Family Health: Celiac disease means completely avoiding gluten

Gluten is a protein that does great things for baked goods and other foods. It gives bread texture and helps it rise and keep its shape. It also helps thicken soups and sauces and stabilizes foods such as ketchup and ice cream.

For people with celiac disease, though, none of gluten’s good points outweigh the fact that it can make them dangerously ill. This condition can cause stomach pain and diarrhea, and left untreated, it can lead to serious problems with the skin, nervous system, bones, joints and spleen.   

What does celiac disease do?

In normal digestion, nutrients are absorbed through tiny, fingerlike projections called villi that line the wall of the small intestine. Celiac disease interrupts that process, leaving you without the nourishment your body needs to function. This happens because with celiac disease, gluten triggers an autoimmune reaction in the small intestine that damages the villi and prevents the absorption of nutrients.

People of any age can get celiac disease, and babies may show symptoms when they start eating cereals and other solid foods. Symptoms vary widely from person to person, and can include some of these:

  • Babies can have diarrhea and a swollen belly from bloating. Belly pain can cause them to be irritable, and they may also lose weight.
  • Older children may have constipation or diarrhea, stomach pain, or recurrent vomiting. They may become anemic and not grow as fast as other kids their age. Children with celiac disease may have defects in the enamel of their permanent teeth. They can become withdrawn and irritable.
  • Teenagers may have diarrhea or constipation, and may be late going through puberty. They may have dental problems and hair loss, and be shorter than average height.
  • Adults are less likely to have severe gastrointestinal symptoms, though they still may occur. In fact, GI symptoms result in many people with celiac disease being mistakenly diagnosed with irritable bowel syndrome (IBS). People this age may also feel generalized fatigue and poor health, with bone or joint pain, anxiety or depression. Osteoporosis and anemia can occur, and women may miss menstrual periods. An itchy, blistery skin condition called dermatitis herpetiformis is also common in adults with celiac disease.

Gluten can cause some of the same symptoms in people without celiac disease. This is known as gluten sensitivity, and it can cause stomach pain, IBS, brain fog, fatigue, depression and other problems. However, gluten sensitivity does not damage the small intestine.

Who gets celiac disease?

The exact cause of celiac disease isn’t known. However, some people are more likely than others to get it. For example, if someone else in your family has celiac disease you have an increased change for getting it yourself. Having another autoimmune disease, such as type 1 diabetes, rheumatoid arthritis or Addison’s disease, also raises your risks for celiac disease. So does having some genetic disorders, such as Down syndrome or Turner’s syndrome.

Having one of these risk factors doesn’t mean that you are certain to develop celiac disease. Also, some people have this condition without getting sick. Their symptoms begin only when they are triggered by a stressful event such as a physical injury, an infection, surgery or pregnancy.

Celiac disease is more common in women than men, and more likely among Caucasians than other races. As many as 1 in 100 people in the U.S. have this condition, and 80 percent or more of them are undiagnosed.

How is it diagnosed?

If you have symptoms of celiac disease, your doctor may suggest a blood test to measure certain antibodies that occur with this condition. Don’t stop eating gluten before this test, since that may cause inaccurate results.

If the blood test shows that you might have celiac disease, an intestinal biopsy can confirm the diagnosis. While you are sedated, a thin tube called an endoscope is inserted through your mouth and stomach to your small intestine. A small tissue sample is removed and analyzed in the laboratory.

In some cases genetic testing is used to help diagnose celiac disease. However, these tests only tell if someone carries the gene for celiac, not if they have the condition. Thirty percent of Caucasians have this gene, while only about 1 percent of everyone in the U.S. has celiac disease.

What can be done?

Celiac disease can’t be cured. But its symptoms and damaging effects can be relieved by completely eliminating gluten from your diet. That means avoiding any food that contains wheat, along with other grains with gluten such as barley, farina, malt, rye, semolina and others.

Gluten can also occur in various foods, including beer, processed meats, salad dressings, candies and many others. Even some medicines contain gluten. Your doctor can give you detailed instructions for avoiding gluten, and it’s also important to read food labels to find hidden sources of gluten.

While a gluten-free diet means eliminating many foods, your meals can still be healthy and delicious. Fresh meats (not processed), fish and poultry are naturally gluten free. So are fruits and vegetables, along with rice, buckwheat, corn and many other foods. Most dairy products don’t contain gluten, and there are many gluten-free breads and other products available.

May is Celiac Awareness Month, and the Celiac Disease Foundation (CDF) is offering gluten-free meal plans and other resources for people with this condition. Visit the CDF at celiac.org. Gluten Intolerance Group (GiG) (gluten.net) is another nationwide organization dedicated to helping people with celiac disease and gluten sensitivity. You can also find information about local restaurants and groceries with gluten free resources by visiting findmeglutenfree.com and entering your zip code.