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Celiac Disease

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The Manual's Editorial Staff

Last full review/revision Jul 2020| Content last modified Jul 2020
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"Celiac" refers to things inside your belly, including your gastrointestinal (GI) tract. Your GI tract is the tube that goes from your mouth to your anus. The GI tract includes your esophagus (food pipe), stomach, and small and large intestines. Your intestines are where food is absorbed.

What is celiac disease?

Celiac disease is a disease of the small intestines that keeps you from absorbing all the nutrients in your food. Nutrients include protein, carbohydrates, fats, vitamins, and minerals. Not absorbing nutrients is called malabsorption. Not getting the nutrients you need is called malnutrition.

  • Celiac disease is an autoimmune disease that runs in families

  • It causes problems eating food that contains the protein gluten, which is in wheat, barley, rye, and foods made from those grains

  • Symptoms include oily, bad-smelling diarrhea, feeling tired, and losing weight

  • Children won't grow at a normal rate

  • There's no cure, but people with celiac disease can avoid problems by eating a gluten-free diet

What causes celiac disease?

Celiac disease is an autoimmune disease. The immune system is your body's defense system that helps protect you from illness and infection. In an autoimmune disease, your immune system attacks part of your own body.

  • In celiac disease, your immune system reacts to a protein called gluten, which is in certain grains

  • The immune reaction makes antibodies that damage the lining of your small intestines

  • Damage to the lining of your intestines keeps you from absorbing nutrients from food

  • Unabsorbed fat makes your stool greasy

  • Other nutrients that aren't absorbed cause gas and diarrhea

Gluten is a protein in wheat and anything made from wheat flour. That means there's gluten in bread, pasta, and many baked goods. There's also some gluten in barley and rye. Other grains, such as oats, don't have gluten. There's no gluten in vegetables or fruit.

Celiac disease runs in families. You inherit a tendency to develop it. But only some people in a family get the disease.

What are the symptoms of celiac disease?

Symptoms can start when you're a child, or they may not start until you're an adult.

Common symptoms include:

  • Not feeling hungry

  • Diarrhea, often with oily or greasy-appearing stool

  • Feeling bloated and passing a lot of gas

  • Feeling weak and losing weight

Because children are growing, they're more likely to have problems from malnutrition. Children may not grow normally and be short and underweight. Girls may not get their period when they should.

Not absorbing enough vitamins and minerals can cause:

  • Anemia (low blood count)

  • Mouth sores and a swollen tongue

  • Thin bones that break easily

  • "Pins and needles" feeling (numbness) in your arms and legs

Other symptoms include:

  • Painful, itchy rash with small blisters (dermatitis herpetiformis)

  • Leg swelling from too much fluid in your body

  • Trouble getting pregnant

People with celiac disease sometimes have other immune system problems such as Crohn disease, type 1 diabetes, thyroid disease and other hormone problems, and rheumatoid arthritis.

How can doctors tell if I have celiac disease?

Doctors do tests, including:

  • A blood test to look for antibodies to gluten

  • Biopsy from your small intestine

  • Sometimes genetic tests

With a biopsy, doctors take a small sample of tissue using instruments on the end of an endoscope (a flexible viewing tube) and then look at the sample under a microscope.

How do doctors treat celiac disease?

The main treatment is to

  • Stop eating any food that contains gluten

Even a little bit of gluten can be a problem. Doctors may also give you vitamins and minerals to replace any that you've lost.

It can be hard to stop eating gluten. Gluten is not only in bread products. It's in lots of processed foods, including in some soups, sauces, ice cream, and hot dogs. You can learn about eating a gluten-free diet from a dietitian or celiac support group, such as the Celiac Disease Foundation.

Celiac disease also gives you a higher chance of getting certain cancers. Not eating gluten can lower this chance.

Doctors may give you medicines if you have the dermatitis herpetiformis rash.

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