Celiac Disease: Symptoms, Causes, and Treatment

Celiac disease is a digestive disorder that develops when you eat gluten, a protein found in wheat and other grains, and damages the small intestine. It is also known as celiac sprue, nontropical sprue, or gluten-sensitive enteropathy.

Most people with celiac disease don’t know they have it. When they consume gluten, their immune system attacks the small intestine and damages the villi, tiny finger-like projections inside the small intestine. The damaged villi are unable to absorb nutrients from the food, which leads to malnutrition and other severe health complications, including permanent intestinal damage.

People with celiac disease need to eliminate all types of gluten from their diet, such as breads, cereals, pasta, beer, and baked goods. Gluten often appears as an additive in food products such as soups, sauces, and packaged foods. 

Celiac Disease Symptoms

The symptoms of celiac disease can vary significantly from person to person. 

Celiac Disease Symptoms in Adults

• Abdominal pain and bloating
• Constipation
• Diarrhea
• Heartburn
• Iron deficiency anemia
• Headache, nausea, and vomiting
• Weight loss
• Numbness and tingling in hands and feet

Celiac Disease Symptoms in Children

• Weight loss
• Constipation
• Diarrhea
• Pale, foul smelling poop
• Upset stomach or vomiting
• Abdominal pain and bloating

Celiac Disease Symptoms in Females

• Early menopause
• Irregular periods
• Miscarriage

Many people with celiac disease develop an itchy, blistering rash. It is more common in adults than in children and is seen more frequently in men than women. The most common areas for celiac rash are the elbows, knees, buttocks, scalp, and lower back.

Causes

The exact cause of celiac disease is not known. Below are some of the common causes mentioned:

• Abnormal response of the body’s immune system to gluten
• Villi damage due to the consumption of gluten
• Gastrointestinal infection, stress, and pregnancy

Risk Factors

The following risk factors can increase the probability of celiac disease development:

• Family history
• Age
• Genetics
• Medical conditions such as Type 1 diabetes, Hashimoto’s thyroiditis, Down syndrome, Rheumatoid arthritis, Addison’s disease, Turner syndrome, Multiple sclerosis, and Sjögren’s syndrome

Complications

If celiac disease is left untreated, it can lead to long-term malnutrition, which can cause:

• Weak or softened bones
• Weak tooth enamel
• Balance problem
• Slow growth and development in children
• Numbness and nerve tingling
• Learning and attention problems

Chronic inflammation from untreated celiac disease could result in:

• Lactose intolerance
• Sores and scarring in the intestine
• Weak immune system
• Liver disease
• Collagenous sprue (collagen build-up and deposit in the small intestine)

Diagnosis of Celiac Disease

It is difficult to diagnose celiac disease as the symptoms are similar to other digestive issues. The following tests are used for diagnosis:

• Serology testing: It is done to check antibodies in the blood. Elevated antibody protein levels indicate an immune reaction to the protein.
• Genetic testing: It is done to check whether you have HLA-DQ2 and HLA-DQ8 genes to celiac disease.
• Biopsy: A small tissue sample is taken from the small intestine and examined under a microscope.
• Capsule endoscopy: A tiny wireless camera is swallowed in a pill, and when the pill moves through the intestine, it examines the signs of celiac disease.

Other tests include:

• Complete blood count (CBC)
• Liver function tests
• Serum albumin test
• Cholesterol test
• Alkaline phosphatase level test
• Vitamin D, B12, and folate tests
• Iron and ferritin tests

It is necessary to avoid having a gluten-free diet before a celiac disease diagnosis, as it can affect the result accuracy.

Stages of Celiac Disease

Celiac disease is characterized by two primary phases:

• Active phase: It includes minor intestinal damage when gluten exposure causes symptoms. The individual may experience symptoms like diarrhea, bloating, abdominal pain, and weight loss. The small intestine also shows inflammation signs and villi destruction.
• Remission phase: After adhering to a strict gluten-diet, this phase occurs which results in fewer or disappeared symptoms. During this stage, the small intestine starts to repair, and the villi may grow again.

Note: Some people living with celiac sprue may not exhibit noticeable symptoms; this condition is called silent celiac disease, which harms the small intestine.

Treatment and Management

Celiac disease can be managed and treated by removing gluten from your diet permanently. Even small amounts of gluten can be harmful.

Your doctor or a registered dietitian will help you plan a gluten-free diet. Removing gluten from your diet will reduce small intestine inflammation and help you feel better. Children can heal more quickly than adults. 

Routine endoscopies and blood tests are essential to evaluate the condition. 

Medications

Your healthcare professional may also prescribe some medications:

• Corticosteroids to treat any inflammation after removing gluten from your diet
• Dapsone to treat the skin rash
• Vitamin or mineral supplements for anemia or nutritional deficiencies

Most people find that their symptoms begin to improve immediately after removing gluten from their diet. Medical follow-ups at regular intervals are vital to ensure that your intestine is healing. 

Your gut can take several weeks to months to fully heal. People with severe damage may take longer to heal. Healing can also be delayed if the person is not strict with the diet. 

“Consult the Best Gastroenterologist in India for expert diagnosis and management of Celiac Disease.”

Food Precautions

If you have celiac disease, you need to avoid:

• Wheat
• Rye
• Barley
• Spelt
• Durum
• Bulgur
• Graham flour
• Semolina
• Malt

You can include the following things in your diet:

• Corn
• Buckwheat
• Cornmeal
• Rice
• Quinoa
• Arrowroot
• Fruits
• Fresh meat, fish
• Peas, potatoes, sweet potatoes, corn
• Rice, beans, and lentils
• Vegetables
• Wine and spirits

Takeaway

If you cut out all the gluten from your diet immediately after a celiac disease diagnosis, your intestine will start healing gradually. With proper care and dietary changes, you can lead a healthy and symptom-free life.