Understanding Celiac Disease

Celiac disease is a chronic, autoimmune condition that is triggered by the consumption of gluten. When a person with celiac disease consumes gluten, an immune-mediated reaction occurs that causes injury to the small intestine. Left untreated, celiac disease can lead to long-term injury to the intestine, preventing the body from absorbing the nutrients it needs for optimal wellness. Celiac disease not only impacts the intestines, but the body as a whole.

While symptoms of celiac disease can include digestive issues like abdominal pain and diarrhea, patients also often experience symptoms outside of the gut. Headaches, fatigue, dermatitis herpetiformis (an itchy rash) and anemia can also be common signs of celiac. Some people with celiac have very few symptoms at all. 

Did you know: the number of people diagnosed with celiac disease has increased 4-5 times over the past 4 decades.

Celiac disease occurs in genetically predisposed people

Celiac is more common in patients who have a history of the disease in their family. People with a first-degree relative, like a parent, with celiac disease are more likely to be diagnosed with celiac themselves. If a family member is diagnosed with celiac disease, it is often recommended that first-degree family members get tested as well. 

Other risk factors for celiac disease include: 

• Having the HLA-DQ2 and HLA-DQ8 Genes: About 95% of celiac patients have these genes. 
• Other autoimmune diseases: Celiac disease may be associated with other autoimmune diseases like Thyroid disease or Type 1 Diabetes. Having an autoimmune disease may make patients more susceptible to developing celiac.

In children, research has shown that delaying the introduction of gluten in early life or while breast-feeding does not reduce the risk of celiac disease. However, higher gluten intake in the first 5 years of life may be associated with increased risk. 4-12 months is the recommended age to introduce children to foods containing gluten.

Celiac disease differs from non-celiac gluten sensitivity

While celiac disease is an autoimmune disease, gluten intolerance is a sensitivity. Gluten sensitivity can be more difficult to diagnose, and patients may exhibit some similar symptoms to those with celiac disease. Typical symptoms of gluten intolerance are often akin to those of IBS, and can include abdominal pain and bloating. While some people with gluten sensitivities can feel healthy by simply cutting back the amount of gluten they eat, people with celiac cannot tolerate any gluten in their diets. 

Vitamins and minerals can help to balance deficiencies in people with celiac disease

When celiac disease is diagnosed, patients can often have micronutrient deficiencies. Some micronutrients that may need to be supplemented include:

• Iron
• Folic acid
• Vitamins B6 and B12
• Vitamin D
• Copper
• Zinc

Doctors can accurately screen and test for celiac disease

For those who are at risk for celiac disease or experiencing symptoms that may be linked to the condition, screening is essential. Once celiac disease is diagnosed, patients can learn how to manage their symptoms, eat a balanced gluten-free diet, and avoid long term health concerns. If left untreated, celiac disease can lead to heart disease, iron deficiency anemia, malnutrition, psychological conditions and other serious problems. However, with a diagnosis and treatment plan, people with celiac can go on to live healthy and joyful lives!

Screening for celiac is done when there is high clinical suspicion or genetic risk

Doctors may screen for celiac disease if a patient has a direct relative with celiac even if there are no symptoms present. Doctors may perform genetic tests to see if the HLA DQ2 and HLA DQ8 genes are present. 

Patients with other autoimmune disorders including Type 1 diabetes, autoimmune thyroid or adrenal disease, or autoimmune connective tissue disorders are also often screened for celiac. Other pre-existing conditions that may be cause for celiac screening include nutrient deficiencies and inflammatory diseases. 

It is important to see a doctor if you think you may have celiac or other gastrointestinal illnesses

 Look out for these symptoms in the gut:

• Reflux
• Bloating
• Lactose intolerance
• Altered bowel habits 

In other parts of the body, people with celiac may notice these celiac symptoms: 

• Rashes
• Iron or folate deficiencies
• Chronic fatigue
• Short stature
• Infertility
• Neuropsychiatric manifestations
• Osteopenia

Celiac is diagnosed through blood tests and biopsies

Serology blood tests are used by doctors to determine whether a patient may have celiac disease. If the results are positive, an endoscopy is used to take a look inside the small intestine. In this test, samples of the lining in the small intestine are taken so the doctor can see if there is damage or inflammation as a result of celiac disease. This is normally an easy outpatient procedure.

Gluten free diets effectively treat most people with celiac disease

Through lifestyle and diet changes, people with celiac disease can cultivate vibrant, healthy lifestyles. Currently, the only treatment for celiac disease is a lifelong commitment to a gluten free diet. Even in small amounts, consuming gluten can trigger an autoimmune response that can damage the small intestine. 

Did you know: Doctors do not recommend gluten free diets for people who do not have celiac disease or gluten intolerance.

Adhering to a strict gluten free diet may seem intimidating, but focusing on the foods that can be enjoyed, rather than those that can’t be eaten can help change the mindset surrounding celiac disease. By maintaining a lifelong gluten-free diet, people with celiac can prevent further damage to their small intestines and allow the small intestine to heal. This ensures that the body has an abundance of nutrients and can perform its functions well. A doctor or registered dietician can help people with celiac disease develop healthy, balanced diets.

These lifestyle changes can help people with celiac optimize their wellness: 

• Choose naturally gluten free foods like fruits, vegetables, and unprocessed meats.
• Optimize the nutritional content of meals and snacks to ensure the body has what it needs to thrive.
• Consume dairy products that are naturally low in lactose like older cheeses, yogurt, and kefir.
• Choose foods that are rich in bioavailable iron like dark meats, poultry, and fish.

Key takeaways

• Celiac disease is an autoimmune disorder that causes damage to the small intestine. This prevents the intestine from absorbing nutrients that the body needs to thrive.
• Celiac disease is found in genetically susceptible people, like those who have a parent with celiac.
• Celiac disease is different from gluten intolerance or non-celiac gluten sensitivity. 
• The only treatment for celiac disease is a lifelong gluten free diet.