What is Celiac Disease?

Celiac Disease is a common autoimmune disorder that presents itself as intolerance to gluten.  Gluten is a protein found in wheat, rye, barley, and ‘contaminated’ oats.  The only acceptable treatment is 100% gluten-free diet.

  • The most recent prevalence figures (NIH) indicate that as many as 1 in 100 people, many with no symptoms whatsoever, may have celiac disease.

Celiac Disease, and to a lesser degree gluten intolerance, is a genetically inherited digestive disorder.  However, many symptoms related to untreated Celiac Disease (CD) do not necessarily involve the gastrointestinal tract.  Celiac Disease is also an autoimmune condition, meaning that destruction of the villi is caused by the body’s immune system.  An untreated celiac’s body attacks itself.  The body identifies gluten as an invader and reacts by attacking the “threat” with villi destruction.  Unlike other autoimmune conditions, Celiac Disease is unique; it is the only auto-immune disorder linked to a known trigger, gluten.

When celiacs ingest gluten, their villi, which are tiny hair-like projections in the small intestine that absorb nutrients from food, get damaged.  Again, this is due to an immunological reaction to gluten, which is poison to celiacs.  The damaged villi interfere with the body’s ability to absorb nutrients, resulting in vitamin and mineral deficiencies.  Consequently, untreated Celiac Disease may result in conditions such as osteoporosis, neurological disorders, anemia etc.

  • If Celiac Disease is untreated, damage to the small bowel can be chronic and life threatening.

The good news is that the damage to the intestines is completely REVERSIBLE with avoidance of dietary gluten.

Before diagnosis, celiacs may suffer from ailments caused by malnutrition.  Vitamin A deficiency, for example, may lead to ‘night vision’ problems.  Vitamin B12 deficiency may be the root cause of depression, or migraine headaches.  Other celiacs may complain of joint pain, caused by calcium deficiency.  Fat-soluble vitamin deficiencies (A,D,E,K) may be present.  Some may show unexplained iron deficiency anemia.  Others may suffer from skin rashes, hair loss, infertility, repeated yeast infections, and water retention.  Celiacs may get diagnosed after suffering symptoms of bloated belly, acid reflux, diarrhea and/or constipation. Weight loss, and weight gain, may be attributed to untreated Celiac Disease.  Elevated transaminases of unknown origin are common among untreated celiacs.  It is important to remember that these conditions improve and disappear after following a gluten free diet.

Celiacs have a permanent intolerance to gluten grains, but the effects of celiac disease may change from time to time.  Celiacs may be sicker at one phase of their life than another. For example, a celiac may be sicker at age two with anorexia and crankiness.  This patient may be completely asymptomatic during his/her teenage years (while the internal damage continues).  This same individual may be sick again in his/her 20s, although symptoms this time may be depression and mood swings.  In his/her 30s, the patient may present with anemia.  Regardless of symptoms being existent or non-existent, celiacs do not outgrow Celiac Disease.  Even if they ‘don’t feel it’ anymore.

Celiac Disease can be a difficult case to diagnose because the degree and type of symptoms that a celiac may experience varies widely among individuals.  Lack of patient and physician awareness is a major factor.  In addition, symptoms may be absent for years!  How do those celiacs get diagnosed?  Asymptomatic Celiac Disease relatives have been diagnosed after family members were tested for CD.

In Celiac Disease, the damage starts in the intestine just after the stomach and works its way down.  The small intestine is about 26 feet long and has a tremendous ability to compensate.

  • So if the damage is mostly near the stomach, which is where biopsies are done, then you may never have diarrhea. The rest of the small intestine may compensate and absorb all the liquid and food that passes by the first few damaged feet.
  • If you have all of the small intestine damaged, you’ll probably have diarrhea and weight loss.
  • If only a small portion of the small intestine is damaged, you may not even have symptoms. However, the damage caused by untreated Celiac Disease continues until symptoms eventually worsen.

Other factors may camouflage Celiac Disease. For example, if a celiac suffers from constipation due to gluten ingestion, but dairy products cause a laxative effect, a celiac may not feel that gluten affects his/her gastrointestinal tract.

History:  Celiac Disease is a consequence of man's transition from hunter to that of a harvester of grains as a food source.  The first documented instances of celiac surfaced in the writings of the Roman physician, Galen and have evolved to the current view of the disease.  Much work was done in the 1800 and 1900's and culminated in the thesis of pediatrician Dr. Willem Karel Dicke of Holland in post war Europe where he noticed childrens nutritional health changing with the elimination of gluten.  Over the last twenty years much progress has been made in understanding the causes and possible treatments of CD.

Central Coast Celiacs provides basic information about Celiac Disease/Dermatitis Herpetiformis. Physician packages are also available upon request. Information shared by this support group does not constitute medical advice. Betty Guthrie and Isabella Porter are not physicians. Central Coast Celiacs does not recommend initiation of a gluten free diet without first consulting a physician familiar with CD/DH.

The information provided herein should not be used for the diagnosis or treatment of any medical condition. A licensed medical professional well versed on CD/DH should be consulted for diagnosis and treatment of any and all medical conditions listed. Links to other websites are provided for informational purposes only, and they do not constitute endorsements of those other sites.