Celiac Disease? - You Have No High Fiber Worries

What is celiac disease?

When a person with celiac disease ingests celiac disease gluten, it results in an immune system reaction that causes the lining of the small intestine to swell and become inflamed. And the tiny hair-like projections on the cells, called villi, shrink and even disappear. Without villi, you can't absorb nutrients from food.

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. Over time, poor absorption of nutrients deprives the brain, nervous system, bones, liver and other organs of important nourishment.

People are frequently misdiagnosed as having irritable bowel syndrome, spastic colon or bowel, or Crohn's disease.

Anemia, delayed growth, and weight loss are signs of malnutrition—not getting enough nutrients. Malnutrition is a serious problem for anyone, but particularly for children because they need adequate nutrition to develop properly.

Because the body's own immune system causes the damage, celiac disease is considered an autoimmune disorder. Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.

What are the symptoms?

Celiac disease affects people differently. Some people develop symptoms as children, others as adults. One factor thought to play a role in when and how celiac appears is whether and how long a person was breastfed—the longer one was breastfed, the later symptoms of celiac disease appear and the more atypical the symptoms. Other factors include the age at which one began eating foods containing gluten and how much gluten is eaten.

Symptoms may or may not occur in the digestive system. For example, one person might have diarrhea and abdominal pain, while another person has irritability or depression. In fact, irritability is one of the most common symptoms in children.

Some people with celiac disease may not have symptoms. The undamaged part of their small intestine is able to absorb enough nutrients to prevent symptoms. However, people without symptoms are still at risk for the complications of celiac disease.

Symptoms of celiac disease may include one or more of the following:

  • recurring abdominal bloating and pain
  • chronic diarrhea
  • weight loss
  • pale, foul-smelling stool
  • unexplained anemia (low count of red blood cells)
  • gas
  • bone or joint pain
  • behavior changes
  • muscle cramps
  • fatigue
  • delayed growth
  • failure to thrive in infants
  • seizures
  • tingling numbness in the legs (from nerve damage)
  • pale sores inside the mouth, called aphthus ulcers
  • painful skin rash, called dermatitis
  • herpetiformis
  • tooth discoloration or loss of enamel
  • missed menstrual periods (often because of excessive weight loss)

How is celiac disease diagnosed?

Diagnosing celiac disease can be difficult because some of its symptoms are similar to those of other diseases, including irritable bowel, Crohn's disease, ulcerative colitis, diverticulosis, intestinal infections, chronic fatigue syndrome, and depression.

Recently, researchers discovered that people with celiac disease have higher than normal levels of certain antibodies in their blood. Antibodies are produced by the immune system in response to substances that the body perceives to be threatening.

To diagnose celiac disease, physicians will perform a blood test. If the tests and symptoms suggest celiac disease, the physician may remove a tiny piece of tissue from the small intestine to check for damage to the villi.

This is done in a procedure called a biopsy: the physician eases a long, thin tube called an endoscope through the mouth and stomach into the small intestine, and then takes a sample of tissue using instruments passed through the endoscope. Biopsy of the small intestine is the best way to diagnose celiac disease.


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The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) . The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1980, the clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.

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