Celiac is a serious autoimmune disease in which the small intestine is extremely sensitive to gluten, a type of protein that’s found in rye, wheat, and barley. Celiac disease normally attacks villi i.e. finger-like projections which form the lining of the small intestine, leading to reduced nutrient absorption. As a result, the affected individual will end up malnourished and suffering from other medical conditions such as neurological disorders, infertility, miscarriages, anemia and low bone density among others.
Celiac is also categorized as a hereditary disease. This means that it runs down from one family member to the next. Individuals who have relatives (sibling, child, or parent) with 1st-degree celiac disease have a 10 percent risk of developing this medical condition.
Note: celiac disease isn’t a food allergy. Additionally, it isn’t a type of intolerance. It is an autoimmune disease just like rheumatoid arthritis, lupus, or type 1 diabetes.
Types of Celiac Diseases
The World Gastroenterology Organization has divided this disease into two types: the classical celiac and non-classical celiac.
1- Classical celiac
patients usually display symptoms that are related to nutrient malabsorption including fatty and pale stools which have a foul smell, a condition that’s medically known as steatorrhea. Other symptoms include slow growth rate, diarrhea, and weight loss.
2- Non-Classical Celiac
patients normally display gastrointestinal symptoms that are mild. They don’t suffer from malabsorption but they may experience abdominal pain and distension.
Research studies indicate that there is another form of celiac that’s known as Silent Celiac. It’s an asymptomatic disease where patients don’t display or experience any complications but their small intestines will still experience severe damage. Reports show that even though a patient with Silent Celiac may not display any symptoms, they usually end up feeling better once they decide to eat gluten-free foods.
General Symptoms of Celiac Disease
Celiac is a disease that usually displays a host of various negative symptoms including malnutrition and digestive problems. Outlined below are the most common symptoms of celiac disease.
This is the most common symptom of celiac. Patients usually experience loose and watery stools before they are diagnosed with this condition. A study that was conducted on a small group of celiac patients indicates that almost 80 percent of them experienced diarrhea before treatment. However, the diarrhea usually subsides after a few weeks of treatment. This problem usually resolves within four weeks.
Note: Celiac isn’t the only main cause of diarrhea and it may be caused by food intolerances, gastrointestinal infections or other types of intestinal problems.
Patients who have untreated celiac often experience gassing. Medical studies show that those with celiac disease usually experience gas problems after consuming gluten-rich foods.
Note: gassing is a digestive problem that may be caused by other digestive issues such as indigestion, irritable bowel syndrome, lactose intolerance, and constipation.
This is another common symptom that people with celiac disease may experience. This autoimmune condition causes inflammation along the digestive tract and as a result, it may result in bloating and other serious digestive issues. A study that was conducted on a group of celiac patients indicates that almost 75 percent of them experienced bloating prior to being diagnosed with celiac. However, the bloating symptoms were effectively resolved once the patients stopped consuming foods with gluten.
Low nutrient absorption means that the body will end up with reduced energy levels. As a result, the patient will end up suffering from constant fatigue. Over 50 percent of celiac disease patients reported that they suffered from severe fatigue as well as other problems that are related to fatigue. Additionally, most of them suffered from fatigue-induced insomnia and sleeplessness.
Note: fatigue may also be caused by anemia, depression, thyroid issues, and other infections.
Iron Deficiency (Anemia)
This disease causes nutrient absorption impairment which may lead to iron-deficiency or anemia – a medical condition that’s caused by a low number of red blood cells. Anemia may display itself in form of chest pains, dizziness, weakness, headaches, and fatigue. A study that was conducted on a group of children suffering from celiac disease established that more than 15 percent of them suffered from mild or moderate anemia.
Malnutrition and reduced nutrient absorption can cause a sharp, unexpected drop in weight. This is one of the early signs of this medical condition. The reduced nutrient absorption leads to growth impairment and results in extreme weight loss. A study that was conducted on a group of celiac patients indicates that more than 20 percent of them experienced drastic weight loss that was accompanied by stomach pain, fatigue, and diarrhea.
Celiac is a disease that has many faces. Apart from the physical symptoms, some patients may also experience psychological symptoms such as depression. However, this symptom is usually prevalent and severe in adults with celiac disease compared to kids. Research shows that more than 40 percent of patients with celiac have experienced depression tendencies at some point.
This is another common symptom of celiac. Before diagnosis, most patients have reported experiencing dermatitis herpetiformis, a blistering and itchy type of skin rash that usually occurs on the buttocks, knees, and elbows. Over 20 percent of people with celiac disease normally experience this skin rash condition and it’s one of the telltale signs that’s used for diagnosis.
Note: an itchy skin rash may also develop after your celiac diagnosis in case you fail to adhere to treatment. Besides celiac, other causes of itchy skin rash include hives, dermatitis, psoriasis, and eczema.
How Symptoms of Celiac Disease Manifest
So, here is how the signs and symptoms eventually manifest themselves. If you consume food with gluten, the gastric acid that’s found in the stomach will break down its protein content during digestion. However, there are some protein elements which may fail to undergo the digestion process. When this occurs in people with celiac disease, it causes a severe immune reaction. In this case, the body tries to attack itself and causes severe damage along the lining of the small intestine.
Specific parts of the intestines that suffer from the brunt effect of this disease are the villi i.e. the little finger-like structures which are responsible for absorbing food nutrients from the small intestines into the bloodstream. Note that the body needs nutrients in order to produce and sustain energy levels, repair cells, enhance organ function, and promote the rate of metabolism. When the villi are attacked, they degenerate and it becomes impossible for them to function efficiently. As a result, the patient will end up suffering from nutrition deficiencies.
Note: the immune reaction is not only localized to the small intestine. Celiac may cause a cascading reaction and result in an inflammatory response from other parts of the body such as nerves, the skin, and joints.
The Symptoms Usually Vary
What makes celiac a disease with many profiles is that it has a wide variety of symptoms. It’s very difficult for it to be diagnosed with one or two symptoms because patients don’t suffer from gastrointestinal problems only. There are some people who are forced to make frequent or emergency bathroom trips while others may suffer from abdominal pain after eating foods that contain gluten. Some of the causes of varying symptoms include:
- Age i.e. when did you start eating foods which contain gluten?
- The amount of gluten you consume
- How many months were you breastfed as an infant? Reports from various studies indicate that kids who are breastfed for much longer have a higher risk of developing celiac disease later in life.
- The severity of damage on your intestinal lining
Symptoms of celiac disease also vary from kids to adults. Infants and children with celiac normally display symptoms such as:
- Chronic diarrhea
- Weight loss
- Increased irritability and other behavioral issues
- Fatty stool with a foul smell and pale color
- Defects on the dental enamel (especially on permanent teeth)
- Failure to grow and thrive
- Short Stature
- Delayed puberty
- Attention deficit hyperactivity disorder
Adults, on the other hand usually display fewer digestive disorders. Research reports show that only one-third of adults with this autoimmune disease normally experience diarrhea. However, they are more likely to experience symptoms such as:
- Joint or bone pain
- Constant fatigue
- Anxiety and depression
- Recurrent miscarriage
- Fertility issues
- Peripheral neuropathy
- Biliary tract and liver problems such as sclerosing cholangitis, fatty liver etc.
- Migraines and seizures
- Itchy skin
All these symptoms vary from patient to patient. Some people may only experience mild symptoms which often go undiagnosed. There are those who just feel bloated after taking foods that contain gluten and that’s all. On the other hand, there are those who can’t even walk past a bakery without feeling like they have a runny stomach. This is not a disease that has a one-size-fits-all symptom. The Celiac Disease Foundation states that because these symptoms aren’t glaring or obvious, almost 3 million Americans have undiagnosed celiac disease.
Causes of Celiac Disease
One main cause of this autoimmune condition is genes. Most people usually inherit the genetic disorder although medical research reports show that this may be partial. While there is the need to have a defective gene for celiac to be triggered, there are still other factors that may facilitate its development. They include factors such as giving newborns antibiotics frequently and kids born via C-Section. These two factors may significantly cause changes and alter the way the gut microbiome function, resulting in a self-immune attack.
Other causes of celiac disease include infections such as stomach flu. This condition may trigger the body to initiate an inflammatory response against itself leading to celiac. Sometimes, this disease may be triggered and become severely active after childbirth, during pregnancy, after a viral infection or surgery, or as a result of severe emotional distress.
Celiac Disease Risk Factors
This autoimmune disease can affect anyone. But some groups of people are at a higher risk of getting it. It’s common in individuals who have:
- Type 1 diabetes
- A family member who has dermatitis herpetiformis or celiac disease
- Microscopic colitis such as collagenous colitis or lymphocytic
- Turner syndrome or down syndrome
- Addison’s disease
- Autoimmune thyroid disease
- Rheumatoid arthritis
Celiac Disease Complications
At face value, this condition may just appear to be mild with no long-term effects. However, celiac is a serious medical condition and if it’s left untreated, it may cause long-term health problems. If your body can’t absorb sufficient nutrients, it can’t function properly and your health with definitely deteriorate with time. Some of the complications that celiac can cause include:
Low Bone Density
Celiac disease leads to the malabsorption of minerals and vitamins such as vitamin D and calcium which help to strengthen bone density. If left untreated, it may lead to low bone density as a result of softened body tissues. Children may end up with rickets or osteomalacia while adults may end up with osteoporosis.
This is one of the most common and long-term side effects of celiac disease. It causes severe damage to the small intestines, causing nutrient absorption issues. Note that malnutrition can lead to weight loss and anemia. Children who are affected by malnutrition may end up with short stature and slow growth rate.
The effect of celiac on small intestines can be so severe that the patient may end up being lactose intolerant in the long run. Most patients may end up experiencing diarrhea and abdominal pain after consuming foods which contain dairy. If you seek the right treatment, your body may be able to tolerate dairy-related products once more. However, most people usually continue to be intolerant to lactose even after managing celiac successfully.
Miscarriage and Infertility Issues
Inadequate absorption of the essential minerals and vitamins may lead to reproductive issues in adults. Women with untreated celiac disease may end up suffering from miscarriages. Besides that, both men and women may end up with infertility problems.
Most people, especially adults with celiac disease, often end up developing neurological issues such as peripheral neuropathy and seizures.
Celiac disease patients who fail to maintain a diet that’s gluten-free have a higher risk of developing certain types of cancer which include small bowel cancer and intestinal lymphoma among others.
Overall, children with this autoimmune condition may end experiencing delayed puberty, epilepsy, irritability, anemia, and delayed growth among other issues.
Celiac Disease Diagnosis
According to medical research reports, only 20 percent of celiac disease patients may be able to receive the right diagnosis. The diagnosis process usually involves two blood tests which are:
- Genetic testing: it involves testing the human-leukocyte antigens.
- Serology testing: certain types of antibody proteins are tested.
In case either of these tests turns to be positive, the doctor may request an endoscopy test in order to get a better view of your small intestines. Additionally, they may take a biopsy i.e. a small tissue sample in order to analyze how the villi have been damaged.
The diagnosis process is usually delayed for several months and sometimes years in case the doctor can’t find symptoms that are related to celiac disease. Often times, doctors use physical examination, medical, and family history. Most patients usually make numerous hospital visits complaining about anemic symptoms, recurrent joint aches, and abdominal pain before they raise the suspicion of celiac disease.
Patients are usually advised to continue eating their regular diet in weeks that lead to testing. This is because if they turn to a gluten-free diet, the tests may turn to be falsely negative. After the diagnosis, the patient may be required to screen for osteoporosis as well.
Note: since this autoimmune disease is familial if one family member has been diagnosed with it, it’s advisable for other close family members to also get checked as well.
Celiac Disease Treatment
At the moment, celiac disease can be treated by just taking a gluten-free diet.
How to Manage Symptoms of Celiac Disease
Most people who have celiac disease usually manage the symptoms by simply but effectively using a gluten-free diet. Food products which contain spelt, barley, wheat, and rye have to be completely eliminated. Some of the foods which aren’t celiac-friendly and should be avoided include:
Hidden gluten may also be found in foods, non-food products, and medications such as:
- Mineral and vitamin supplements
- Modified food stabilizers, preservatives, and food starch.
- Lipstick products
- Over-the-counter drugs and prescription medications
- Nutritional and herbal supplements
- Stamp or envelope glue
- Mouthwash and toothpaste among others.
Fortunately, celiac patients can eat a wide range of natural and nutritious foods that are free of gluten. They include:
- Gluten-free grains like millet, rice, quinoa, and buckwheat
- Herbs and spices
- Healthy Fats
Note: in case you suspect that you have celiac disease, ensure that you first seek medical attention. Your doctor will test you, recommend possible treatment, and the appropriate diet. Avoid using a gluten-free diet until you have been tested for this disease because doing so will lead to skewed results and improper diagnosis.
Once you cut off gluten from your diet, the symptoms of celiac will automatically start to lessen. After a couple of weeks, you will generally start to feel better but full healing may take a couple of months. Children usually heal more quickly than adults.
Celiac-friendly Mineral and Vitamin Supplement
In case celiac disease causes severe nutrition deficiencies, then the doctor may recommend that you take vitamin and mineral supplements which have high levels of:
- Vitamin B12
- Vitamin K
- Vitamin D
- Calcium and
These supplements have to be taken as pills and if your digestive process isn’t effective, then they may be given as injections.
Medications Used to Control Celiac Inflammation
Sometimes celiac disease may cause significant intestinal damage. This may prompt the doctor to recommend certain steroids which can be used to control inflammations. Using steroids helps to ease the signs and symptoms of this disease as the small intestine heals.
Dermatitis Herpetiformis Treatment
In case your celiac has caused a severe skin rash that’s accompanied by itchy blisters, then the doctor may prescribe a skin medication such as dapsone which should be used alongside a gluten-free diet that’s full of vegetables and fruits.
Refractory Celiac Disease Treatment
A refractory type of celiac may continue to display severe symptoms even after eliminating gluten from your diet. Additionally, the symptoms may reduce but then they may relapse. In such a scenario, the small intestine may fail to heal completely. Refractory celiac can be very serious and patients need to be handled by experienced medical experts. Doctors may prescribe a steroid therapy which can be in form of systematic steroids like prednisone or topical budesonide.
Coping and Support
It’s not easy to fully rely on a gluten-free diet hence celiac disease patients need all the necessary care and support. Some of the coping mechanisms that can help a patient handle this autoimmune condition include:
- Getting Educated: educate yourself and those around you about celiac. This way they will be able to recognize and support all your personal efforts when it comes to dealing with this disease.
- Following the Doctors Advice: This involves all their diet recommendations and prescribed medication dosages.
- Finding a Support Group: for a disease that does not have clinical cure, it’s important to join a celiac disease support group. Comfort sharing helps you to understand that you are not alone.
Like most autoimmune diseases which have no cure, celiac is a serious medical condition that needs proper handling. The patient is required to strictly follow a gluten-free diet so as to prevent subsequent immune attacks along the small intestine.
Once you notice some of the above-mentioned symptoms, kindly seek immediate medical attention. This is because if celiac disease is left untreated for long, it may cause adverse health problems such as neurological disease, nutrition deficiencies, constant fatigue, depression, digestive problems, and weight loss among others. Celiac disease doesn’t cause physical side effects only, it may also interfere with your mental health as well.