Celiac Disease

Last Updated November 2023 | This article was created by familydoctor.org editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

What is celiac disease?

Celiac disease is a digestive disorder that causes problems in your small intestine. You experience the problems when you eat foods that have gluten. Gluten is a protein found in grains like wheat, rye, and barley. Celiac disease is not the same is having gluten sensitivity. Celiac disease is an autoimmune disease.

In people with celiac disease, gluten causes the immune system to attack and damage the small intestine. When this happens, your body doesn’t absorb or get the important nutrients it needs. These include vitamins, calcium, protein, carbohydrates, and fats. Your body can’t work well without these nutrients.

Symptoms of celiac disease

Some people with celiac disease don’t notice or have symptoms. But most people do, including:

In infants and young children:

  • Digestive trouble, including abdominal pain, bloating, vomiting, diarrhea, and constipation
  • Feeling irritable, fretful, emotionally withdrawn, or excessively dependent
  • Failure to grow and gain weight
  • Damage to tooth enamel
  • Being overweight or having obesity

In teenagers:

  • Digestive issues such as diarrhea and constipation
  • Delayed puberty
  • Slowed growth and short height
  • Hair loss

In adults:

  • Digestive symptoms, such as diarrhea or constipation (less likely than children)
  • General feeling of poor health, including fatigue and bone or joint pain
  • Irritability, anxiety, and depression
  • Missed menstrual periods in women
  • Osteoporosis (loss of calcium from the bones) and anemia

Other common symptoms in people of any age include:

  • Lactose intolerance: A problem digesting milk products
  • Dermatitis herpetiformis: An itchy, blistery skin problem
  • Canker sores in the mouth

What causes celiac disease?

Doctors and researchers don’t know exactly what causes celiac disease. It’s more common in people who:

  • Have a family member with celiac disease. If 1 member of your family has it, about 1 out of 10 other family members likely has it.
  • Have an autoimmune disease. This could include type 1 diabetes, rheumatoid arthritis, autoimmune thyroid or liver disease, Addison’s disease, or Sjogren’s syndrome.
  • Have a genetic disorder such as Down syndrome or Turner syndrome.

If you have celiac disease, you probably won’t know right away. You may have this disease without getting sick. It could be triggered later on by severe stress, physical injury, infection, childbirth, or surgery.

How is celiac disease diagnosed?

Celiac disease can be hard to diagnose. Its symptoms are similar to other digestive disorders, such as irritable bowel syndrome. But blood tests can help your doctor diagnose this disease.

If your blood test indicates that you might have celiac disease, an intestinal biopsy is often done. Using a thin tube, the doctor takes a small piece of tissue from your small intestine. Positive biopsy results will confirm you have celiac disease.

Diagnosis of dermatitis herpetiformis—a chronic skin condition caused by a reaction to gluten ingestion—will also confirm it.

Don’t stop eating gluten before you have a blood test or a biopsy. If you do, it can skew your results.

Can celiac disease be prevented or avoided?

There is no way to prevent or avoid getting celiac disease.

Treatment

Celiac disease is serious. Fortunately, you can control the disease by following a gluten-free diet. This means you remove gluten completely from your diet. By doing this, you can reverse the damage caused by celiac disease. You’ll feel better. But if you “cheat” on your diet, the damage will come back. Sometimes you may not feel sick right away, so you think it’s okay to eat gluten. But it’s not.

People who follow a gluten-free diet avoid all foods that contain:

  • Wheat
  • Barley
  • Rye
  • Spelt
  • Triticale products (including many breads, pastas, cereals, and processed foods)

Foods that don’t contain gluten and are safe to eat include:

  • Rice
  • Corn
  • Oats
  • Quinoa
  • Buckwheat
  • Millet

Some oat products can be contaminated with wheat gluten. Because of this, some people choose to avoid oats.

Gluten sometimes appears in foods or places you wouldn’t expect:

  • It’s used as a thickening agent in many gravies and sauces.
  • It’s sometimes used in medicines. Talk to your doctor or pharmacist before taking a new medicine. This includes vitamins and supplements.
  • It can be found in lip balm, lipstick, and other cosmetics.

Celiac disease and other gluten sensitivities have become more well-known. Gluten-free eating has become more mainstream. Many restaurants offer gluten-free options. Many grocery stores have gluten-free sections. These mean plenty of gluten-free products can be found.

Living with celiac disease

Learning to be gluten free may be hard at first. It will take time for you and your family to learn how to avoid gluten. You’ll have to learn to read ingredient labels at the grocery store. You’ll have to be careful when you eat out. You’ll probably have to learn some new cooking recipes.

If you’re looking for help, there are many resources available. Books and websites provide information, tips, and recipes for gluten-free living. Your local celiac disease support group is a good source of information and support. You may also find it helpful to meet with a registered dietician. He or she can help you learn what foods to avoid, how to read food labels, and how to make healthy substitutions. Ask your doctor for help finding a certified registered dietician in your area.

Questions to ask your doctor

  • My mother had celiac disease. Am I at risk?
  • I have celiac disease. Are my children at risk of having it too?
  • What are the symptoms of celiac disease, and how are they different from other digestive problems?
  • Is celiac disease a sign of another health problem? Does it put me at risk of other health problems?
  • Can celiac disease be cured?
  • Can you recommend a support group for people with celiac disease?
  • How can I make gluten-free meals my family will like?
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