It may seem like everything - from bread at the grocery store to entrees on a restaurant menu - is labeled “gluten-free” these days. Why are people nixing gluten, a protein found in wheat, oats, barley and rye? One reason is celiac disease, a genetic autoimmune disorder that affects as many as one in 133 people. Celiac disease is serious because not only does it cause a host of uncomfortable and even painful symptoms, it can lead to conditions like malnourishment, osteoporosis and anemia.
How does celiac disease affect the body?
“Celiac disease is an autoimmune disorder in which the body sees the gluten protein as foreign and sends inflammation to the villi, tiny, fingerlike protrusions in the small bowel lining,” explains Howard Seeman, M.D., a gastroenterologist. “Over time, the lining becomes damaged and goes flat. It then absorbs less calcium and iron, which can lead to osteoporosis or anemia.”
Who is at risk?
Anyone can have celiac disease, and in many cases, the symptoms don’t occur until adulthood. It is a genetic disease, so it runs in families. It occurs more often in patients with diabetes or other autoimmune diseases.
What are the symptoms?
“In some patients, the symptoms are vague,” Dr. Seeman says. “A person may have anemia, but not diarrhea or bloating.” Symptoms span a wide range and include:
- Bloating
- Chronic diarrhea or constipation
- Intermittent abdominal pain
- Nausea
- Gas
- Pale, foul-smelling stool
- Weight loss
- Unexplained anemia
- Delayed growth
- Pain in the joints
- Tingling and numbness in the legs
- Missed menstrual periods
- Tooth discoloration or loss of enamel
- Painful skin rash
- Fatigue
- Muscle cramps or bone pain
“The symptoms of Celiac disease mimic those of irritable bowel syndrome, peptic ulcers, Crohn’s disease, and other inflammatory bowel diseases,” Dr. Seeman says.
How is it diagnosed?
“Some patients eliminate gluten from their diet and feel better,” Dr. Seeman says. However, for a true diagnosis, patients must undergo a blood test or biopsy.
How is it treated?
“The only treatment is the avoidance of gluten,” he says. “Luckily, celiac disease is reversible, and the villi in the small intestine will return.” While it is important for those with celiac disease to avoid gluten, it is uncommon to have a severe reaction from gluten exposure. “I have patients who may have gluten one weekend and feel badly the next week,” Dr. Seeman says. “But that is a sensitivity, not a true allergic reaction.” If you have any of the above symptoms, speak with your doctor to rule out celiac disease. To find a gastroenterologist near you, click here.
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