Celiac Disease

• Digestive problems (abdominal bloating, pain, gas, diarrhoea, pale stools, and weight loss).
• A severe skin rash called dermatitis herpitiformis.
• Anemia (low blood count).
• Musculoskeletal problems (muscle cramps, joint and bone pain).
• Growth problems and failure to thrive (in children).
• Seizures.
• Tingling sensation in the legs (caused by nerve damage and low calcium).
• Aphthous ulcers (sores in the mouth).
• Missed menstrual periods.

Health Problems

What other health problems can accompany celiac disease?

Celiac disease can leave the patient vulnerable to other health problems, including:

• Cancer of the intestine (very rare).
• Osteoporosis, a disease that weakens bones and leads to fractures. This occurs because the person has trouble absorbing enough calcium and vitamin D.
• Miscarriage or infertility.
• Birth defects, such as neural tube defects (improper formation of the spine) caused by poor absorption of such nutrients as folic acid.
• Seizures.
• Growth problems in children because they don't absorb enough nutrients.

People who have celiac disease may have other autoimmune diseases, including:

• Thyroid disease.
• Type 1 diabetes.
• Lupus.
• Rheumatoid arthritis.
• Liver disease.
• Sjogren's syndrome (a disorder that causes insufficient moisture production by the glands).

Diagnosis

How is celiac disease diagnosed?

If your doctor thinks you might have celiac disease, he or she will perform a careful physical examination and will discuss your medical history with you. He or she may also perform a blood test to measure levels of antibodies to gluten. People with celiac disease have higher levels of certain antibodies in their blood.

Your doctor may perform other tests to look for nutritional shortages, such as a blood test to detect iron levels; a low level of iron (which can cause anaemia) can occur with celiac disease. A stool sample may be tested to detect fat in the stool, since celiac disease prevents fat from being absorbed from food.

Your doctor may take a biopsy from your small intestine to check for damage to the villi. In a biopsy, the doctor inserts an endoscope (a thin, hollow tube) through your mouth and into the small intestine and takes a sample of the small intestine with an instrument.

Treatment

How is celiac disease treated?

If you have celiac disease, you can't eat any foods that contain gluten (including wheat, rye, barley, and oats). Dropping gluten from your diet usually improves the condition within a few days and eventually ends the symptoms of the disease. In most cases, the villi are healed within 6 months.

You'll have to remain on this diet for the rest of your life; eating any gluten at all can damage your intestine and restart the problem.

Some people with celiac disease have so much damage to their intestines that a gluten-free diet will not help them. These patients may have to receive intravenous (through a vein) nutrition supplements. Following a gluten-free diet means you cannot eat many "staples," including pasta, cereals, and many processed foods that contain grains. There may also be gluten in ingredients added to food to improve texture or flavour, and products used in food packaging.

If you have celiac disease, you can still eat a well-balanced diet. For instance, bread and pasta made from other types of flour (potato, rice, corn, or soy) are available. Food companies and some grocery stores also carry gluten-free bread and products.

You can also eat fresh foods that have not been artificially processed, such as fruits, vegetables, meats and fish, since these do not contain gluten.

Living With Celiac Disease

What are the practical aspects of celiac disease?

A gluten-free diet will be a big change in your life. You have to rethink your eating habits, including what you buy for lunch, what you eat at parties, or what you snack on. When you go grocery shopping, be sure to read the ingredient label carefully.

A dietitian, a healthcare professional who specializes in food and nutrition, can help you with the gluten-free diet. There are also support groups that can help patients who have just been diagnosed with celiac disease. 

Recommended websites

Reliable videos:

• Celiac disease - causes, symptoms, diagnosis, treatment & pathology

References:

1. National Institute of Diabetes and Digestive and Kidney Diseases. Celiac Disease. Accessed 1/16/2017.
2. National Institutes of Health Osteoporosis and Related Bone Diseases - National Resource Center. What People With Celiac Disease Need to Know About Osteoporosis. Accessed 1/16/2017.
3. National Celiac Association. What is Celiac Disease? Accessed 1/16/2017.

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