What is celiac disease?

Celiac disease (also known as celiac sprue or gluten-sensitive enteropathy) is a digestive and multisystem disorder. Multisystem means that it may affect several organs. Celiac disease is a complex immune-mediated disorder, one in which the immune system causes damage to the small bowel when affected people eat gluten (a protein in some grains such as wheat, barley, and rye).

What is the difference between celiac disease and non-celiac gluten sensitivity (NCGS)?

Celiac disease causes damage to the small intestine. There are specific markers in the blood that help confirm the diagnosis. Non-celiac gluten sensitivity causes symptoms that may include nausea, vomiting, abdominal pain, headaches, diarrhea, joint pain, fatigue, and “brain fog." These might be slight or severe. However, NCGS does not injure the intestine; there are no specific markers in the blood; and the diagnosis requires improvement of symptoms after following a diet without gluten.

What are the causes of celiac disease?

Normally, the body's immune system is designed to protect it from foreign invaders. When people with celiac disease eat foods that contain gluten, their immune systems attack the lining of the intestine. This causes inflammation (swelling) in the intestines and damages the villi, the hair-like structures on the lining of the small intestine. Nutrients from food are absorbed by the villi. If the villi are damaged, the person cannot absorb nutrients and ends up malnourished, no matter how much he or she eats.

What are the symptoms of celiac disease?

Symptoms of celiac disease vary among sufferers and include:

  • No symptoms at all (like some family members of celiac patients).
  • Digestive problems (abdominal bloating, pain, gas, constipation, diarrhea, pale stools and weight loss).
  • A severe blistering skin rash called dermatitis herpetiformis and sores in the mouth (called aphthous ulcers).
  • Unexplained anemia (low blood count) or hepatitis (inflammation of the liver).
  • Musculoskeletal problems (muscle cramps, joint and bone pain) and defects in dental enamel.
  • Growth problems and failure to thrive (in children). This is because they cannot absorb the nutrients.
  • Tingling sensation in the legs (caused by nerve damage and low calcium).
  • Depression.

What other health problems can accompany celiac disease?

Celiac disease can leave the patient vulnerable to other health problems, including:

  • Malnutrition.
  • Osteoporosis, a disease that weakens bones and leads to fractures. This occurs because the person has trouble absorbing enough calcium and vitamin D.
  • Infertility.
  • Cancer of the intestine (very rare).

People who have celiac disease may have other autoimmune diseases, including:

Some people have “non-classic celiac disease,” such as when the only symptom is anemia. Non-classic celiac disease is becoming the most common form of celiac disease. Others might have “asymptomatic celiac disease,” which is one without any symptoms at all.

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