Patient education: Celiac disease (The Basics)

What is celiac disease? — Celiac disease is an "autoimmune" disease. When a person has celiac disease, their immune system (the body's infection-fighting system) reacts to a protein called "gluten." This reaction causes damage to the intestines (figure 1). Because of this, the body can't absorb nutrients from food.

People who have celiac disease get symptoms if they eat anything that contains gluten. Gluten is found in wheat, rye, barley, and (sometimes) oats. Gluten is in foods like bread, pasta, pizza, and cereal. It is also in many other foods, including some sauces and dressings.

Celiac disease can affect both children and adults.

What are the symptoms of celiac disease? — Celiac disease can cause different symptoms in different people. Some people have no symptoms, and only learn that they have the disease when they get tests for other reasons.

When symptoms do happen, they commonly include:

●Pain in the belly

●Diarrhea

●Bowel movements that are oily and float

●Weight loss

●Feeling bloated, or too full all of the time

●Low appetite

●Bad gas

●Itchy skin rashes

●Weak bones or low iron levels

●Slow growth in children

What if I think that my child might have celiac disease? — Celiac disease can develop in children of any age.

Your child should see a doctor if they:

●Have diarrhea that lasts for weeks

●Have constipation that won't go away

●Have brown or yellow teeth with pits or grooves in them

●Are too small or weigh too little for their age

●Are almost a teen but have not yet gone through puberty (doctors call this "delayed puberty")

●Have other family members with celiac disease

Is there a test for celiac disease? — Doctors usually use 2 tests to diagnose celiac disease. If possible, these tests should be done before you stop eating foods containing gluten:

●Blood test – The first step is a blood test to check for "antibodies." These are proteins that some people's bodies make after eating gluten. People who have celiac disease have lots of these antibodies.

●Biopsy – If a blood test shows a lot of antibodies, the next step is a "biopsy." For this test, the doctor puts a thin tube with a tiny camera down your throat. When the tube is in your small intestine, they take a small sample of tissue. Then, they look at the tissue under a microscope and see if eating gluten has damaged the intestine.

If you are already on a gluten-free diet, your doctor might do other tests to see if you are likely to have celiac disease.

How is celiac disease treated? — The only treatment is to stop eating gluten completely. But don't try to stop eating gluten on your own. Work with a dietitian (food expert) or doctor before changing your diet. They can help you learn how to change your eating habits and still be healthy. You will also need to learn how to read and understand labels on foods.

On a gluten-free diet, you need to avoid rye, wheat, barley, and maybe oats. These ingredients appear in many common foods, including:

●Bread, pasta, pastries, and cereal

●Many sauces, spreads, and condiments

●Beers, ales, lagers, and malt vinegars

Some people with celiac disease also have "lactose intolerance." If your doctor thinks that you have this, they might recommend that you avoid milk, cheese, and other dairy foods for a time. These foods can be hard for your body to break down. You might be able to start eating these foods again after your intestines have had a chance to heal.

Foods that do not contain gluten (and are OK to eat) include:

●Rice, corn, potatoes, buckwheat, and soybeans

●Fruits and vegetables

●Flours, pasta, and other products made from these ingredients that are labeled as "gluten free"

●Wine and "distilled" alcoholic drinks, such as rum, tequila, vodka, and whiskey

Your doctor might also prescribe vitamins to make up for nutrients you have not been getting from food.

What will my life be like? — Most people feel a lot better within 2 weeks of starting a gluten-free diet, but it can take longer for some people. If you have celiac disease, you need to avoid gluten for the rest of your life. Your doctor will most likely suggest getting a blood test at least once a year. This is to see how your body is responding to a gluten-free diet.

The hardest part about the disease is getting used to eating in a whole new way. The good news is that there are plenty of gluten-free foods as well as resources for people with celiac disease. Some people also find that it helps to get support from other people living with celiac disease.

More on this topic

Patient education: Gluten-free diet (The Basics)
Patient education: Low-fiber diet (The Basics)

Patient education: Celiac disease in adults (Beyond the Basics)
Patient education: Celiac disease in children (Beyond the Basics)