“For people with celiac disease, the gluten-free diet is like insulin for diabetics”
–Dr. Alessio Fasano
What is Celiac disease?
Celiac disease is an autoimmune disease where the ingestion of gluten leads to damage of the small intestine, which affects genetically predisposed patients. The primary job of the small intestine is to absorb minerals and nutrients from the food we eat. If your small intestine becomes damaged, it is not able to absorb vital nutrients and minerals that our bodies need. This leads to symptoms that result due to malabsorption and can result in serious illness.
First-degree relatives of patients with celiac disease have a 10-15% risk of celiac disease. Celiac disease affects 1 in 133 Americans.
What is Gluten?
– Gluten is a family of proteins that is found in grains like wheat, dry, and barley. Patients that suffer from this disease develop inflammation within their small bowel when it regularly comes into contact with gluten. It only takes 1/64 of a teaspoon of gluten to cause intestinal damage to a patient with celiac disease. In the last 50 years, there has been a substantial increase in the number and rate of patients diagnosed with celiac disease.
A little history:
- Celiac disease takes its name from “koiliakaos,” the ancient Greek word for “suffering in the bowels.”
- Initially, it was thought that the disease was caused by a food allergy.
- In the early 20th century various diets were tried and eliminated. Some were successful, but they did not identify the toxic component.
- In the 1940s it was discovered that celiac disease declined during the bread shortages of World War II but climbed again after the war. A link with wheat products was made.
What are some symptoms of celiac disease?
- Bulky, foul-smelling, floating stools
- Abdominal pain
- Weight loss
- Abnormal liver tests
- Iron deficiency
- Bone disease (due to deficiencies and vitamin D and calcium)
- Skin disorders
- Some patients with celiac disease may not show any signs or symptoms at all
How is the diagnosis made?
- Your doctor will first start with your family and personal medical history, and a physical exam. There are some skin conditions and other autoimmune disorders that can be associated with celiac disease (diabetes mellitus, dermatitis herpetiformis, etc.).
- The diagnosis can usually be suggested through blood work performed in the office. However, it is confirmed by biopsies taken from the first portion of your small intestine called your duodenum. This can usually be done during an endoscopy.
- If you think you may have celiac disease it is important to first speak with your physician and have blood testing and biopsies taken before starting a gluten-free diet. The strict gluten-free diet will cause the blood work and biopsy results to appear normal and a proper diagnosis may be difficult to make.
- It is important to know whether you have celiac disease or not, as patients that go undiagnosed are at risk for osteoporosis, infertility, and lymphoma.
How is celiac disease treated?
The only known effective treatment for celiac disease is establishing and maintaining a gluten-free diet. If you are diagnosed with celiac disease then your doctor can help you figure out what you can and cannot eat.
Could I be sensitive to gluten and not have a food allergy?
Yes! Many people have gluten intolerance without having celiac disease. Patients with gluten intolerance/sensitivity may still benefit from a gluten-free diet, however, it is important to know if you have celiac disease or gluten intolerance. Undiagnosed celiac disease is associated with possible complications.
By: Dr. Apsara Prasad
Board-certified gastroenterologist at Digestive Health Specialists.
She works at our Winston-Salem location.
Learn more about her here: https://digestivehealth.ws/provider/apsara-prasad-md/
Digestive Health Specialists, PA is here to help if you, or someone you know, would like more information, or if you are experiencing any of the above symptoms and would like further evaluation. Feel free to give us a call at 336-768-6211.