Celiac disease is an autoimmune disorder. This genetic condition causes damage to the small intestine when gluten is eaten. Symptoms range from severe vomiting and diarrhea to more subtle reactions such as bloating and general malaise. The Celiac Disease Foundation (CDF) estimates 1 in 100 people have the disease, yet 2.5 million Americans remained undiagnosed.  

What is Celiac Disease?

Celiac Disease is triggered by the consumption of gluten. When gluten is consumed, the body responds by attacking the small intestine. The finger-like villi in the small intestine are damaged. Vitamin and mineral absorption is negatively impacted. This is a serious disease and differs from gluten intolerance.

What Are the Symptoms of Celiac Disease?

This disease has been called a “chameleon”, as symptoms vary amongst individuals.((https://www.beyondceliac.org/celiac-disease/myths/)) Severe gastrointestinal issues, such as vomiting and diarrhea, are classic symptoms. Some people with celiac disease have no recognizable symptoms at all. The CDF describes the difference in symptoms:

In classical celiac disease, patients have signs and symptoms of malabsorption, including diarrhea, steatorrhea (pale, foul-smelling, fatty stools), and weight loss or growth failure in children.

In non-classical celiac disease, patients may have mild gastrointestinal symptoms without clear signs of malabsorption or may have seemingly unrelated symptoms. They may suffer from abdominal distension and pain, and/or other symptoms such as: iron-deficiency anemia, chronic fatigue, chronic migraine, peripheral neuropathy (tingling, numbness or pain in hands or feet), unexplained chronic hypertransaminasemia (elevated liver enzymes), reduced bone mass and bone fractures, and vitamin deficiency (folic acid and B12), late menarche/early menopause and unexplained infertility, dental enamel defects, depression and anxiety, dermatitis herpetiformis (itchy skin rash), etc.

Silent celiac disease is also known as asymptomatic celiac disease. Patients do not complain of any symptoms, but still experience villous atrophy damage to their small intestine. Studies show that even though patients thought they had no symptoms, after going on a strict gluten-free diet they report better health and a reduction in acid relux, abdominal bloating and distention and flatulence. ((https://celiac.org/celiac-disease/understanding-celiac-disease-2/celiacdiseasesymptoms/#KJRoUHtVvumy72Up.99))

Common Celiac Disease Symptoms

• bloating
• nausea
• vomiting
• diarrhea
• fatigue
• irritability
• joint pain
• weight loss
• ADHD
• failure to thrive
• constipation((https://celiac.org/celiac-disease/understanding-celiac-disease-2/celiacdiseasesymptoms/))((https://www.beyondceliac.org/celiac-disease/symptoms-checklist/))

A complete checklist is available from the Celiac Disease Foundation. 

What Foods Contain Gluten?

Gluten can be found in a lot of processed food and hidden amongst common ingredients. The most obvious source of gluten are grains such as barley, wheat, and rye. It can also be found in less obvious places like Nutella (vanillin), ketchup (grain vinegar), and shredded cheese (if dusted with flour).   

Celiacs have to be hyper-aware of gluten. They must read labels, become aware of hidden sources, and question restaurants at every meal. For example, french fries are by nature gluten-free, yet if they are cooked in the same oil as breaded onion rings, cross contamination is likely. Even food labeled “gluten-free” can be cross contaminated and cause a reaction.

Who Should Be Tested for Celiac Disease?

Anyone with a first degree relative with Celiac Disease should be tested, i.e., sibling, parent, or child. This is a genetic disorder and can develop at any time. Negative results in childhood do not mean as an adult the disease will not present itself. The disease is mostly diagnosed in adulthood during the 40s and 50s. According to Quest Diagnostics:

Celiac disease occurs in:

• 1 in 133 healthy people
• 1 in 22 first-degree relatives
• 1 in 39 second-degree relatives ((https://www.questdiagnostics.com/home/physicians/testing-services/condition/celiac/who-tested)) 

Risks of Untreated Celiac Disease

The treatment for this autoimmune disorder is simple:  remove gluten from the diet. If gluten is consumed or the disease remains undiagnosed, common complications include:

• infertility
• bone loss
• nerve damage((https://newsnetwork.mayoclinic.org/discussion/left-untreated-celiac-disease-can-result-in-serious-complications/))
• anemia
• lactose intolerance
• vitamin and mineral deficiencies
• pancreatic insufficiency
• gall bladder issues((https://celiac.org/celiac-disease/understanding-celiac-disease-2/what-is-celiac-disease/24477-2/))
• gasto-intestinal cancer
• lymphoma
• liver disease
• ataxia((https://scdlifestyle.com/2012/01/the-celiac-disease-epidemic-why-gluten-free-isnt-enough/))

It’s important to get tested and start a gluten-free diet immediately. It can take six months to a year for your body to heal once gluten is removed from your diet, but often improvement is seen immediately. Thus, if you have any symptoms and/or a Celiac relative, get tested soon.