Celiac Disease

Celiac disease is an immune disorder in which people cannot tolerate eating gluten because it damages the inner lining of their small intestine and prevents it from absorbing nutrients. (The small intestine is the tube-shaped organ between the stomach and large intestine.) Gluten is a protein found in wheat, rye, and barley. Occasionally, it is found in products such as vitamin and nutrient supplements, lip balms, and certain medications. People who must avoid all gluten should read all food and nutrition labels carefully.

An estimated 1 in 141 people in the U.S. have celiac disease, although the disease often goes undiagnosed. Celiac disease is most common in Caucasians.

The immune system is the body's natural defense system and normally protects the body from infection. However, when a person has celiac disease, gluten causes the immune system to react in a way that can cause intestinal inflammation, including irritation or swelling. When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying the tissue that lines the small intestine. This lining normally absorbs nutrients from food and passes the nutrients through the walls of the small intestine and into the bloodstream. Without this absorption, people can become malnourished, no matter how much food they eat. The intestinal damage can cause weight loss, bloating and sometimes diarrhea. Eventually, your brain, nervous system, bones, liver and other organs can be deprived of vital nourishment.

Celiac disease affects each person differently. Symptoms may occur in the digestive system, or in other parts of the body. One person might have diarrhea and abdominal pain, while another person may be irritable or depressed. Irritability is one of the most common symptoms in children. Some people have no symptoms. In children, malabsorption can affect growth and development. The intestinal irritation can cause stomach pain, especially after eating.

Celiac disease is genetic. Blood tests can help your doctor diagnose the disease. Your doctor may also need to examine a small piece of tissue from your small intestine. The only treatment is eating a gluten-free diet.

Researchers do not know the exact cause of celiac disease. Celiac disease sometimes runs in families. Approximately half of people who have celiac disease also have a family member who also has the disease.

In celiac disease, certain gene variants and other factors, such as a person's exposure to things in his or her environment, can lead to celiac disease. For most people, eating something with gluten is harmless. For others, an exposure to gluten can cause, or trigger, celiac disease to become active. Sometimes surgery, pregnancy, childbirth, a viral infection, or severe emotional stress can also trigger celiac disease symptoms.

Cceliac disease tends to be more common in people who have autoimmune diseases, including:

• type 1 diabetes
• autoimmune thyroid disease
• autoimmune liver disease
• rheumatoid arthritis
• Addison's disease, a condition in which the immune system damages the glands that produce critical hormones
• Sjögren's syndrome, a condition in which the immune system destroys the glands that produce tears and saliva
• Down syndrome or Turner syndrome
• Microscopic colitis (lymphocytic or collagenous colitis)

See your doctor for ongoing diarrhea, bloating, abdominal pain, or unexplained weight loss, and get tested before removing gluten from your diet. A check-up can confirm the diagnosis and prevent nutrient deficiencies.