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CELIAC DISEASE SYMPTOMS

Celiac disease (gluten-sensitive enteropathy), sometimes called sprue or coeliac, is an immune reaction to eating gluten, a protein found in wheat, barley and rye.

If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine’s lining and prevents absorption of some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight reduction, bloating and anemia, and can lead to serious complications.

In children, malabsorption can affect growth and development, in addition to the symptoms seen in adults.

There’s no cure for celiac disease but for most people, following a strict no-gluten diet can help manage symptoms and promote intestinal healing.

Symptoms

The signs and symptoms of celiac disease can vary greatly and are different in children and adults. The most common signs for adults are diarrhea, fatigue and weight reduction. Adults may also experience bloating and gas, abdominal pain, nausea, constipation, and vomiting.

However, more than half of adults with celiac disease have signs and symptoms that are not related to the digestive system, including:

• Anemia, usually resulting from iron deficiency

• Loss of bone density (osteoporosis) or softening of bone (osteomalacia)

• Itchy, blistery skin rash (dermatitis herpetiformis)

• Damage to dental enamel

• Mouth ulcers

• Headaches and fatigue

• Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment

• Joint pain

• Reduced functioning of the spleen (hyposplenism)

• Acid reflux and heartburn

Causes

Celiac disease occurs from an interaction between genes, eating foods with gluten and other environmental factors, but the precise cause isn’t known. Infant feeding practices, gastrointestinal infections and gut bacteria might contribute to developing celiac disease.

Sometimes celiac disease is triggered or becomes active for the first time after an operation, pregnancy, childbirth, viral infection or severe emotional stress.

When the body’s immune system overreacts to gluten in food, the reaction damages the tiny, hair-like projections (villi) that line the small intestine. Villi absorb vitamins, minerals and other nutrients from the food you eat. If your villi are damaged, you can’t get enough nutrients, no matter how much you eat.

Some gene variations appear to increase the risk of developing the disease. But having those gene variants doesn’t mean you’ll get celiac disease, which suggests that additional factors must be involved.

The rate of celiac disease in Western countries is estimated at about 1 percent of the population. Celiac disease is most common in Caucasians; however, it is now being diagnosed among many ethnic groups and is being found globally.

Risk factors

Celiac disease can affect anyone. However, it tends to be more common in people who have:

• A family member with celiac disease or dermatitis herpetiformis

• Type 1 diabetes

• Down syndrome or Turner syndrome

• Autoimmune thyroid disease

• Microscopic colitis (lymphocytic or collagenous colitis)

• Addison’s disease

• Rheumatoid arthritis

Diagnosis

Researchers estimate that only 20 percent of people with celiac disease may receive a diagnosis.

Physician smay order two blood tests to help diagnose celiac disease.

• Serology testing looks for antibodies in your blood. Elevated levels of certain antibody proteins indicate an immune reaction to gluten.

• Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can be used to rule out celiac disease.

If the results of these tests indicate celiac disease, your physician may order an endoscopy to view your small intestine and to take a small tissue sample (biopsy) to analyse for damage to the villi.

It’s important to be tested for celiac disease before trying a no-gluten diet. Eliminating gluten from your diet may change the results of blood tests so that they appear to be normal.

Treatment

A strict, lifelong gluten-free diet is the only way to manage celiac disease. In addition to wheat, foods that contain gluten include:

• Barley

• Bulgur

• Durum

• Farina

• Graham flour

• Malt

• Rye

• Semolina

• Spelt (a form of wheat)

• Triticale

Your physician may refer you to a dietitian, who can help you plan a healthy gluten-free diet.

Once you remove gluten from your diet, inflammation in your small intestine generally begins to lessen usually within several weeks, though you may start to feel better in just a few days. Complete healing and regrowth of the villi may take several months to several years. Healing in the small intestine tends to occur more quickly in children than adults.

If you accidentally eat a product that contains gluten, you may experience abdominal pain and diarrhoea. Some people experience no signs or symptoms after eating gluten, but this doesn’t mean it’s not harmful to them. Even trace amounts of gluten in your diet can be damaging, whether or not they cause signs or symptoms.

Hidden gluten can be present in foods, treatments and nonfood products, including:

• Modified food starch, preservatives and food stabilizers

• Prescription and over-the-counter treatments

• Vitamin and mineral supplements

• Herbal and nutritional supplements

• Lipstick products

• Toothpaste and mouthwash

• Envelope and stamp glue

• Play-Doh