Celiac Disease

We’ve often seen “gluten-free” food items in groceries or commercials, and not all of us know why some people cannot take gluten or try to avoid gluten.

This is due to celiac disease - an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages.

Celiac disease is caused by a reaction to gliadin, a gluten protein found in wheat, and similar proteins found in triticeae crops which include other common grains such as barley and rye.

Upon exposure to gliadin, the enzyme tissue transglutaminase modifies the protein, and the immune system reacts with the small-bowel tissue, causing an inflammatory reaction.

Symptoms

• Digestive problems (abdominal bloating, pain, gas, diarrhea, pale stools, and weight loss)
• Iron deficiency anemia (low blood count) and other vitamin deficiencies
• Fatigue
• Muscle cramps, joint and bone pain
• Growth problems and failure to thrive (in children)
• Seizures
• Tingling sensation in the legs (caused by nerve damage and low calcium)
• Aphthous ulcers (sores in the mouth)
• Missed menstrual periods
• A severe skin rash called dermatitis herpetiformis

Diagnosis

If your doctor suspects you have celiac disease, he or she will perform a careful physical exam and will discuss your medical history with you. He or she may also perform a blood test to measure for higher levels of certain types of antibodies (substances produced by the immune system to fight harmful invaders) found in people with celiac disease.

Your doctor may perform other tests to detect nutritional deficiencies, such as a blood test to see if your iron levels are low. A stool sample may also be tested to detect fat in the stool, since celiac disease prevents fat from being absorbed from food.

Treatment

The only known effective treatment is a lifelong gluten-free diet. While the disease is caused by a reaction to wheat proteins, it is not the same as wheat allergy.