Celiac disease (CD) is a food allergy that prevents the body from using certain nutrients. The allergy is to a substance (protein) called gluten. Gluten is found in many grains, such as wheat, rye, oats, and barley. The allergy mostly affects the small intestine, which is where the food travels after it leaves the stomach.
It usually first appears in babies when they start eating food containing gluten. Celiac disease is more common in those of Western European descent. It often runs in families.
Celiac disease is not curable but can be controlled with a gluten-free diet.
Celiac disease is also known as celiac sprue, non-tropical sprue, and gluten-sensitive enteropathy.
An allergic reaction to gluten causes celiac disease. Autoantibodies are antibodies that are abnormally directed against one’s body due to a malfunction of one’s immune system. The blood of patients with CD may contain several autoantibodies. Immunologic, genetic, and environmental factors all play a role in the development of celiac disease. When people with celiac disease eat food products containing gluten, their immune system attacks and damages finger-like projections known as villi lining the small intestine. The small intestine cannot absorb some nutrients, and people can become malnourished.
Symptoms include diarrhea, with light tan or gray stools that may be watery or part solid, often smell bad, and look oily or frothy; weight loss; failure to grow and develop (babies and children); frequent gas; swollen abdomen (belly) or abdominal pain; mouth ulcers; tiredness, or weakness; paleness; rash; and muscle cramps. Many adults with CD have fewer symptoms than children, and diagnosis is often suggested by blood tests showing unexplained anemia (low red blood cell count). Another manifestation of celiac disease is an itchy rash known as dermatitis herpetiformis. It occurs in up to 25% of people with CD and is usually found on elbows, knees, and buttocks.
The health care provider tests blood to check for lack of nutrients and antibodies produced in response to gluten.
The doctor may do other tests (such as endoscopy) to confirm the diagnosis and exclude other diseases. In endoscopy, a thin, flexible tube with a camera on one end is put into the throat and then down through the stomach into the small intestine. Then the doctor removes a piece of tissue for study under a microscope (biopsy). In a newer test, capsule endoscopy, a small camera in a swallowed pill can look inside the bowels.
The health care provider may also do x-rays (small bowel series), which are taken after drinking a white chalky liquid (barium).
The main treatment is eating a special diet that avoids anything containing gluten, which includes grains, particularly wheat, barley, and rye. Rice, potato, buckwheat, and soy are safe to eat.
Food supplements to help boost low nutrient levels and medicine to help control the allergy may also be required.
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