Celiac disease (also known as celiac sprue or gluten-sensitive enteropathy) is a digestive and autoimmune disorder. An autoimmune disorder is one in which the immune system directs antibodies (substances produced by the immune system to fight harmful invaders) to attack the body. The antibody of celiac disease is directed against gluten, a protein found in grains.
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 system forms antibodies to gluten, which then 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.
Other causes of malabsorption include:
Symptoms of celiac disease vary among sufferers and include:
Celiac disease can leave the patient vulnerable to other health problems, including:
People who have celiac disease may have other autoimmune diseases, including:
If your doctor thinks you might have celiac disease, he or she will perform a careful physical examination and will discuss your medical history with you. He or she may also perform a blood test to measure levels of antibodies to gluten. People with celiac disease have higher levels of certain antibodies in their blood.
Your doctor may perform other tests to look for nutritional shortages, such as a blood test to detect iron levels; a low level of iron (which can cause anemia) can occur with celiac disease. A stool sample may be tested to detect fat in the stool, since celiac disease prevents fat from being absorbed from food.
Your doctor may take a biopsy from your small intestine to check for damage to the villi. In a biopsy, the doctor inserts an endoscope (a thin, hollow tube) through your mouth and into the small intestine, and takes a sample of the small intestine with an instrument.
If you have celiac disease, you can't eat any foods that contain gluten (including wheat, rye, barley, and oats). Dropping gluten from your diet usually improves the condition within a few days and eventually ends the symptoms of the disease. In most cases, the villi are healed within 6 months.
You'll have to remain on this diet for the rest of your life; eating any gluten at all can damage your intestine and restart the problem.
Some people with celiac disease have so much damage to their intestines that a gluten-free diet will not help them. These patients may have to receive intravenous (through a vein) nutrition supplements.
Following a gluten-free diet means you cannot eat many "staples," including pasta, cereals, and many processed foods that contain grains. There may also be gluten in ingredients added to food to improve texture or flavor, and products used in food packaging.
If you have celiac disease, you can still eat a well-balanced diet. For instance, bread and pasta made from other types of flour (potato, rice, corn, or soy) are available. Food companies and some grocery stores also carry gluten-free bread and products.
You can also eat fresh foods that have not been artificially processed, such as fruits, vegetables, meats and fish, since these do not contain gluten.
A gluten-free diet will be a big change in your life. You have to rethink your eating habits, including what you buy for lunch, what you eat at parties, or what you snack on. When you go grocery shopping, be sure to read the ingredient label carefully.
A dietitian, a healthcare professional who specializes in food and nutrition, can help you with the gluten-free diet. There are also support groups that can help patients who have just been diagnosed with celiac disease.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 12/12/2016