What is celiac disease?
Celiac disease is an inherited autoimmune disease that affects individuals of all ages. The disease affects the digestive process of the small intestine and these individuals cannot tolerate foods containing gluten, a protein found in wheat, barley, and rye. When people with celiac disease eat foods containing gluten, their immune system responds by damaging villi, the tiny, fingerlike protrusions lining the small intestine. Villi allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream.
How common is celiac disease?
Nearly one out of every 133 Americans suffer from celiac disease. Approximately three million Americans have celiac disease.
What are the symptoms of celiac disease?
- Recurring abdominal pain
- Chronic diarrhea/constipation
- Vomiting
- Weight loss
- Pale, foul-smelling stool
- Pain in joints
- Delayed puberty
- Tooth discoloration or loss of enamel
- Unexplained infertility, recurrent miscarriage
- Failure to thrive or short stature
- Iron deficiency (anemia)
- Pale sores inside the mouth
- Depression or anxiety
- A skin rash called dermatitis herpetiformis
What should I do if I think I have celiac disease?
An early diagnosis is vital. It can take years from onset of initial symptoms until a final diagnosis is determined because it can be confused with other diseases, such as irritable bowel syndrome, iron deficiency (anemia) or chronic fatigue. The goal of our Center is to shorten this time, and provide you with the resources necessary to start living a gluten-free lifestyle.
How is celiac disease diagnosed?
Your doctor will test blood for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). If blood tests and symptoms imply celiac disease, biopsy of the small intestine is performed to confirm the diagnosis. Doctors remove tiny pieces of tissue from the small intestine to check for damage done to the villi.
When does celiac disease usually develop?
Celiac disease can develop at any time or age. Most people with celiac disease have had it for many years and on average are forty years old before being diagnosed. If you are experiencing any of the symptoms above, contact your physician immediately to get properly diagnosed. Delaying a diagnosis can cause further problems.
What are the long-term effects of celiac disease?
Untreated celiac disease can be life threatening. People who are not diagnosed are more likely to develop problems relating to malabsorption and gynecological disorders. There has also been a link for the risk of certain types of cancer, if the condition goes untreated.
What support is available for someone living with the disease?
For many people, living with celiac disease can be difficult. Gathering information about celiac disease, talking to your doctor, reading books or researching on the Internet can help you manage your disease and help you about a gluten-free diet. Ask your doctor or the Celiac Center at Paoli Hospital for a referral to a support group.
Should I see a dietitian once I’m diagnosed?
A dietitian has expert knowledge of the nutritional aspects of what foods you can and cannot eat, and can help you come up with more suitable menus to help you enjoy your favorite foods.
Should I have follow-up care after being diagnosed with celiac disease?
Patients do need to follow-up after being diagnosed. Symptoms that persist after changing their diet will need to be evaluated. Bone density tests should be measured and certain vitamins and minerals may need to be administered by your physician. Blood tests are used to monitor adherence to the gluten-free diet. Patients should also have at least one follow-up biopsy to confirm their response to the gluten-free diet.
Should I have my family get screened for celiac disease?
Screenings are recommended for first degree relatives of patients with celiac disease. One in about ten family members has the disease.
Is celiac disease a food allergy?
No, celiac disease is not a food allergy. It is an autoimmune disease that patients do not outgrow.
Are there any concerns with pregnancy and celiac disease?
For women who are pregnant with celiac disease it is important to remain on a gluten-free diet. It is the best and only option for the health of the mother and child. Remaining on a gluten-free diet will not take away from the nutrients the growing baby needs. Having a gluten-free diet will still provide the mother and child with all the nutrients they need to grow and be healthy. However, undiagnosed celiac disease can have negative effects on pregnancy. An increased risk of growth retardation, low birth weight, miscarriage and Cesarean section are linked to undiagnosed celiac disease.
Are there any unique considerations for children with celiac disease, or whose parents have celiac disease?
If you are a parent with celiac disease it is important that your children be tested for celiac disease. It is known to be a common genetic disorder, so testing your children immediately is important.
Can a person with celiac disease donate blood?
Yes. The American Red Cross does not restrict people with celiac disease from donating blood.
Will a gluten-free diet help with my diabetes?
Unfortunately, there is no evidence suggesting that gluten-free diet will help with diabetes. However, there have been reports recommending a gluten-free diet to help control serum glucose levels.
For Physicians
What symptoms may signal celiac disease?
If your patient presents with any of the symptoms above, especially diarrhea and irritable bowel syndrome, you should consider that your patient may have celiac disease.
Who should I test for celiac disease?
Celiac disease is a hereditary autoimmune disorder. If one of the patient’s first degree relatives has this disease and they are presenting with the symptoms above, you should order a blood test for the disease. The test will measure for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA).
Should I screen only children for the disease?
No. Celiac disease can present itself through adulthood.
How do I test for celiac disease?
It is important for your patient to get a blood test to test for celiac disease. If the blood test comes back positive, a biopsy and a clinical response to a gluten-free diet is necessary to confirm celiac disease. You may want to consider referring them to a specialist through the Celiac Center at Paoli Hospital.
If one of my patients has celiac disease, what should I do to help medically manage him?
Being a resource for your patient with celiac disease is important. Testing first-degree relatives for the disease is a needed first step, as a delayed diagnosis may cause damage to the patient. Also, making sure that the medications they are taking are gluten-free is vital, especially since many medications are taken throughout the day. Another is to keep an eye on bone density, as patients with celiac disease are at an increased risk for fractures. For more information, contact the Celiac Center at Paoli Hospital.
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