What is Celiac Disease?

million Americans suffer from celiac disease

Celiac disease is an autoimmune disorder that damages the villi in the small intestine. The damage occurs when food containing the protein gluten is consumed by a person prone to having this disease.

The exact cause of celiac disease is unknown, however, research suggests that the disease only happens to individuals who have particular genes. These genes are common and are carried by about one-third of the population. In order for celiac disease to be triggered, those carrying the gene must also be eating food that contains gluten.

Celiac Disease Symptoms

People with celiac disease don’t always present with obvious symptoms. There are instances when a person is not sick or does not have symptoms and instead, the disease is triggered by a health issue.

Most people think of digestive issues when they hear the term celiac disease, but the symptoms—especially for adults—can cause issues not related to digestion.

Most Common Symptoms of Celiac Disease in Adults

  • Anemia
  • A red, smooth, shiny tongue
  • Bone or joint pain
  • Depression or anxiety
  • Dermatitis herpetiformis
  • Headaches
  • Infertility or repeated miscarriage
  • Missed menstrual periods
  • Mouth problems such as canker sores or dry mouth
  • Seizures
  • Tingling numbness in the hands and feet
  • Tiredness
  • Weak and brittle bones

If digestive symptoms are present, you may experience abdominal pain and bloating, intestinal blockages, chronic tiredness, and ulcers.

Children can present with different symptoms than adults, including these common digestive issues.

Most Common Symptoms of Celiac Disease in Children

  • Chronic diarrhea
  • Constipation
  • Gas
  • Nausea
  • Pale, foul-smelling, or fatty stools that float
  • Stomach pain
  • Vomiting

Since celiac disease interferes with a child’s ability to absorb nutrients they may have damage to their permanent teeth, delayed puberty, failure to thrive in infants, mood changes, slowed growth, and weight loss.

Diagnosing Celiac Disease

If you are experiencing symptoms of celiac disease, it’s important you contact your doctor. Based on the information you provide, they may order two different blood tests to determine a diagnosis. The first is a serology test, which looks for antibodies in your blood. Elevated levels of certain antibody proteins indicate an immune reaction to gluten. The second is genetic testing for human leukocyte antigens, which can be used to rule out celiac disease.

Treatment For Celiac Disease

Celiac disease can cause long-term digestive problems and keep you from getting the nutrients you need. Since there is no cure for celiac disease, treatment focuses on the role of a gluten-free diet in managing symptoms. Gluten can be found in foods that contain wheat (all varieties and derivatives), rye, barley, triticale, malt, and brewer’s yeast. In addition to food and beverages, gluten can be found in some lipsticks and lip balms, vitamins, herbal and nutritional supplements, drugs and over-the-counter medications, and wheat-based play dough.

A medical team comprised of doctors and dietitians will prescribe you a gluten-free diet to manage symptoms. Typically, inflammation in your small intestine begins to lessen once you begin a gluten-free diet. Some people may notice a decrease in symptoms in as little as a few days, but more likely within several weeks.

In cases of severe damage to the small intestine, a doctor may prescribe a steroid to control the inflammation. Additionally, those suffering from dermatitis herpetiformis (an itchy, blistering skin rash that can occur as a result of celiac disease) may be prescribed a skin medication.

Special Considerations

People with celiac disease need to be aware of cross-contact, which can happen when a food is exposed to gluten during processing or handling. For example, contamination can occur if a knife used to butter wheat bread is then used to butter “gluten-free” bread without being cleaned off. Even though the bread is “gluten-free,” the knife that was used on both types of bread has now introduced gluten to a person with celiac disease.

Regulations Related to Gluten-Free Labeling

“Gluten-free” was officially approved as a term for food labeling by the U.S. Food and Drug Administration (FDA) in August 2013. Prior to this, it was extremely difficult for consumers to determine if a food was gluten-free. This new regulation standardized what “gluten-free” means on a food label.

Manufacturers that choose to use this label are accountable for complying with all requirements established and enforced by the FDA. Since this label is not required, food and beverages that are in fact gluten-free, may not be identified as such on the packaging.

The FDA regulation applies to the following four labels:

  • Gluten-free
  • Free of gluten
  • No gluten
  • Without gluten

Early in 2017, the FDA tested 702 samples from more than 250 products labeled “gluten-free” and only one of those products did not comply with the labeling requirements. However, if you believe you’ve been exposed to gluten from a product with a “gluten-free” label, you can report it through the FDA’s Safety Information and Adverse Event Reporting Program.