An estimated one 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.
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
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.
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
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.
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
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
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.
For more information, call 1.866.CALL.MLH.