Celiac Disease

Celiac disease can affect anyone at any age. The symptoms differ for children, teens, and adults:

Children

• Irritability
• Lethargy
• Abdominal pain
• Abdominal bloating
• Vomiting
• Problems with growth
• Poor appetite
• Failure to thrive (gain weight)
• Diarrhea (some blood in stools)
• Constipation
• Malnourishment

Teens. Teens usually experience the onset of this disease after a stressful event or trigger such as illness, injury, traumatic life event, or leaving home for school.

• Abdominal pain
• Problems with growth
• Late-onset of puberty
• Lethargy
• Weight loss
• Irritable moods
• Depression
• Bloating
• Itchy rash
• Mouth sores

Adults. Adults do not have severe problems with the digestive tract like children do. Only one-third of adults experience severe diarrhea.

• Anemia (lack of iron absorption)
• Bone pain
• Joint pain
• Arthritis
• Depression
• Anxiety
• Osteoporosis
• Seizures
• Tingling of hands and feet
• Irregular menstrual periods
• Itchy skin rash
• Mouth sores

The initial onset of the disease may be brought on by things like stress, a virus, pregnancy, or trauma. Thereafter, the body begins to respond to gluten and attacks the lining of the intestines. It causes damage to the villi that absorb nutrients. Celiac disease is thought to have a genetic component. Celiac disease typically occurs in people who have a genetic alteration in two genes known as DQ2 or DQ8. However, not all people who have these variants will develop celiac disease. Only 3% of people with genetic variants developing celiac. Exposure to gluten in early childhood may have a greater risk for developing the disease if they already have the alterations on DQ2 or DQ8.

• Family history of celiac disease
• Autoimmune thyroid disease
• Type 1 diabetes
• Down syndrome
• Turner syndrome
• Sjögren’s syndrome
• Lymphocytic colitis

Your doctor may collect blood to test for antibodies in the blood.

These tests include:

Tissue transglutaminase antibodies (tTG-IgA). This test comes back positive for celiac in around 98 percent of people with the condition who have been eating gluten. It also comes back negative for celiac in around 95 percent of people that do not have the condition. The only drawback with this test is there is a high chance for false-positive results in those who suffer from other autoimmune disorders but do not have celiac.

IgA endomysialantibody. This test is not as sensitive as the tTG-IgA test and can be very expensive. Around 5 to 10 percent of celiac patients come back negative on this test.

Total serum IgA. Certain individuals can have genetically low levels of IgA (antibody) in the blood. Since the aforementioned tests rely on elevated levels of IgA, these individuals can have false-negative results. This test will show if the IgA levels are low.

Deaminated gliadin peptide. If you do come back IgA deficient, the doctor can use this test to check for celiac disease.

If any of the above tests are positive, your doctor may suspect celiac disease. To confirm the diagnosis, an endoscopic biopsy may be performed.

Endoscopic biopsy. This test needs to be done after you have been eating a total gluten diet for up to three months. The doctor will pass a scope through your mouth while you are sedated. This scope has a camera at the end that will allow your physician to examine your small intestine and take a sample of it for further analysis.

Treatment involves going on a gluten-free diet. While it may be possible for some people to eat small amounts of gluten, others cannot ingest any.

The diet includes:

No wheat, rye, or barley. These foods may be present in cereals, pasta, cakes, cookies, pies, crackers, and gravy thickened with wheat flour.

No oats. Some people can eat oats, but the gluten in oats may upset others.

No foods containing gluten as an ingredient. This includes canned and processed foods, ice cream, candy bars, salad dressing, instant coffee, yogurt, and condiments.

Use caution with medications. Gluten may be used as a binder in many supplements and tablets.

No grain alcohol. Wine is okay, but beer, some whiskey, and other alcohol made from grains contain gluten.

Stay away from lactose. During the first few months of treatment, some people experience lactose intolerance. This usually goes away and dairy can be reintroduced.

Research ingredients. Learn to read your food labels and know what ingredients mean. Most products have a gluten warning on them now, but some ingredients may list gluten under another name. Make sure boxed and prepared foods are truly gluten-free.

You may need supplements. Many people with absorption issues may need to supplement missing nutrients like vitamin B12, calcium, iron, folate, and vitamin D.

In addition to a gluten-free diet, you can try the following remedies to help your intestines heal:

Paprika. Natural anti-inflammatory

Aloe Vera. Natural anti-inflammatory

Probiotics. Replenishes good bacteria that can help intestinal healing

Eat plenty of healthy foods. Eat enough gluten-free whole grains and make sure you include enough fruits, vegetables that contain calcium (leafy greens), and protein in your diet.

Use caution when eating out. If you attend gatherings or eat at a restaurant, you will need to inquire about what is in the food you are eating. You may want to call ahead and let them know you are on a gluten-free diet.

Inquire about gluten-free baking products. Many natural food suppliers are coming up with easy-to-use gluten-free flours. You can save expense by learning to bake your own gluten-free products.

Clinical trials help to find new treatments for conditions or diseases that are safe and effective. They are vital in the discovery of new drugs and helping the approval process through the U.S. Food and Drug Administration. The Celiac Disease Foundation created a clinical trial finder application to help people with non-celiac gluten or wheat sensitivity and celiac disease participate in clinical trials. The link for this resource can be found here.

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Mayo Clinic Staff. (2020, October 21). Celiac disease. Retrieved from:https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220

National Institute of Diabetes and Digestive and Kidney Diseases. (2020, October). Symptoms and causes of celiac disease. Retrieved from:https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/symptoms-causes

Pelkowski, T. D. & Viera, A. J. (2014, January 14). Celiac disease: Diagnosis and management. American Family Physician, 89(2), 99-106. Retrieved from:https://www.aafp.org/afp/2014/0115/afp20140115p99.pdf