What Is Celiac Disease?

Celiac disease is an autoimmune disease in which the body mistakenly attacks itself, damaging the lining in the intestine after ingesting gluten.

People with celiac disease must avoid all gluten, a protein found in wheat, rye, barley, and certain oats. The only treatment for celiac disease is following a gluten-free diet.

This article discusses celiac disease's symptoms, causes, diagnosis, and treatment.

<p>Larisa Stefanuyk / Getty Images</p>

Larisa Stefanuyk / Getty Images

How Does Celiac Disease Develop?

About 2 million people in the United States and 1% of the worldwide population has celiac disease. However, many people have not been diagnosed. People predisposed to celiac disease usually have a family history or specific genes that increase their risk of developing it.

Causes of Celiac Disease

Multiple factors can increase the risk of developing celiac disease. People who have first-degree relatives with celiac disease are at increased risk. People who develop celiac disease also are likely to have one of these two main genes: HLA-DQ2 and HLA-DQ8. However, not everyone with these genes develops celiac disease.

Celiac disease occurs more often in people assigned female at birth. It is also more common in people with other health conditions, such as:

Of the 30% of people who have the HLA-DQ2 and HLA-DQ8 genes, about 3% develop celiac disease.

When Do Symptoms Usually Appear?

Celiac disease can develop at any time, and symptoms are highly individual. Children may experience symptoms as soon as gluten is introduced to their diet, while others may not have symptoms for many years. Some people also get misdiagnosed due to unconventional symptoms, while others can have celiac disease without any symptoms.

What Are the Symptoms of Celiac Disease?

Because celiac disease is a systemic (body-wide) condition that impairs the body's ability to absorb nutrients, symptoms can affect any body system. This wide range of symptoms includes:

  • Gas

  • Diarrhea

  • Bloating

  • Smelly stools

  • Joint pain

  • Skin conditions

  • Reproductive issues

  • Teeth and bone problems

Children with undiagnosed celiac disease may experience weight loss, failure to thrive, short stature, and delayed puberty.

People with untreated celiac disease may have dermatitis herpetiformis, an itchy blistering rash that usually occurs on the buttocks, back, scalp, elbows, and knees.

Related:Symptoms of Celiac Disease

How to Be Diagnosed With Celiac Disease

To get diagnosed with celiac disease, you should discuss your symptoms with a healthcare provider or gastroenterologist. They will likely draw blood to check for antibodies associated with celiac disease, as well as do an endoscopy. During the endoscopy, a healthcare provider may also perform a biopsy by taking a small sample of your intestine to be analyzed in a lab.

If you suspect you have celiac disease, you should not stop eating gluten before your tests. Avoiding gluten can impact your results.

How Is Celiac Disease Treated?

The only treatment for celiac disease is following a gluten-free diet. The best way to adhere to and fully understand gluten-free eating while ensuring you have an adequate intake of essential vitamins and minerals is to work with a registered dietitian specializing in celiac disease.

While medications and vaccines have been investigated, no alternative treatment to a gluten-free diet exists.

Maintaining a Gluten-Free Diet

Eating a gluten-free diet may seem overwhelming initially, but once you understand the fundamentals and know what ingredients to avoid, it should become second nature. Many foods are naturally gluten-free, including:

  • Fruits

  • Vegetables

  • Gluten-free grains

  • Nuts, seeds, legumes

  • Fish

  • Milk, yogurt

  • Eggs

  • Meat

  • Poultry

Variations of your favorite gluten-containing foods, such as pasta, are also available in gluten-free forms. There is a variety of bean-based pasta on the market and gluten-free pasta made from corn or other types of gluten-free grains.

Foods to Avoid

If you have celiac disease, you must avoid all foods containing gluten. Gluten can be found in wheat, rye, and barley. Wheat includes spelt, kamut, farro, durum, and products like bulgur and semolina. Triticale, a wheat and rye hybrid, also contains gluten. Products containing these ingredients include bread, cereals, bread crumbs, crackers, bars, cookies, cakes, pastries, and frozen pizza.

While oats are naturally gluten-free, it's important to check labels for gluten-free certification to ensure they have not been cross-contaminated, meaning they have come into contact with other gluten-containing products during processing.

Other food sources that contain gluten are processed products that use malt, malt extract, and brewer's yeast. Colors, flavors, starches, and thickeners can also contain gluten and are often added to processed foods. You may need to avoid hot dogs, candy, condiments, sausages, ice cream, salad dressing, and soups.

Diet Tips

Gluten-free does not mean grain-free. Gluten-free whole grains provide important vitamins and minerals, including B vitamins, iron, magnesium, zinc, and selenium. Whole grains also provide a rich source of fiber, which helps balance the digestive system. Familiarize yourself with gluten-free grains, such as:

  • Amaranth

  • Buckwheat

  • Millet

  • Quinoa

  • Rice

  • Sorghum

  • Teff

  • Wild rice

You also don't need to spend much money on gluten-free foods by focusing on eating naturally gluten-free foods. Create meals based on vegetables, lean proteins, and healthy fats. Nutrient-dense carbohydrate choices may include regular and sweet potatoes, beans, peas, corn, and squashes.

If you want to find gluten-free options that are portable, quick, and comparable to your favorite snack foods, know that there are plenty of options in that area, too.

Related:The Best Gluten-Free Snacks, According to a Dietitian

Long-Term Complications of Celiac Disease

Untreated celiac disease is associated with long-term complications, including:

It can also reduce quality of life, especially in people experiencing symptoms daily.

Can You Prevent Celiac Disease?

Although researchers continue to search for ways to prevent celiac disease, currently, there is no proven method for prevention. Investigations into environmental risk factors have not uncovered a way to prevent the condition before it occurs.

NexVax2, a desensitizing vaccine that works to restore the body's immune response to gluten, was being tested in clinical trials. Still, it has yet to be approved by the Food and Drug Association (FDA).

Early detection and treatment can reduce the risk of complications, but researchers acknowledge that diagnosing celiac disease can be challenging. Since celiac disease is genetic, it's important for family members to be screened for it, as well.

Talking to Your Healthcare Provider About Celiac Disease

You should always feel comfortable discussing your health concerns with your medical provider, especially if you have symptoms impacting your quality of life. If you are seriously concerned about celiac disease, your provider will assess your risk factors and investigate further if necessary. Do not start eating gluten-free until after you have been tested for celiac disease, as doing so can affect your results.