What is Celiac Disease?
Celiac disease is a serious autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. When celiac patients eat gluten (a protein found in wheat, rye and barley), their body mounts an immune response that attacks the small intestine. These attacks lead to damage on the villi, small fingerlike projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.
It is estimated to affect 1 in 100 people worldwide. Two and one-half million Americans are undiagnosed and are at risk for long-term health complications.
Can you develop Celiac Disease later in life?
New research shows that you can develop this condition at any age — even if you previously tested negative. Celiac disease can develop at any age after people start eating foods or medicines that contain gluten. Left untreated, it can lead to additional serious health problems.
Type I diabetes and multiple sclerosis (MS), dermatitis herpetiformis (an itchy skin rash), anemia, osteoporosis, infertility and miscarriage, neurological conditions like epilepsy and migraines, short stature, and intestinal cancers can also occur in Celiac patients.
Types of Celiac Disease
According to the World Gastroenterology Organization, celiac disease may be divided into two types: classical and non-classical.
Classical celiac disease
Patients have signs and symptoms of malabsorption, including diarrhea, steatorrhea (pale, foul-smelling, fatty stools), and weight loss or growth failure in children.
Non-classical celiac disease
Patients may have mild gastrointestinal symptoms or may have seemingly unrelated symptoms. They may suffer from abdominal distension, pain, fatigue, migraines, depression, anxiety, rashes, numbness and tingling and infertility. Signs of iron-deficient anemia, elevated liver tests, reduced bone mass and fractures, vitamin deficiency (folic acid and B12) may also be present.
Silent celiac disease
Also known as asymptomatic celiac disease. Patients do not complain of any symptoms, but still experience villous atrophy damage to their small intestine. Studies show that even though patients thought they had no symptoms, after going on a strict gluten-free diet they report better health and a reduction in acid reflux, abdominal bloating and distention and flatulence. First-degree relatives (parents, siblings, children), whether experiencing symptoms, should always be screened, since there is a 1 in 10 risk of developing the disease.
The number of ways celiac can affect patients, combined with a lack of training in medical schools and primary care residency programs, contributes to the poor diagnosis rate in the United States. Currently it is estimated that 80% of the celiac patient population remains undiagnosed.
What are the symptoms?
Diarrhea– Loose, watery stool is one of the first symptoms that many people experience before being diagnosed. In one small study, 79% of celiac patients reported experiencing diarrhea prior to treatment. Following treatment, just 17% of patients continued to have chronic diarrhea.
Bloating– is another common symptom that people experience. Celiac disease can cause inflammation in the digestive tract, which may result in bloating as well as many other adverse digestive issues.
Gas– Excess gas is a common digestive issue experienced by those with untreated celiac disease. In one small study, gas was one of the most common symptoms caused by gluten consumption in those with this disease.
Fatigue– Decreased energy levels and fatigue are prevalent in those with celiac disease. One study of 51 celiac patients found that those who were untreated had significantly more severe fatigue and fatigue-related problems than those on a gluten-free diet. Another study found that those with celiac disease were more likely to have sleep disorders, which could contribute to fatigue. Additionally, untreated celiac disease can cause damage to the small intestine, resulting in vitamin and mineral deficiencies that may also lead to fatigue.
Weight Loss– A sharp drop in weight and difficulty keeping weight on are often early signs of celiac disease. This is because your body’s ability to absorb nutrients is impaired, which can potentially lead to malnutrition and weight loss.
Iron Deficiency Anemia– Celiac disease can impair nutrient absorption and may lead to iron-deficiency anemia, a condition caused by a lack of red blood cells in the body. Symptoms of iron-deficiency anemia include fatigue, weakness, chest pain, headaches and dizziness.
Constipation– While this disease may cause diarrhea in some people, it may also cause constipation in others. Celiac disease damages the intestinal villi, which are tiny, finger-like projections in the small intestine that are responsible for absorbing nutrients. As food travels through the digestive tract, the intestinal villi are unable to fully absorb nutrients and may often absorb extra moisture from the stool instead. This leads to hardened stool that is difficult to pass, resulting in constipation.
The bottom line
Celiac disease is a serious condition in which the immune system attacks the small intestine in response to eating gluten. If left untreated, it can result in many adverse side effects, including digestive issues, nutritional deficiencies, weight loss and tiredness.
If you suspect you may be at risk, speak with one of the doctors at Hunterdon Gastroenterology Associates about getting tested. You can make an appointment and reach our physicians by calling 908-483-4000.
Celiac Disease Foundation. 2018.
Healthline. 7 Signs and Symptoms of Celiac Disease. 2017.
Mann, D. (2010). Celiac Disease Can Develop at Any Age. WebMD.
World Gastroenterology Organization, 2018.