Celiac Disease

Last Updated: June 1, 2003

People with celiac disease cannot tolerate gluten, a protein in wheat, rye, barley, and possibly oats.

Celiac disease damages the small intestine and interferes with nutrient absorption. Treatment is important because people with celiac disease could develop complications like cancer, osteoporosis, anemia and seizures.

A person with celiac disease may or may not have symptoms. Symptoms may or may not occur in the digestive system. For example, one person might have diarrhea and abdominal pain, while another person has irritability or depression. In fact, irritability is one of the most common symptoms in children.

Diagnosis involves blood tests and biopsy. Because celiac disease is hereditary, family members of a person with celiac disease may need to be tested.

Celiac disease is treated by eliminating all gluten from the diet. The gluten-free diet is a lifetime requirement.

Symptoms of celiac disease may include one or more of the following:
Recurring abdominal bloating and pain
Chronic diarrhea
Weight loss
Pale, foul-smelling stool
Unexplained anemia (low count of red blood cells)
Gas
Bone pain
Behavior changes
Muscle cramps
Fatigue
Delayed growth
Failure to thrive in infants
Pain in the joints
Seizures
Tingling numbness in the legs (from nerve damage)
Pale sores inside the mouth, called aphthus ulcers
Painful skin rash, called dermatitis herpetiformis
Tooth discoloration or loss of enamel
Missed menstrual periods (often because of excessive weight loss)

Diagnosing celiac disease can be difficult because some of its symptoms are similar to those of other diseases, including irritable bowel syndrome, Crohn’s disease, intestinal infections, chronic fatigue syndrome and depression.

Recently, researchers discovered that people with celiac disease have higher than normal levels of certain antibodies in their blood. Antibodies are produced by the immune system in response to substances that the body perceives to be threatening. To diagnose celiac disease, physicians test blood to measure levels of antibodies to gluten. If the tests and symptoms suggest celiac disease, the physician may remove a tiny piece of tissue from the small intestine to check for damage to the villi (Small fingerlike projections in the lining of the small intestine that are used for the absorption of all nutrients).

Who gets celiac disease?
Celiac disease is the most common genetic disease in Europe. In Italy about 1 in 250 people and in Ireland about 1 in 300 people have celiac disease. It is rarely diagnosed in African, Chinese and Japanese people.

An estimated 1 in 4,700 Americans have been diagnosed with celiac disease. Some researchers question how celiac disease could be so uncommon in the United States since it is hereditary and many Americans descend from European ethnic groups in which the disease is common. A recent study in which random blood samples from the Red Cross were tested for celiac disease suggests that as many as 1 in every 250 Americans may have it.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

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