Celiac disease primarily affects the small intestine (bowel part). It can occur at any age. Celiac disease is caused by a bowel reaction to gluten. Gluten is part of certain foods – especially foods made from wheat, barley and rye. Several symptoms may develop such as abdominal pain, fatigue and weight loss. Symptoms go if you do not eat any food containing gluten.
On this page
- What is celiac disease?
- Who is affected by celiac disease?
- What causes celiac disease?
- What are the symptoms of celiac disease?
- How is the diagnosis confirmed?
- Are there screening tests for celiac disease?
- What are the treatments for celiac disease?
- Are there any complications?
- Tracing
- More help and information
- References
What is celiac disease?
Celiac disease is a condition that causes inflammation in the lining of the small intestine (part of the intestine).
Celiac disease is not a food allergy or a food intolerance. It is an autoimmune disease. The immune system makes white blood cells (lymphocytes) and antibodies to protect against foreign agents, such as bacteria, viruses and other germs. In an autoimmune disease, the immune system mistakes part or parts of the body as foreign. Other autoimmune diseases include type 1 diabetes, rheumatoid arthritis and some thyroid disorders.
The lining of the small intestine contains millions of small tube-like structures called villi. These foods help and digest the nutrients more effectively in the body. But in people with celiac disease, the villi are flattened as a result of inflammation. This means that foods and nutrients are not easily digested by the body.
Who is affected by celiac disease?
Celiac disease affects about 1 in 100 people in the UK. Anyone of any age can develop celiac disease. It is a condition that is associated with young children. However, it is now more commonly diagnosed in adults. It is most often diagnosed in people between 40 and 50 years. Approximately 1 in 4 cases are diagnosed in people over 60 years.
Celiac disease runs in families. If you have a close relative with celiac disease (a brother, sister, parent or child), then you have a 1 in 10 chance of developing celiac disease. It is also more common in people who have other autoimmune diseases – for example, some thyroid diseases, rheumatoid arthritis and type 1 diabetes.
What causes celiac disease?
The cause is a sensitivity to gluten. Gluten occurs in common foods such as wheat, barley and rye, and some foods made from them, such as bread, pasta and biscuits. Some people with celiac disease are also sensitive to oats.
People with celiac disease produce antibodies to gluten. Antibodies are immune system proteins that normally attack bacteria, viruses and other germs. Indeed, errors intestinal gluten which is harmful, and reacts against it as if a germ fighting. These antibodies lead to developing inflammation of the lining of the small intestine.
Celiac disease can develop in babies. Older children or adults who have not had problems also may become sensitive to gluten at some point in their lives and to develop celiac disease. It is not known why some people's immune system becomes sensitive to gluten.
What are the symptoms of celiac disease?
The inflammation in the small intestine coating stops absorbing power appropriately. Then do not absorb nutrients very well in your body. A variety of symptoms, then you can develop.
Babies
Early symptoms develop soon after weaning when your baby starts eating solid foods containing gluten. The baby may not grow or gain weight. Since food is not absorbed properly, excrement (feces) can be pale and voluminous. Smelly diarrhea may occur. The abdomen (belly) may swell. The baby may have repeated vomiting.
Older children
Symptoms of celiac disease in older children may be similar to those of babies. Poor absorption of foods can cause deficiencies of vitamins, iron and other nutrients. This can lead to anemia and other problems. As the dietary fat is not absorbed well, stools may be pale, smelly and difficult to evacuate immediately. The diarrhea may develop. However, symptoms may not be very typical or obvious. If the intestine and bowel symptoms are mild, the first thing you may notice poor growth.
Adults
Poor absorption of foods can cause deficiencies of vitamins, iron and other nutrients. Anemia due to iron malabsorption is common. Other common symptoms include abdominal pains that tend to come and go, excessive wind, bloating, diarrhea and fatigue or weakness. Mouth ulcers can occur. You can lose weight due to poor absorption of food. However, most adults with celiac disease do not lose weight and keep weight low.
Sometimes an itchy skin condition called dermatitis herpetiformis can occur in some people with celiac disease.
If the common symptoms described above develop, the diagnosis can be made quickly. However, common or typical symptoms are not always implemented. Especially in adults, the affected areas in the intestine may be irregular. Then the symptoms can be mild, or not typical, and may be a while before the diagnosis is made.
How is the diagnosis confirmed?
If celiac disease is suspected, a blood test to detect certain antibodies that occurs in celiac disease can be advised by your doctor. It is important that you are eating a gluten diet for at least six weeks before the blood test is performed.
If the blood test is positive, then you may be referred to a specialist who can arrange for a biopsy to take. Is small biopsy tissue sample is taken in the inner lining of the small intestine. This is analyzed under a microscope to see if the changes typical of celiac disease are present. The biopsy is usually taken by a thin, flexible tube (endoscope) is passed down the throat (esophagus), through the stomach and small intestine.
Other tests may be done to determine the number of poor absorption of food and nutrients has affected. For example, blood tests for anemia and vitamin levels, iron, protein, etc. You may be advised to have a special bone scan (DEXA scanner) to see if their bones are affected due to malabsorption calcium and vitamin D.
Note: if you suspect that you may have celiac disease symptoms, then consult a doctor. Do not treat yourself and go on a gluten-free diet (described below) without a confirmed diagnosis. If you do go on a gluten-free diet before the diagnosis is confirmed, then the tests done at a later time may not be conclusive and may even be negative. So, get it checked first – and then treat if confirmed.
Are there screening tests for celiac disease?
Celiac disease tends to be under-diagnosed. There are certain groups of people are much more likely to have celiac disease than others. They should have a test for celiac disease even if they have no or few symptoms. This includes people with:
- Diabetes Type 1: If available, children should be tested for the most common types of genes that are associated with celiac disease. These are HLA-DQ2 or HLA-DQ8. If you do not have these types are extremely unlikely to develop celiac disease. If this test is not available, should have the blood test to detect specific antibody every three years.
- Close relatives (parent, child, brother / sister) of a patient with celiac disease.
- Down Syndrome
- Autoimmune diseases such as thyroiditis, Sjogren's syndrome or arthritis.
What are the treatments for celiac disease?
Gluten-free diet
The main treatment for celiac disease is to not eat any foods containing gluten for the rest of his life. Symptoms usually then go in a few weeks. The key is to stop any food containing wheat, barley or rye. Many common foods contain these ingredients, such as breads, pastas, cakes, pastries and some cereals. Foods made with oats are generally safe to eat. However, some people with celiac disease have symptoms if they eat oats. Potatoes, rice food, maize, corn, fruits, dairy and soy are well based.
You should obtain advice from a dietitian. Coeliac UK also offers advice on what foods are suitable (see address below). You can buy special gluten flour, pasta, bread and other foods. Also available by prescription in health food stores, by mail and over the Internet. There are many alternatives leaves diet foods and recipes. Unfortunately, many processed foods, ready meals and fast foods contain gluten. Food labels usually say if the food contains gluten or not.
Avoid gluten for life. If you eat gluten again, the symptoms will return. Even small amounts of gluten can again raise the intestine. To prevent symptoms and complications (see below), should be strict in avoiding all foods that contain gluten.
You may have to accept some restrictions on lifestyle. However, many foods that are allowed are varied and interesting.
Other treatments
Besides avoiding gluten, you may be advised to take some supplements of vitamins, calcium and iron, at least for the first six months after diagnosis. This is to replace the deficiencies and to make sure you get enough of these, while the lining of the intestine is returning to normal.
Celiac disease can cause the spleen to work less efficiently, making it more vulnerable to infection with certain germs. Therefore, it can have several immunizations including:
- The flu (influenza) jab.
- Hib vaccine – which protects against septicemia, pneumonia and Hib meningitis.
- Pneumococcal vaccine – which protects against infections caused by the bacterium Streptococcus pneumoniae.
Are there any complications?
Although there is no cure once and for all for celiac disease, the symptoms can be removed by having a gluten-free diet. Also, having a gluten-free diet reduces the risk of complications in the future.
Apart from the above symptoms, people with celiac disease have an increased risk of the following:
- The development of osteoporosis (thinning of the bones) due to nutritional deficiencies that occur with celiac disease.
- The development of lymphoma (a type of cancer) of the bowel in the elderly. This is rare.
- The development of other diseases related to the immune system (autoimmune disease) and type 1 diabetes, hypothyroidism, Sjögren's syndrome and primary biliary cirrhosis.
- Having a baby with a low birth weight or born prematurely if you become pregnant.
A common mistake is to eat small amounts of foods containing gluten. This may be intentional. However, some people mistakenly think that a small amount does not matter. It does. A well known example is to think that the small amount of bread in a host does not matter. Even this small amount of gluten is enough to cause symptoms, and to maintain the increased risk associated with celiac disease detailed above.
Some people with celiac disease do not realize that they are taking small amounts of gluten. It may feel good, or to ignore mild symptoms, such as bloating or diarrhea. Again, the greatest risks (osteoporosis, etc.) remain in their case eat gluten.
If you do not eat any gluten, can expect to be free of symptoms and have a healthy normal life. The increased risk of developing other autoimmune diseases is reduced. Eating a gluten-free diet also reduces the risk of developing lymphoma.
Tracing
Once you have been diagnosed with celiac disease, is likely to have regular follow-up appointments. This principle can be after three to six months to ensure that you are making satisfactory progress and managing your gluten free diet. Depending on your age and other factors, can be monitored to see if you have developed osteoporosis.
You can expect to live a life free of the symptoms of celiac disease if totally avoid gluten.
More help and information
Coeliac UK
3rd Floor, Apollo Centre, Desborough Road, High Wycombe, Buckinghamshire HP11 2QW
Helpline: 0845 305 2060 Web: www.coeliac.org.uk
