Celiac Disease
(Gluten Enteropathy)

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Celiac disease facts

  • Celiac disease is a chronic digestive disorder in which damage to the lining of the small intestine leads to the malabsorption of minerals and nutrients.

  • The destruction of the inner lining of the small intestine in celiac disease is caused by an immunological (allergic) reaction to gluten.

  • Gluten is a family of proteins present in wheat, barley, rye, and sometimes oats.

  • Individuals with celiac disease may develop diarrhea, steatorrhea, weight loss, flatulence, iron deficiency anemia, abnormal bleeding, or weakened bones. However, many adults with celiac disease may have either no symptoms or only vague abdominal discomfort such as bloating, abdominal distension, and excess gas.

  • Children with celiac disease may have stunted growth, and if untreated, childhood celiac disease can result in short stature as an adult.

  • Small intestinal biopsy is considered the most accurate test for celiac disease.

  • Blood tests can be performed to diagnose celiac disease; these include endomysial antibodies, anti-tissue transglutaminase antibodies, and anti-gliadin antibodies.

  • There is no cure for celiac disease. The treatment of celiac disease is a gluten free diet.

  • In most individuals, a gluten free diet will result in improvement in symptoms within weeks. Many individuals report symptom improvement within 48 hours.

  • In children with celiac disease, successful treatment with a gluten free diet can lead to the resumption in growth (with rapid catch up in height).

  • Failure to respond to a gluten free diet can be due to several reasons; the most common reason is failure to adhere to a strict gluten free diet.

  • Refractory celiac disease is a rare condition in which the symptoms of celiac disease (and the loss of villi) do not improve despite many months of a strict gluten free diet. It may progress to cancer.

  • The treatment of refractory celiac disease is first to make sure that all gluten is eliminated from the diet. If there still is no improvement, corticosteroids such as prednisone, and immunosuppressive agents (medications that suppress a person's immune system) such as azathioprine and cyclosporine may be used.

  • Adults with celiac disease have a several-fold higher than normal risk of developing lymphomas (cancers of the lymph glands) in the small intestine and elsewhere. They also have a high risk of small intestinal and, to a lesser degree, of esophageal carcinomas (cancers of the inner lining of the intestine and esophagus).

  • The prognosis of individuals with celiac disease who develop lymphoma, collagenous celiac disease, or jejunal ulcers is poor.
Reviewed by Bhupinder Anand, MD on 6/28/2011


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Celiac Disease - Diagnosis Question: How was your celiac disease diagnosed?
Celiac Disease - Symptoms Question: The symptoms of celiac disease can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
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Celiac Disease Symptoms

Depending on the degree of malabsorption, the signs and symptoms of celiac disease vary among individuals, ranging from no symptoms, few or mild signs and symptoms, to many or severe signs and symptoms. There are two categories of signs and symptoms: 1) signs and symptoms due to malabsorption, and 2) signs and symptoms due to malnutrition including vitamin and mineral deficiencies.

1. Signs and symptoms due to malabsorption: Fat is the most commonly and severely affected nutrient in celiac disease. Gastrointestinal symptoms of fat malabsorption include:

  • diarrhea,
  • foul smelling gas,
  • increased amount of fat in the stool, and
  • abdominal bloating.

2. Signs and symptoms due to malnutrition including vitamin and mineral deficiencies include:

  • weight loss,
  • fluid retention,
  • anemia,
  • osteoporosis,
  • bruising easily,
  • peripheral neuropathy,
  • infertility, and
  • muscle weakness.

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