Once thought to be a rare disease that only affected children, we now understand that celiac disease is a common and serious genetic autoimmune disease. Affecting 1 in 100 people worldwide, celiac disease can develop at any age, but only about 30% of people with celiac disease are diagnosed. When people with celiac disease eat gluten (a protein found in wheat, rye, barley, and triticale - a cross between wheat and rye), an immune reaction occurs that damages their small intestine, so that they are not able to absorb nutrients from food. Untreated celiac disease can lead to serious health complications. These include type 1 diabetes, multiple sclerosis, anemia, osteoporosis, infertility and miscarriage, epilepsy and migraines, heart disease, and intestinal cancers.

Symptoms of Celiac Disease

Celiac disease can be difficult to diagnose because it affects people differently. Some people develop celiac disease as a child, and others as an adult. While celiac disease is commonly associated with gastrointestinal symptoms, there are more than 200 known symptoms. Some people with celiac disease have no symptoms at all (also called silent celiac disease). But all people with celiac disease are at risk for long-term complications, whether or not they display any symptoms.

Do You Have Celiac Disease?

Celiac disease can develop at any age after people start consuming gluten. Some of the more common symptoms include:

• Digestive problems (abdominal bloating, pain, gas, constipation, diarrhea, pale stools, and weight loss)
• Dermatitis herpetiformis (a severe blistering skin rash)
• Mouth sores (called aphthous ulcers)
• Unexplained anemia (low blood count) or hepatitis (inflammation of the liver)
• Musculoskeletal problems (muscle cramps, joint and bone pain) and defects in dental enamel
• Growth problems and failure to thrive (in children)
• Tingling sensation in the legs (caused by nerve damage and low calcium)
• Fatigue
• Depression

Testing and Diagnosis of Celiac Disease

There are two steps to finding out if you have celiac disease: a blood test and an endoscopy. To test for celiac disease, your doctor will order a celiac disease blood panel. This will include the Tissue Transglutaminase IgA antibody test. You must be eating gluten for this to be accurate. If the blood test is positive, the next step is to have an endoscopy. A gastroenterologist takes tiny samples of the small intestine to determine if you have celiac disease.

You should be tested if a close family member (first degree) has been diagnosed with celiac disease. People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease themselves.

Treatment

The treatment for celiac disease is to follow a strict gluten-free diet for life. This means avoiding foods and beverages that contain wheat, rye, barley, and triticale. In the United States, a product may be labeled “gluten-free” if it contains less than 20 parts per million (ppm) of gluten. Fortunately, there is a wide variety of delicious foods that are naturally gluten-free. This includes fruits, vegetables, meat and poultry, fish and seafood, dairy, beans, legumes, and nuts.

When following a gluten-free diet, it is important to focus on what you can eat rather than what you cannot, knowing that a gluten-free diet heals the damage in the small intestine, improving symptoms and decreasing risk for long-term health complications. Working with a registered dietitian who is trained in celiac disease is recommended to help manage health. It is also important to follow-up with your doctor at least annually.

Fast Facts About Celiac Disease

• 1 in 100 people worldwide have celiac disease
• People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease
• There are more than 200 symptoms associated with celiac disease which may occur in the digestive system or any other part of the body
• Patients with celiac disease have a 2x increased risk of coronary artery disease and a 4x increased risk of small bowel cancers
• A gluten-free diet is the only treatment for celiac disease

For more information about celiac disease or the gluten-free diet, please visit www.celiac.org.

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