Celiac disease is an autoimmune disorder that causes damage to the small intestine. This damage leads to nutrient absorption problems and gastrointestinal symptoms.
People with celiac disease must follow a strict gluten-free diet to prevent further damage to the small intestine. This can take a while, but eventually the intestinal lining will heal and symptoms will go away.
Symptoms
When you have celiac disease, your body doesn’t absorb key nutrients from the foods you eat. This can cause many different symptoms in your intestines and other parts of your body.
Symptoms can vary from person to person, and some people don’t experience any symptoms at all. However, these people can still have long-term health problems and complications if they don’t get treated for celiac disease.
The main symptom of celiac disease is gastrointestinal (GI) symptoms, which may include diarrhea and bloating. These symptoms typically improve after a person begins eating a gluten-free diet.
Other GI symptoms that are common in people with celiac disease include abdominal pain, weight loss, and fatigue. These symptoms may also be accompanied by skin issues, such as dermatitis herpetiformis (DH), which is an itchy, blistering rash that occurs on the elbows, knees, and buttocks.
Celiac disease also can affect other areas of the body, such as the eyes, joints, and mouth. Children with celiac disease may have growth delays and poor muscle tone. They can also have tooth defects, such as pitting or mottled enamel.
You can also get a rash called dermititis herpetiformis, which is an itchy, blistering skin rash that appears on the elbows, knees, buttocks, and back. This rash is most common among young children with untreated celiac disease and can also happen in adults.
Blood tests and a tissue test, called a biopsy, can help doctors diagnose celiac disease. These tests measure how much of the protein gluten is in your blood. The higher the levels of these cells, the more likely you are to have celiac disease.
The most accurate way to diagnose celiac disease is with a biopsy, which involves taking a sample of your small intestine. The sample is then examined under a microscope to look for damage to the tiny fingerlike projections on your intestine called villi.
The villi are necessary for your body to absorb the nutrients it needs. But when you have celiac disease, your immune system attacks the villi. This can lead to inflammation and other problems in your intestines. The longer you have celiac disease, the harder it can be to treat. This can also make you more likely to develop other autoimmune conditions, such as type 1 diabetes and lupus.
Diagnosis
If you have celiac disease, you can improve your symptoms by following a gluten-free diet. This is a way to make sure that your intestine heals properly, so that you can absorb the nutrients that are needed for good health.
Doctors diagnose celiac disease by checking your blood for infection-fighting cells (antibodies) that are made by your immune system to fight off gluten. These cells are higher in people with celiac disease. They may also test for antibodies called antigliadin and endomysial antibodies, which are specific to celiac disease.
Celiac disease usually begins in childhood or adolescence, but it can start at any age. It can cause many different symptoms, including diarrhea, weight loss, bloating, steatorrhea (a type of acne-like condition), and anemia. It can also have an impact on your liver, heart, and bones.
Your doctor will use information from your medical and family history, a physical exam, and medical tests to determine whether you have celiac disease. He or she will look for signs that you could have celiac disease such as inflammation, damage to the small intestine, and changes in your body’s immune system.
You will likely be tested for celiac disease with a blood test and a tissue biopsy. This is the most accurate way to detect celiac disease.
The blood test checks your level of an antibody called tissue transglutaminase IgA, which is produced by the body to protect against gluten. It is sensitive and specific, but it can have a slight risk of false positive results for people with other autoimmune disorders such as type 1 diabetes, rheumatoid arthritis, Hashimoto’s thyroiditis, and psoriatic or rheumatoid arthritis who do not have celiac disease.
If the blood test is positive, a biopsy will be taken of your small intestine to confirm the diagnosis. This is done by passing a long, thin tube (endoscope) into your small intestine and taking samples of tissue to check for celiac disease.
The biopsy will show that the tissue is inflamed and damaged, which is a sign of celiac disease. Then your doctor will work with you to create a plan for eating a gluten-free diet. This diet is important for your overall health, and it can also help prevent other health problems from developing.
Treatment
Celiac disease is an autoimmune disorder that can be treated with a gluten-free diet and medications. It isn’t a medical emergency, but it can cause long-term problems and make it harder for your body to absorb nutrients.
A blood test may be done to determine if you have celiac disease. Your doctor can also biopsy your small intestine to confirm the diagnosis. They can do this if you have symptoms, such as diarrhea, weight loss or other digestive issues, that may be related to celiac disease.
Your doctor will check your family history, do a physical exam and talk to you about your eating habits. They can also do tests that check for other intestinal diseases, including irritable bowel syndrome and Crohn’s disease.
When you eat foods containing gluten (a protein found in wheat, barley, rye and oats), your immune system attacks the protein, causing inflammation of the lining of your small intestine. This can lead to the destruction of the small, fingerlike projections called villi in your intestine that help your body absorb nutrients from food.
These villi normally help your body get essential nutrients from foods, such as iron, B vitamins, calcium and zinc. When the villi are destroyed, your body cannot get these nutrients. This can cause malnutrition.
If you have celiac disease, it’s important to get tested often. Your doctor will check your blood test results to see if you’re getting enough of the right nutrients and to monitor how well your body is healing.
Treatments for celiac disease are designed to remove gluten from your diet and prevent it from triggering your immune system to attack the villi in your small intestine. The goal is to allow the intestinal villi to heal, so they can properly absorb the nutrients that your body needs.
Your doctor will recommend a gluten-free diet and give you instructions for reading food labels to identify any ingredients that contain gluten. You can find gluten-free versions of many foods at supermarkets and health food stores.
You can also get steroid medicine, such as prednisone or azathioprine, to help control the inflammation caused by celiac disease. These medicines will relieve your symptoms, but you must keep up regular blood tests to check for side effects.
Prevention
Celiac disease is an autoimmune disorder, meaning your body’s immune system attacks the protein gluten. This attack damages the lining of your small intestine (mucosa), impairing your ability to absorb nutrients from food. This can lead to malnutrition and many other health problems.
People with celiac disease have to avoid gluten, which is the protein found in wheat, barley, rye and triticale. It is also in some foods made from other grains, such as oats.
The disease usually develops when a person has one or both of the genes for it, known as HLA-DQ2 and HLA-DQ8. But it can occur even in people who don’t have the gene.
This happens because the immune system mistakenly thinks gluten is a threat to your body, so it sends antibodies against it. In doing so, it destroys small finger-like projections in the small intestine called villi.
These villi help the body absorb nutrients and send them into the bloodstream where they are needed. When the villi are damaged, they can’t do their job, leading to many of the symptoms and complications associated with celiac disease.
Children who have celiac disease may have a hard time gaining weight or putting on height at a normal pace, they can have diarrhea and stomach pain, and they might develop anemia or mouth sores. They may also have behavior problems.
Some people who have celiac disease are able to control their symptoms with a gluten-free diet. But others have refractory or nonresponsive celiac disease, which means their symptoms don’t improve with a gluten-free diet.
Getting diagnosed early is important because symptoms can be very severe. They can lead to severe malnutrition, such as rickets in children or osteoporosis in adults. These effects can be difficult to reverse.
In addition, they can cause damage to the nervous system and skeletal system. This can cause a variety of symptoms, such as tingling and numbness in the hands and feet. These symptoms can cause balance and coordination problems, muscle spasms and a short stature.
At the Center for Celiac Disease at CHOP, clinical experts use a variety of tests to diagnose and manage celiac disease. They start with a screening blood test that measures certain antibodies in the blood. They then take a sample of the small intestine using a thin tube and perform a biopsy to see what’s wrong. If the biopsy shows a reaction to gluten, your doctor can make a diagnosis of celiac disease.
