Celiac disease, sometimes called celiac sprue or gluten-sensitive enteropathy, is an autoimmune disorder that’s triggered when you eat gluten, a protein found in wheat, barley and rye.
If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine's lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.
In children, malabsorption can affect growth and development, besides causing the symptoms seen in adults.
There's no cure for celiac disease — but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing.
Symptoms
The signs and symptoms of celiac disease can vary greatly and differ in children and adults. Digestive signs and symptoms for adults include:
- Diarrhea
- Fatigue
- Weight loss
- Bloating and gas
- Abdominal pain
- Nausea and vomiting
- Constipation
However, more than half the adults with celiac disease have signs and symptoms unrelated to the digestive system, including:
- Anemia, usually from iron deficiency
- Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
- Itchy, blistery skin rash (dermatitis herpetiformis)
- Mouth ulcers
- Headaches and fatigue
- Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment
- Joint pain
- Reduced functioning of the spleen (hyposplenism)
Children
Children with celiac disease are more likely to have digestive problems than adults, including:
- Nausea and vomiting
- Chronic diarrhea
- Swollen belly
- Constipation
- Gas
- Pale, foul-smelling stools
The inability to absorb nutrients might result in
- Failure to thrive for infants
- Damage to tooth enamel
- Weight loss
- Anemia
- Irritability
- Short stature
- Delayed puberty
- Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination and seizures.
Causes
Your genes combined with eating foods with gluten and other factors can contribute to celiac disease, but the precise cause is unknown. Infant-feeding practices, gastrointestinal infections and gut bacteria might contribute, as well. Sometimes celiac disease becomes active after surgery, pregnancy, childbirth, viral infection or severe emotional stress.
When the body's immune system overreacts to gluten in food, the reaction damages the tiny, hairlike projections (villi) that line the small intestine. Villi absorb vitamins, minerals and other nutrients from the food you eat. If your villi are damaged, you can't get enough nutrients, no matter how much you eat.
Dermatitis herpetiformis
Gluten intolerance can cause this itchy, blistering skin disease. The rash usually occurs on the elbows, knees, torso, scalp and buttocks. This condition is often associated with changes to the lining of the small intestine identical to those of celiac disease, but the skin condition might not cause digestive symptoms.
Risk factors
Celiac disease tends to be more common in people who have:
- A family member with celiac disease or dermatitis herpetiformis
- Type 1 diabetes
- Down syndrome or Turner syndrome
- Autoimmune thyroid disease
- Microscopic colitis (lymphocytic or collagenous colitis)
- Addison's disease
Diet recommended for celiac patient
Allowed fresh foods
Many naturally gluten-free foods can be a part of a healthy diet:
- Fruits and vegetables
- Beans, seeds, legumes and nuts in their natural, unprocessed forms
- Eggs
- Lean, non- processed meats, fish and poultry
Most low-fat dairy products
Grains, starches or flours that can be part of a gluten-free diet include:
- Amaranth
- Arrowroot
- Buckwheat
- Corn — cornmeal, grits and polenta labeled gluten-free
- Flax
- Gluten-free flours — rice, soy, corn, potato and bean flours
- Hominy (corn)
- Millet
- Quinoa
- Rice, including wild rice
- Sorghum
- Soy
- Tapioca (cassava root)
- Teff
Grains not allowed
Avoid all foods and drinks containing the following:
- Wheat
- Barley
- Rye
- Triticale — a cross between wheat and rye
- Oats, in some cases
While oats are naturally gluten-free, they may be contaminated during production with wheat, barley or rye. Oats and oat products labeled gluten-free have not been cross-contaminated. Some people with celiac disease, however, cannot tolerate the gluten-free-labeled oats.
