What Exactly is Celiac Disease?

A gluten-free diet isn’t just a trend for the 3 million Americans living with celiac disease. 

Gluten is a hot topic these days, with more and more people opting to reduce gluten in their diets or to be gluten-free, often because they feel better and less bloated by limiting or eliminating gluten from their diets. But for the three million Americans diagnosed with celiac disease, being gluten-free is a medical necessity, not a trendy option.

Celiac disease is a chronic, genetic autoimmune disease. When people susceptible to the disease ingest gluten (a protein found in wheat, rye and barley), they experience an immune system response that damages the small intestine and impairs the body’s ability to absorb nutrients. To develop celiac disease, a person must be genetically predisposed to the condition, be consuming gluten in their diet (a staple in most normal diets) and have the disease activated. However, not all predisposed individuals develop the condition, and approximately 80% of those with celiac in the U.S. are undiagnosed. The disease can be activated by triggers including stress, trauma (surgeries, etc.) and possibly viral infections.

The Symptoms of Celiac Disease

There are nearly 200 different symptoms associated with celiac disease. Symptoms related to malabsorption of nutrients include diarrhea, bloating, weight loss, anemia and growth failure. Other non-gastrointestinal symptoms include migraines, infertility, fatigue, joint pain, premature osteoporosis, depression and seizures. Many people do not have gastrointestinal symptoms, some may have just one symptom and some individuals have no obvious symptoms at all.

upset stomach

How is Celiac Disease Diagnosed?

If your doctor suspects you have celiac disease, she or he will order a blood test to look for the antibodies associated with the disease. If this screening suggests celiac disease, a small intestine biopsy is the next step to confirming diagnosis. In some cases a test for the genetic markers necessary to develop celiac may be recommended prior to biopsy.

Treatment and Prognosis of Celiac Disease

With celiac disease, the adage “food is the best medicine” is absolutely on the mark. The right food, i.e. a strict gluten-free diet for life, is in fact the only treatment or “medicine” currently available. A gluten-free diet involves eliminating all wheat, barley, rye and foods made with these grains or their derivatives. Additional medication is typically not required unless there is an accompanying condition, such as osteoporosis or dermatitis herpetiformis. When you follow a gluten-free diet, blood tests should eventually come back to normal, indicating good control of celiac disease – not a cure. You will always require a gluten-free diet until another form of treatment is discovered. The good news is there are more gluten-free products and foods available than ever before.

The other good news is that the prognosis for those with this chronic disease is generally excellent when a strict gluten-free diet is maintained. The small intestine will steadily heal and start absorbing nutrients normally. You should start to feel better within days; however, complete recovery may take several months to several years.

To learn more, join the Charleston Celiac/Gluten Free Group along with Roper St. Francis – for a Gluten Free Food Expo on Monday, August 14, 6 to 7:30 p.m. at Bon Secours St. Francis Hospital in West Ashley. Local vendors will be displaying and selling their gluten-free products. The event is free to the public and no registration is required.

By Sara Forbes, MS, RD, CDE, clinical dietitian