Celiac Disease

An estimated 1 in 100 people have celiac disease. Correctly identifying the disease is the critical first step to relieving symptoms and avoiding more serious problems. Unfortunately, many people have symptoms for years or suffer complications before finally getting a diagnosis. The gastroenterologists at Lankenau Medical Center are alert to the problem of celiac disease and skilled in making the diagnosis.

To schedule an appointment with a Lankenau gastroenterologist, call 866.CALL.MLH or use the online appointment request form.

Go To:  Cause | Symptoms | Diagnosis | Treatment

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Cause

Celiac disease is caused by intolerance to gluten—a protein found in wheat, rye, and barley but also in many condiments as well as medicines and vitamins. When people with celiac disease consume gluten, their immune system responds inappropriately and attacks the lining of the small intestine, causing inflammation and damage to the tiny structures (called villi) that facilitate absorption of nutrients from food. Intestinal damage from celiac disease can lead to malnutrition and related problems.

Celiac disease is a genetic disorder, meaning that people inherit the tendency to have an abnormal immune response to gluten. An interaction between this genetic risk factor and environmental factors is believed to trigger the disease.

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Symptoms

Symptoms vary depending on the severity of the disease. Digestive symptoms may include diarrhea, constipation, abdominal pain, bloating, and vomiting. Other symptoms or problems may include iron-deficiency anemia, fatigue, depression or anxiety, bone loss (osteoporosis), joint pain, itchy skin rash, tingling numbness in the feet or hands, or missed menstrual periods.

People with celiac disease also tend to have other immune-mediated diseases, such as type 1 diabetes, autoimmune thyroid or liver disease, or rheumatoid arthritis.

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Diagnosis

Diagnosis of celiac disease involves two steps:

• Antibody testing. If celiac disease is suspected, a blood test is done to check for high levels of autoantibodies associated with the disease. Three distinct autoantibodies are commonly found in people with celiac disease.
• Small intestinal biopsy. If antibody tests are positive, a biopsy is performed to confirm the diagnosis. Tiny tissue samples are taken from the small intestine to check for damage to villi. The samples are obtained during an upper endoscopy<link to term in Health Library> procedure.

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Treatment

Treatment of celiac disease is lifelong avoidance of gluten. In most cases, a strict gluten-free diet will relieve symptoms, heal existing villi damage, and prevent further damage. A gluten-free diet eliminates:

• Problem grains. These include all forms of wheat (einkorn, durum, faro, graham, kamut, semolina, spelt), rye, barley, and triticale as well as oats that are not labeled “gluten-free.”
• Ingredients made from problem grains. Processed foods commonly contain ingredients made from problem grains. Soy sauce, for example may contain wheat. Malt, hydrolyzed vegetable or plant protein, texturized vegetable protein, and modified food starch also should be avoided.
• Wheat-containing beverages. The most common include beer, ale, and lager.

Lankenau gastroenterologists work closely with nutritional specialists to ensure effective dietary treatment of patients with celiac disease.

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Learn more about celiac disease >

Related services:

• Nutrition Center