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Celiac disease is a condition that creates inflammation in the small intestine, and damage in the lining. This prevents important components of food from being absorbed. The damage to the lining of the intestine comes from a reaction to eating gluten, which is found in wheat, rye, barley, and possibly oats, and in food made from these ingredients.
The exact cause of celiac disease is unknown. The lining of the intestines have small projections contains areas called villi. These structures help absorb nutrients. When people with celiac disease eat foods or use products that contain gluten, their immune system reacts by damaging the villi. As a result, the villi are unable absorb nutrients properly. Therefore, a person becomes malnourished, no matter how much food he or she eats.
The disease can develop at any point in life, from infancy to late adulthood.
People who have a family member with celiac disease are at greater risk for developing the disease. The disorder is most common in Caucasians and persons of European ancestry. Women are affected more often than men.
Children with celiac disease may have:
Blood tests can detect antibodies, called antitissue transglutaminase antibodies (tTGA) or anti-endomysial antibodies (EMA) which may help detect the condition. The health care provider will order these antibody tests if celiac disease is suspected.
If the tests are positive, upper endoscopy is often performed to sample a piece of tissue (biopsy) from the first part of the small intestine (duodenum). The biopsy may show a flattening of the villi in the parts of the intestine below the duodenum.
Genetic testing of the blood can also be done to help determine who may be at risk for celiac disease.
A follow-up biopsy or blood test may be ordered several months after the diagnosis and treatment. These tests assess how well treatment is working. Normal results mean that you have responded to treatment. This confirms the diagnosis. However, this does not mean that the disease has been cured.
Celiac disease cannot be cured. Your symptoms will go away and the villi in the lining of the intestines will heal if you follow a lifelong gluten-free diet. Do not eat foods and beverages or take medicines that contain wheat, barley, rye, and possibly oats.
You must read food and drug labels carefully to look ingredients that may include these grains. It may be hard to stick to a gluten-free diet because wheat and barley grains are common in the American diet. Over time, most people are able to adapt and get better. You should NOT begin the gluten-free diet before you are diagnosed. Starting the diet will affect testing for the disease.
Your health care provider may prescribe vitamin and mineral supplements to correct nutritional deficiencies. Sometimes, short-term use of corticosteroids (such as prednisone) may be needed if sprue does not respond to treatment. In most cases, following a well-balanced, gluten-free diet is the only treatment you need to stay well.
When you are diagnosed, get help from a registered dietitian who specializes in celiac disease and the gluten-free diet. A support group may also help you cope with the disease and diet.
