Celiac disease (British: Coeliac disease) is a disorder resulting from an immune reaction to gluten.
Celiac disease can affect genetically predisposed people of all ages, but often begins in middle infancy. Symptoms include chronic diarrhea, weight loss and fatigue, but in some cases the disorder can be asymptomatic (no symptoms).
Celiac disease is caused by a reaction to gliadin - a gluten protein found in wheat, barley, rye, and sometimes oats.
The inflammation and destruction of the inner lining of the small intestine in celiac disease is caused by an allergic reaction to gluten in the diet. This chronic digestive disorder leads to the malabsorption of minerals and nutrients.
According to the Celiac Sprue Association1, there is no cure for celiac disease, the only effective treatment for this disorder is a gluten-free diet.
Symptoms of celiac disease
A symptom is something the patient feels and describes, such as a stomachache, while a sign is detected by other people too, such as a rash.
Signs and symptoms of celiac disease may range from severe to mild. It is also possible to have celiac disease without any symptoms at all.
Many adults with subtle disease only have fatigue and anemia, or may have only vague abdominal discomfort such as bloating, abdominal distension and excess gas.
Celiac disease is a permanent disorder and its effects may change from time to time during a person's lifetime.
Subtle symptoms can occur in other organs - other than the bowel itself.
Some signs and symptoms are due to malabsorption and malnutrition resulting from the disorder. It should also be noted that symptoms can vary greatly from person to person.
According to the The University of Chicago Celiac Disease Center2, there are hundreds of different signs and symptoms of celiac disease.
Some common symptoms of celiac disease include:
Stomach cramps are a common symptom of celiac disease
- Abdominal cramps, gas and bloating
- Bone and joint pain
- Easy bruising
- Failure to thrive in children
- Flatulence (gas)
- Fluid retention
- Foul-smelling stools
- Gastritis, gastrointestinal symptoms, including hemorrhage
- General weakness, fatigue
- Increased amount of fat in the stools
- Persistent hunger
- Iron deficiency anemia
- Mouth Sores
- Muscle wasting, muscle weakness, muscle cramps
- Nausea, vomiting
- Nerve damage (tingling in the legs and feet)
- Nose bleeding
- Nutrient Deficiencies
- Panic Attacks
- Red urine
- Skin Rash
- Stomach Discomfort, stomach rumbling
- Unhealthy pale appearance
- Vitamin B12, D, and K deficiencies
- Weight Loss
- A degree of lactose intolerance may develop
- Dermatitis herpetiformis (rashes typically on the elbows, knees and buttocks)
- Sometimes symptoms are not clear, and the patient just generally feels unwell.
Diagnosis of celiac disease
Other diseases can produce the same signs and symptoms and can be confused with celiac disease (pancreatic insufficiency, Crohn's disease of the small intestine, irritable bowel syndrome, and small intestinal overgrowth of bacteria).
1) Blood tests
Blood tests that are specific for celiac disease include antigliadin antibodies, endomysial antibodies, and anti-tissue transglutaminase antibodies. Blood is screened for AGA (Antigliadin) and EmA (Andomysium Antibodies).
2) Small intestinal biopsy
This procedure is considered the most accurate test for celiac disease. During the endoscopy samples of the intestinal lining are taken. Usually several samples are obtained to increase the accuracy of the diagnosis.
On the next page we look at the treatment options for celiac disease and we examine untreated celiac disease.