the patient celiac

Brief overview of Celiac Disease from Beyond Celiac, www.beyondceliac.org, formerly the National Foundation for Celiac Awareness (NFCA):

What is Celiac Disease?

Celiac disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food. What does this mean? Essentially the body is attacking itself every time a person with celiac consumes gluten.

Celiac disease is triggered by consumption of the protein called gluten, which is found in wheat, barley and rye. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the finger-like villi of the small intestine. When the villi become damaged, the body is unable to absorb nutrients into the bloodstream, which can lead to malnourishment.

Left untreated, people with celiac disease can develop further complications such as other autoimmune diseases, osteoporosis, thyroid disease, and cancer.

Celiac Symptoms:

There are more than 300 symptoms of celiac disease, and symptoms may vary among different people.

One person might have diarrhea and abdominal pain, while another person has irritability or depression. Some patients develop celiac symptoms early in life, while others feel healthy far into adulthood. Some people with celiac disease have no signs or symptoms.

These differences can make celiac diagnosis extremely difficult, resulting in 83% of celiacs undiagnosed or misdiagnosed with other conditions.

                                   Bloating and Gas:

bloatingBloating can cause abnormal swelling of the abdomen. This results in the feeling of a full or tight abdomen and is often accompanied by discomfort and pain. Gas can also cause bloating. Celiac Disease and gluten intolerance is one of the many causes of these two symptoms. They are also associated with many of the conditions that are a result of celiac disease such as irritable bowel syndrome and constipation.

                                   
                                   Diarrhea:

ToiletPaperDiarrhea is the condition of having frequent loose or liquid bowel movements. This may be accompanied by cramping, abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Chronic diarrhea may be a symptom of a chronic disease. For someone with celiac disease diarrhea is often caused by malabsorption, the inability to absorb food.


                                   Constipation:

toiletConstipation is a condition of the digestive system the stool is hard, difficult, and painful to pass. The most common causes of constipation are poor diet and lack of exercise. Frequent Constipation can be a symptom of more serious problem or health issue and can be an indicator of a disease or health condition.


                                   Fatigue:

Fatigue is a state of physical or mental weariness. It can be the result of both physical and mental sources. Chronic fatigue can be symptom of many different diseases or conditions among them are autoimmune diseases such as celiac disease.


                                   
                                   Itchy Skin Rash:

Dermatitis herpetiformis (DH) has been associated with gluten sensitivity. It is characterized by an intensely itchy, chronic rashes that usually can be found primarily on elbows, knees, buttocks, back, and back of neck.


                                 
                                   Tingling/Numbness:

Tingling or Numbness are abnormal sensations that can occur anywhere in your body. It is a sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect. It can also be described as "pins and needles" or referred to as a limb being "asleep."


                                   Pale Mouth Sores:

Pale Mouth Sores are caused by a break in the mucous membrane or the epithelium on the lips or surrounding the mouth. Various types of sores can appear anywhere within the mouth, including the inner cheeks, gums, tongue, lips, or palate. They can have many causes. Mouth Sores can be a sign of an a more serious medical conditions including but not limited to celiac disease.

   
                                   Joint Pain:

Joint pain can be caused by many types of injuries or conditions. It can range from mild or serious discomfort to chronic pain that can decrease a person’s range of motion in a joint or limb.



                                  Delayed Growth:

A slow rate of growth is defined as poor or abnormally slow height or weight gains, more specifically in children. Many children with delayed growth also have delays in mental development. This often occurs in children who have celiac disease as a result of malabsorption, the failure to properly absorb necessary nutrition, and provide the body with its needed nutrients for development .


                                   Poor Weight Gain:

Poor weight gain is the inability to gain weight at a normal rate. Malnutrition is one of the sources of this symptom. If poor weight gain is observed even though a proper diet is being maintained then complication caused by celiac disease could be possible explanation.



                                   Thin Bones:

             Thin Bones are the thinning of bone tissue and loss of bone density over time. This occurs when enough new bone is not formed, when too much old bone is reabsorbed by the body, or both. There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include, bone pain or tenderness, fractures with little or no trauma, unexplained loss of height, low back pain, neck pain and stooped posture.

   
                                   Infertility:

Infertility primarily refers to an inability to contribute to conception. It can also refer to a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility. Celiac disease can result in infertility as well as serious complications during pregnancy.


                                   Headaches:

Headaches are a symptom of a number of different conditions of the head and sometimes neck. It is among the most common pain complaints. Like other types of pain, headaches can serve as warning signals of more serious disorders. If headaches occur three or more times a month one should seek a doctor or medical professional for assistance immediately.


                                   Depression:

Depression refer to a feeling of being sad, helpless, and hopeless. Some symptoms of depression are anxious or empty moods, feeling hopeless, feelings of guilt, feelings of worthlessness, and a loss of interest in activities that were once enjoyed. Health conditions such as celiac disease are among the biological influences that can cause depression.


                                   Irritability:

Irritability can also be described as crankiness and is defined as excessive feelings of annoyance or frustration. Irritability is one of the most common symptoms in children.




                                   Discolored Teeth:

Discolored teeth can be a symptom of celiac disease among other possible health issues. This symptom manifest as white, yellow, or brown spots on the teeth often appear on the incisors and molars. Tooth defects resulting from celiac disease are permanent and do not improve once a diagnosed patient adopts a gluten-free diet.

 

Diagnosis:

Accurately diagnosing celiac disease can be quite difficult largely because the symptoms often mimic those of other diseases, including irritable bowel syndrome (IBS), Crohn's disease, intestinal infections, lactose intolerance and depression.

Blood tests are the first step in a diagnosis of celiac disease. A doctor will order one or more of a series of blood tests to measure your body's response to gluten.

Currently, recommended tests include:

  • Total IgA

  • IgA-tTG

  • IgA-EMA

  • If IgA is deficient, it is recommended that the IgG/IgA-DGP also be ordered. At the discretion of the doctor, IgG-AGA can also be ordered.

**It is important to continue eating a normal, gluten-containing diet before being tested for celiac. If the blood tests and symptoms indicate celiac, a physician may suggest a biopsy of the lining of the small intestine to confirm the diagnosis.

Treatment:

The only treatment for celiac disease is a lifelong gluten-free diet.  Eating gluten, no matter how small the amount, can damage the intestine.

A gluten-free diet means avoiding all foods that contain wheat (including spelt and triticale), rye, and barley.

Despite these restrictions, people with celiac disease can eat a well-balanced diet with a variety of foods, including bread and pasta. Many gluten-free products are now made with potato, rice, soy, or bean flour. In addition, plains meat, fish, fruits and vegetables do not contain gluten, so celiacs can eat as much of these foods as they like. Please follow this link to download Beyond Celiac's "Getting Started: A Guide to Celiac Disease and the Gluten-Free Diet."

Please follow this link for a comprehensive overview of celiac disease which is geared toward medical professionals (from the March 2016 edition of the Cleveland Clinic Journal of Medicine). The website Verywell.com also has a nicely written overview of celiac for the lay population, which can be found here.

In 2013 I wrote a post for the newly diagnosed called, "So you just found out that you have celiac disease...now what?" According to an anonymous website it is "halfway-decent," which makes me laugh for some reason! I am sharing it in hopes that it may actually help some of you, as it is full of advice that I wish I had known when I first went GF in 2010.

 

 

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