Overview
Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. When individuals with celiac disease consume gluten, it triggers an immune response that damages the lining of the small intestine, leading to inflammation and interference with nutrient absorption. This can result in a wide range of symptoms, including gastrointestinal issues (such as abdominal pain, diarrhea, constipation, bloating), fatigue, weight loss, anemia, joint pain, skin rash and neurological symptoms. Celiac disease has a genetic component and tends to run in families. The only effective treatment for celiac disease is to follow a strict gluten-free diet, which allows the intestine to heal and symptoms to resolve.
How is it diagnosed?
Blood serological tests, such as tissue transglutaminase (tTG) antibodies and anti-endomysial antibodies (EMA), are commonly used to screen for celiac disease. If serological tests are positive, confirmation of the diagnosis is typically done through an upper endoscopy with biopsy of the small intestine. During the endoscopy, multiple biopsy samples are taken from the duodenum (the first part of the small intestine) to assess for characteristic changes associated with celiac disease, such as villous atrophy, crypt hyperplasia, and intraepithelial lymphocytosis.
How is it treated?
The primary treatment for celiac disease is a strict gluten-free diet, which involves avoiding all foods and products containing wheat, barley, and rye. This includes bread, pasta, cereal, baked goods, sauces, and processed foods. Patients are encouraged to consume naturally gluten-free foods such as fruits, vegetables, meats, fish, dairy, and gluten-free grains (such as rice, quinoa, and corn). It’s essential to carefully read food labels and be aware of hidden sources of gluten in medications, supplements, and personal care products. In addition to dietary modifications, individuals with celiac disease may benefit from nutritional supplements to address deficiencies caused by malabsorption, and in some cases, corticosteroids or immunosuppressant may be prescribed to manage severe symptoms or complications.
Helpful Links
The Celiac Disease Foundation website contains helpful information on research, patient brochures, meal plan ideas, recipes, and much more.
References
Celiac Disease Foundation. (n.d.) What is Celiac Disease? https://celiac.org/about-celiac-disease/what-is-celiac-disease/
Mayo Clinic. (2023). Celiac Disease. https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220
