Celiac disease 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 that, over time, can cause damaging inflammation to the intestinal lining.
Classic signs of celiac disease are diarrhea and weight loss, but many people experience few, if any, digestive symptoms. Other signs of the disease include:
- Fatigue or paleness (resulting from anemia)
- Loss of bone density (osteoporosis)
- Itchy, blistery skin rash (dermatitis herpetiformis)
The cause of celiac disease isn't known. When the body's immune system overreacts to gluten, the reaction damages the small intestine lining. It often goes undiagnosed, but the National Institutes of Health estimates about 1 in 141 people in the U.S. have celiac disease. It can affect anyone, but tends to be more common in people who have type 1 diabetes, microscopic colitis or who have a family member with celiac.
There are various tests and procedures used to diagnose celiac disease, including:
- Blood tests. Elevated levels of certain antibodies in your blood can detect celiac disease even if you have few or no symptoms.
- Endoscopy. Your provider may order an endoscopy to view your small intestine.
Risk Factors for Celiac Disease
Certain factors can increase the risk that someone will develop celiac disease. These risk factors include:
- A family member with celiac disease or the bumpy, itchy rash known as dermatitis herpetiformis
- Type 1 diabetes
- Autoimmune thyroid disease
- Down syndrome or Turner syndrome
- Addison’s disease
- Inflammation of the large intestine, known as microscopic colitis
Complications of Celiac Disease
Left undiagnosed and untreated, celiac disease can cause long-term health complications, such as:
Malnutrition – occurs when the small intestine cannot absorb enough nutrients to feed the body; malnutrition can lead to slow growth and short stature in children, along with anemia and weight loss in adults or children
Weakened bones – poor absorption of calcium and vitamin D can lead to a loss of bone density (osteopenia or osteoporosis) in adults and a softening of the bone (rickets) in children
Infertility and miscarriage – malabsorption of calcium and vitamin D can contribute to these reproductive problems
Lactose intolerance – intestinal damage from celiac disease may cause abdominal pain and diarrhea after consuming dairy products containing lactose; lactose intolerance may disappear after the intestine has healed
Cancer – people with celiac disease who continue to consume gluten have a greater risk of developing certain forms of cancer, although developing cancer due to celiac is quite rare
Nervous system problems – some people with celiac disease can experience neurological complications, such as seizures, headache, and peripheral neuropathy, which causes weakness, numbness and pain in the hands or feet
A gluten-free diet is the only treatment for celiac disease and is essential in successful management. It's important to be tested before trying a gluten-free diet. Eliminating gluten from your diet prior to diagnosis may change the result of blood tests.
Frequently Asked Questions about Celiac Disease and Treatment
What is celiac disease?
Celiac disease is an autoimmune reaction to eating gluten, which is a protein in wheat, barley, and rye.
What is an autoimmune disease?
In autoimmune diseases, the body’s immune system mistakenly attacks normal body tissue as it would a virus, bacteria, or other pathogen. This auto-immune attack in celiac disease can damage the small intestine.
What body systems does celiac affect?
Celiac disease primarily affects the small intestine, which is the organ responsible for 90% of the digestion and absorption of food. Because celiac disease causes poor absorption of the nutrients other organs need to function well, though, the condition can affect bones, teeth, the nervous system, and the pancreas, liver, gall bladder, and spleen.
Do some medicines contain gluten?
While most medications are gluten-free, some drugs do contain traces of the protein.
At what age does celiac disease usually develop?
Celiac disease can develop at any age after someone starts consuming foods or medicines containing gluten.
Is there a cure for celiac disease?
There is no cure for celiac disease, but celiac disease treatment can reduce symptoms and help prevent damage to the intestine.
What happens when someone with celiac disease eats gluten?
When people with celiac disease consume gluten, their immune system attacks small, finger-like projections lining the small intestine. These projections, known as villi, promote the absorption of nutrients. The damage inflicted by the immune system prevents the body from absorbing nutrients from food.
How many people in the United States have celiac disease?
About 1% of average, healthy people in the United States have celiac disease – this means the condition affects at least 3 million Americans, but 97% of them (more than 2.5 million) are undiagnosed and at risk for long-term health complications.
Should I stop eating gluten before my tests for celiac disease?
You should continue your normal diet, including gluten, prior to having a blood test or endoscopy for celiac disease diagnosis. These tests look for signs of the body’s improper immune reaction to the presence of gluten. In fact, your doctor may recommend that you consume glutens in a “gluten challenge” to give antibodies time to build up in your bloodstream.
Does a gluten-free diet always work for the treatment of celiac disease?
Unfortunately, about 20% of those with celiac disease do not respond to a gluten-free diet.
Is a gluten-free diet boring or hard to follow?
Not at all! Manufacturers have introduced thousands of gluten-free cereals and other food products to make meal preparation easier and more interesting. You do not have to buy pre-packaged food, however – you can enjoy fresh fruits, vegetables, and whole meats; most beverages are gluten-free as well.
If I have celiac disease but no symptoms, can I eat gluten?
Unfortunately, no. Even if you do not experience celiac disease symptoms after eating gluten, the protein could be triggering the immune response that damages your small intestine.