Early detection can prevent long-term complications

In the midst of the gluten-free frenzy that lined the aisles of grocery stores, was the topic of celiac disease – a condition that causes damage to the small intestines when ingesting gluten. There is some research that argues a strict gluten-free diet is only necessary for those who suffer from celiac disease. This autoimmune disorder can occur in genetically predisposed individuals, according to the Celiac Disease Foundation, and affects up to one in 100 people in the world. When undiagnosed, the disease can cause long-term health complications; and the CDF estimates an upward of two and a half million Americans are living undiagnosed with celiac disease.

Gluten is a protein found in wheat, rye and barley, and when ingested by someone with celiac disease, causes the body to initiate an immune response that targets the small intestine. The small intestine is responsible for absorbing nutrients into the body by way of villi – small projections that line the inside walls of the intestine. The villi become damaged during the immune response after someone with celiac disease ingests gluten. According to the CDF, long-term health complications can include Type I diabetes, multiple sclerosis, dermatitis herpetiformis – which is an itchy skin rash, anemia, osteoporosis, infertility and miscarriage, epilepsy, migraines, short stature and even intestinal cancers.

Understanding and identifying symptoms of celiac disease can be challenging, as some experience no symptoms at all while others have a range of approximately 300 other varying types of symptoms. For children and infants, the CDF lists common symptoms as abdominal bloating and pain, chronic diarrhea, vomiting, constipation, weight loss, fatigue, irritability and behavioral issues, dental enamel defects of the permanent teeth, delayed growth and puberty, short stature and failure to thrive. Digestive symptoms are more common in infants and children.

For adults, identifying symptoms is more difficult as only one-third experience diarrhea and are less likely to have digestive symptoms. Celiac disease in adults is more commonly experienced in symptoms such as unexplained irondeficiency anemia, fatigue, bone or joint pain, arthritis, bone loss of osteoporosis, depression or anxiety, tingling numbness in the hands and feet, seizures or migraines, missed menstrual periods, infertility or recurrent miscarriage, canker sores inside the mouth, and a skin rash (dermatitis herpetiformis). The University of Chicago’s Celiac Disease Center offers a full and complete list of all 300 known symptoms that can be found at www.cureceliacdisease.org.

If any of the listed symptoms are causing concern about the possibility of having celiac disease, it is important to consult with a physician to get a diagnosis. Diagnosing celiac disease is a two-part process; screening and diagnosing. According to the CDF, there are several blood tests that can screen for celiac disease antibodies. Should the results suggest the condition, a biopsy of the small intestine is used to confirm the diagnosis. It is stressed in order to receive an accurate diagnosis, the patient should not be on a gluten-free diet at the time. The endoscopic biopsy is an outpatient procedure in which a biopsy of the small intestine is analyzed to see if there is any damage that is reflective of celiac disease. Additionally, the diagnosis may be confirmed once more by improvement following a gluten-free diet.

Because celiac disease is a chronic autoimmune disorder, the condition is life-long. According to the CDF, the treatment for the condition is a strict adherence to a gluten-free diet. After going gluten-free, the small intestine begins to heal from the damage caused and some symptoms begin to resolve. According to the CDF, medication is not usually needed except in some cases of dermatitis herpetiformis. Follow-up with a nutritionist after going glutenfree is equally as important, to be sure that the body is receiving all the proper nutrients and there is an understanding of which foods are safe. In some cases, a physician may require a repeat biopsy or blood work after three to five years.

For more on testing and diagnosing, a full list of the 300 known symptoms, a gluten-free meal plan and finding a practitioner, go to www.celiac.org.