Celiac disease is an immune disease in which people cannot eat gluten because it damages the small intestine. If you have celiac disease and eat foods with gluten, your immune system can damage the small intestine. Gluten is a protein seen in wheat, rye, and barley. It can also be found in other products such as vitamins and supplements, hair and skin products, toothpaste, and lip balm.

Celiac disease affects each person differently. Symptoms can occur in the digestive system or in other parts of the body. One person may have diarrhea and abdominal pain, while another may experience irritability or depression. Impatience is one of the most common symptoms in children. Some have no symptoms.

Causes

In general, the body’s immune system is designed to preserve against foreign invaders. When somebody with celiac disease eats foods that include gluten, their immune systems hit the lining of the intestine. It causes swelling in the intestines and damages structures such as hair in the lining of the small intestine. Villi absorb nutrients from food. If the villi are damaged, the person will not be able to absorb the nutrients and will end up with malnutrition no matter how much they eat.

Risk factors

Risk factors for celiac disease include:

• Autoimmune liver disease

• Autoimmune thyroid disease

• Being of northern European descent

• Down syndrome

• Family history of celiac disease

• Microscopic colitis (inflammation of the colon)

• Rheumatoid arthritis

• Turner symptoms (a female-only condition caused by a missing or incomplete sex chromosome)

• Type 1 diabetes

Symptoms

Celiac disease affects people in different ways. Some have symptoms when they were children. Others have adult-only symptoms. Some people have diarrhea and abdominal pain. Others suffer from mood swings or depression.

The characteristics of each person may vary. There are common signs of celiac disease:

• Constant (chronic) diarrhea or constipation

• Weight loss

• Gas

• Pale, bad-smelling stool

• Unexplained low blood count that gives you feel weak (anemia)

• Tingling, numb feeling in the legs

• Dropped menstrual periods (connected to too much weight loss)

• Infertility

• Early osteoporosis or fractures

• Teeth changing color or losing their enamel

Celiac disease can be painful. Some common pain symptoms are:

• Stomach pain or swelling that keeps getting back

• Muscle cramps or bone pain

• Pain in the joints

• Painful, itchy skin rash

Children with celiac disease may not grow at a normal rate.

You may have celiac disease but no symptoms. This is because the part of the small intestine that is not affected still gets enough nutrients. But you are still at risk for disease problems.

Diagnosis

Many tests can help your doctor determine if you have celiac disease or another digestive condition.

Your doctor may recommend:

• Blood tests: People can have a blood test to determine if they have certain genes because those who do not have them are less likely to develop celiac disease. However, a positive test does not diagnose celiac disease because most people who do not have celiac disease have these genes.

• Endoscopy: If a blood test shows that you have celiac disease, your doctor may ask your gastroenterologist to perform an endoscopy to confirm your diagnosis. You swallow a small, comfortable tube that contains a small camera. Through this tube, your doctor will perform a biopsy and remove a small piece of tissue from the wall of the small intestine. A specialist (usually a pathologist) will examine this tissue under a microscope to see if it is damaged by celiac disease.

• Genetic testing: Your doctor may order a genetic test to rule out a diagnosis of celiac disease. Most people with celiac disease have a specific variation in the HLA-DQ2 or -DQ8 genes. But most people who don’t have celiac disease also have these variations, so the celiac disease cannot be diagnosed by genetic testing alone.

• Bone density testing: If you have celiac disease, your doctor may recommend a test to check for bone loss. This may not happen until you are on a gluten-free diet for a year. This test uses a scanning machine similar to an X-ray. If the scan shows a significant bone loss, you may need diet or other treatments to promote bone growth.

Treatment

Celiac disease is serious. Fortunately, you can manage the disease by following a gluten-free diet. This means that you eliminate gluten completely from your diet. By doing this, you can reverse the damage caused by celiac disease. You feel good. But if you “cheat” on your diet, the loss will return. Sometimes you may not feel bad right away, do you think eating gluten is okay? But it is not.

People who maintain a gluten-free diet avoid all foods that include:

• Wheat

• Barley

• Rye

• Spelled

• Triticale products (including many pieces of bread, pasta, cereals, and processed foods)

There are safe and gluten-free foods to eat:

• Rice

• Corn

• Oats

• Quinoa

• Buckwheat

• Millet

Some oat products are contaminated with brown gluten. For this reason, some people choose to avoid oatmeal.

Gluten can sometimes be found in unexpected foods or places:

• It is used as a hardening agent in many sauces and gravies.

• It is sometimes used in medicine. Speak to your doctor or pharmacologist before using new medicine. Contains vitamins and supplements.

• It can be found in lip balms, lipsticks, and other cosmetics.

Celiac disease and other gluten sensitivities are more popular. Gluten-free food has become even more common. Most restaurants offer gluten-free options. Most grocery stores have gluten-free sections. This means that you can find many gluten-free products.

Complications

Hair loss, anemia, broken bones, and osteoporosis can occur because the body does not absorb nutrients effectively. Ulcers of the small intestine develop.

Celiac disease is associated with certain types of cancer, including intestinal lymphoma and adenocarcinoma of the small intestine, pharynx, and esophagus.