Celiac disease is an autoimmune disease characterized by an inappropriate immune response to gluten, a protein found in wheat, and to related dietary proteins in rye and barley. When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi which are tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food they eat.
People with celiac disease tend to have other diseases in which the immune system attacks the body's healthy cells and tissues. The connection between celiac disease and these diseases may be genetic. Some of these include type 1 diabetes, autoimmune thyroid disease, autoimmune liver disease, rheumatoid arthritis and Addison's disease, a condition in which the glands that produce critical hormones are damaged.
It has been estimated that 1 in 100 to 150 people in the US have celiac disease. It can affect anyone at any age but it is more common in infants and those in their 30s and 40s. It is estimated that about 20% of people with celiac disease are over 60 years old.
There are no typical signs and symptoms of celiac disease. Most people with the disease start with general complaints, such as intermittent diarrhea, abdominal pain and bloating Sometimes people with celiac disease may have no gastrointestinal symptoms at all. Celiac disease symptoms can also mimic those of other conditions, such as irritable bowel syndrome, gastric ulcers, Crohn's disease, parasite infections and anemia. Celiac disease may also present itself in less obvious ways such as Irritability or depression, stomach upset, joint pains, muscle cramps, skin rashes, mouth sores or various dental and bone disorders.
If blood tests and symptoms suggest celiac disease, a biopsy of the small intestine is performed to confirm the diagnosis. During the biopsy, the doctor removes tiny pieces of tissue from the small intestine to check for damage to the villi. To obtain the tissue sample, the doctor eases a long, thin tube called an endoscope through the patient's mouth and stomach into the small intestine. The doctor then takes the samples using instruments passed through the endoscope.
The only treatment for celiac disease is a gluten-free diet. Doctors may ask a newly diagnosed person to work with a dietitian on a gluten-free diet plan. A dietitian is a health care professional who specializes in food and nutrition. Someone with celiac disease can learn from a dietitian how to read ingredient lists and identify foods that contain gluten in order to make informed decisions at the grocery store and when eating out.
For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvement begins within days of starting the diet. The small intestine usually heals in 3 to 6 months in children but may take several years in adults. A healed intestine means a person now has villi that can absorb nutrients from food into the bloodstream.
To stay well, people with celiac disease must avoid gluten for the rest of their lives. Eating even a small amount of gluten can damage the small intestine. The damage will occur in anyone with the disease, including people without noticeable symptoms.