • Failure to thrive in infants and children

  • Stoppage of normal menstrual periods (amenorrhea)

  • Vaginal bleeding during pregnancy

  • Weight loss

Seek immediate medical care or call 911 if you experience vaginal bleeding during pregnancy. Seek prompt medical care for any other symptoms listed above.

Causes

What causes celiac disease?

The cause of celiac disease is not known. But celiac disease commonly runs in families and in people with certain genetic disorders and autoimmune diseases. A blood test can help diagnose the disease and determine whether you need a gluten-free diet.

What are the risk factors for celiac disease?

A number of factors increase your risk of developing celiac disease including genetic disorders and autoimmune diseases. Not all people who are at risk for celiac disease will develop the condition. Risk factors include:

Treatments

How is celiac disease treated?

The primary treatment for celiac disease is eliminating gluten from your diet. Common foods that contain gluten include cereals, breads, pasta, and other foods or products that contain wheat, barley, oats or rye. Less obvious sources of gluten include:

  • Alcoholic beverages including ale, beer, vodka, whiskey and gin

  • Certain medications and vitamin supplements

  • Foods that may be contaminated with gluten when they are processed with equipment that is also used to process grains that contain gluten

  • Glue on stamps and envelopes

  • Mouthwashes

Treatment of celiac disease also might involve:

  • Corticosteroid medications, which may be occasionally used to reduce inflammation of the small intestine. These are unnecessary in most cases and have many side effects.

  • Treating any complications, such as vitamin deficiencies and osteoporosis

Maintaining a gluten-free diet

Most people with celiac disease who follow a gluten-free diet experience an improvement in symptoms. Following a gluten-free diet can be challenging because of the many dietary limitations and hidden sources of gluten. Look for food that is labeled “gluten free.” You might also consider consulting with a registered dietician to learn and understand all your dietary options and to build a healthy, well-balanced, and tasty eating plan.

What are the possible complications of celiac disease?

Complications of untreated celiac disease can be serious and even life threatening in some cases. Complications can include:

  • Anemia

  • Birth defects if the mother has celiac disease

  • Bone fractures

  • Depression

  • Failure to thrive in infants and children

  • Miscarriage if the mother has celiac disease

  • Small intestine cancer

  • Vitamin and mineral deficiencies and malnutrition

You can eliminate or minimize your risk of serious complications by following your treatment and dietary plan and seeking regular medical care as recommended by your health care provider.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 14
  1. Celiac Disease – Sprue. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000233.htm.
  2. Celiac Disease.  National Digestive diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/.
  3. What is Celiac Disease? Celiac Support Associtaion. http://www.csaceliacs.org/celiac_defined.php 
  4. Gujral N, Freeman HJ, Thomson AB. Celiac disease: prevalence, diagnosis, pathogenesis and treatment. World J Gastroenterol 2012; 18:6036.
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