Summary: Celiac disease is an autoimmune disease that triggers an internal response inside of the body where healthy intestinal cells and villi are permanently damaged due to the exposure to the protein gluten. This disease is also linked to certain types of gastrointestinal cancers and other medical issues. While Celiac disease has no cure, the treatment is following a strict gluten free diet for life. For those with a positive diagnosis, a few crumbs of gluten-filled bread can cause immense and irreversible damage.
Celiac disease is an immune system response and reaction to eating or being exposed to the protein gluten. Gluten can be found in wheat, barley and rye, plus a whole lot of processed and shelf-stable foods, condiments and spices. For those who have Celiac disease, ingesting any amount of gluten, sometimes as few as five crumbs, can cause permanent irreversible internal damage. Over time, this damage builds up and creates serious complications in the small intestine preventing nutrients from being absorbed. Malnutrition is often the end results, however someone with exposure may also deal with diarrhea, fatigue, weight loss, bloating, anemia and in severe cases, certain types of cancer. There is no cure for Celiac disease other than following a strictly gluten free diet to bolster your internal health.
What are the symptoms or signs of developing Celiac disease?
The signs of Celiac disease can be extremely different from person to person, in children and in adults. The common signs in any human are diarrhea, fatigue, and weight loss. More than half of those adults diagnosed have these signs and symptoms which are not related to the gastrointestinal system:
-mouth ulcers, or open sores in the mouth.
-itchy, blistering skin rash called dermatitis herpetiformis.
-anemia from iron deficiency.
-damage to enamel of teeth with discoloration or decay.
-acid reflux and heartburn.
-malfunctioning spleen called hyposplenism.
-joint pain with or without swelling.
-headaches and fatigue.
-nervous system injury with numbness or tingling in the feet or hands.
-equilibrium and balance can be “off” and feel different.
With Celiac disease in children, they may present with any of the following symptoms:
-failure to thrive
-learning disabilities including ADHD, slow to learn functions and lack of coordination.
What causes Celiac disease to develop?
The definite cause of Celiac disease is unknown, although many doctors and specialists now believe that gastrointestinal infections, poor gut health, infant feeding practices and environmental triggers could be the cause. In other cases, surgery, pregnancy, childbirth, viral infection and severe emotional stress can trigger this disease.
When the body of a Celiac positive human is exposed to gluten, the body goes in to attack mode, and starts with the tiny villi projections that line the intestines and parts of the GI tract. Villi are important in our bodies as they absorb vitamins, minerals and all other nutrients that your body needs from the foods and beverages you eat.
In some cases, gene mutations show a higher risk of developing Celiac disease but having any variant does not mean you will indeed get this disease. The rate of Celiac diagnosis is about one percent of the population, with Caucasian humans being most likely to be diagnosed. Celiac disease can be found in almost every ethnic group around the globe, so no one is void of the possibility of this disease.
What are the risk factors that increase my chances of having Celiac disease?
Because there are so many factors determining if one has Celiac disease, certain triggers or illnesses have been linked to an increase in diagnosis rate in families. They are:
-any autoimmune thyroid disease
-Rheumatic diseases like rheumatoid arthritis
-a family member with the disease
-type 1 diabetes
-Down Syndrome or Turner Syndrome
What are the complications that can arise with Celiac disease?
If left untreated and the patient does not follow a strict gluten free diet, these things can happen:
– Lactose intolerance. Damage to your small intestine may cause you to experience abdominal pain and diarrhea after eating lactose-containing dairy products, even though they do not contain gluten. Once your intestines have healed, you may be able to tolerate dairy products again. That said, most people choose to also avoid dairy products.
– Cancer. People with celiac disease who do not follow a gluten free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer. This is due to the fact that the gluten with damage the intestines, causing small ulcers and even holes which leads to abnormal cell growth in the body. Celiac disease is an autoimmune disease, which enables the body to attack itself. Instead of attacking damaged cells, infection or otherwise, the body attacks normal cells, healthy organs and the brain.
–Malnutrition. The damage to your small intestine means it cannot absorb enough nutrients. Malnutrition can lead to anemia and drastic weight loss. In children, malnutrition can cause slow growth and short stature. Severe malnutrition can be treated with feeding tubes and medications to calm the GI system.
–Loss of calcium and bone density. Malabsorption of calcium and vitamin D may lead to a softening of the bone in children and a loss of bone density or osteoporosis in adults.
–Infertility and miscarriage. Malabsorption of calcium and vitamin D can contribute to reproductive issues like infertility and miscarriage.
–Neurological problems. Some people with celiac disease may develop neurological problems such as seizures or peripheral neuropathy, which causes a numbness or tingling in the extremities.
What is nonresponsive Celiac disease? Refractory Celiac disease?
Nonresponsive Celiac disease is something that nearly thirty-percent of those with the disease will deal with and is the inability to maintain a gluten free diet, and the contamination in the body with gluten containing foods. People with this condition may also experience SIBO or small intestinal bacterial overgrowth, microscopic colitis, poor pancreas function, IBS, or intolerance to sugar. People with nonresponsive Celiac disease may also have refractory celiac disease.
In rare cases, the intestinal damage of Celiac disease continues on and leads to substantial malabsorption, even if following a gluten free diet. If you continue to experience signs even after following the strict diet and lifestyle changes required for Celiac disease living, you doctor may consider putting you on steroids to help to reduce inflammation and give you body a break from the autoimmune attacks. In extreme cases, an immune suppressant may be prescribed to give the body a longer, more intense break from itself. Any patient with Celiac disease should be monitored frequently to ensure that malnutrition has not begun.
How is Celiac disease diagnosed and treated?
There is no cure or specific medication for Celiac disease. Your doctor may order one of two tests to confirm this disease and if they are positive, they may then request an endoscopy to view your small intestine and any damaged villi present. The tests that may be ordered are:
–Serology testing that looks for the antibodies in your blood. Elevated levels of certain antibody proteins prove an immune reaction to gluten.
–Genetic testing for leukocyte antigens, specifically HLA-DQ2 and HLA-DQ8, can be used to rule out Celiac disease.
One important part of testing that many do not know is that to be tested for Celiac disease, you need to do your testing WHILE you are STILL eating gluten-laced foods. If you stop eating gluten, you will have to spend six months to one-year eating gluten once again to have a confirmed test result. In many cases, the patient has already gone gluten free and is not willing to reembark on the gluten-filled diet because their symptoms and other ailments have been eased. In this case, most doctors will treat the patient as if they do have Celiac disease, and if the results follow the same course, will continue to treat the patient with gluten free diets and recommendations.
Treatment for Celiac disease is simple and complex at the same time. Following an extremely strict gluten free diet for the rest of your life is the only way to go. Many people do not understand all of the places where gluten can be found because they attribute it to ‘wheat.’ In addition to wheat, gluten can be found in all of these places and more:
Processed foods and meats
Spelt, a form of wheat
This can be a complicated diet to learn on your own. If you are unsure if you can manage on your own, do not hesitate to ask your doctor to refer you to a dietitian who can help you plan a healthy, nutrient dense gluten free diet. Once you have maintained this diet for six months, you intestinal lining and damaged villi may begin to heal. Complete healing may take years, or never fully happen. Children heal faster from gluten exposure than adults tend to.
When you accidentally ingest gluten, you may experience abdominal pain and diarrhea, while others may not experience any visible damage. With Celiac disease, there does not need to be any symptoms or visible signs for permanent damage to be done to the intestines and GI tract.
If you suspect you may have Celiac disease, make an appointment to meet with your doctor to begin testing immediately. The sooner you catch this disease, the less likely you will need feeding tubes or malnutrition help in your life. Remember, Celiac disease is known as the silent killer because the damage is often done before the patient has any idea what has even been happening inside their bodies.