What is celiac disease?

It is a genetic, autoimmune disorder, which damages small intestine by interfering with the absorption of nutrients. According to the University of Maryland’s Center for Celiac Research, “1 in 133 Americans have celiac disease…making it twice as common as Crohn’s disease, ulceric colitis and cystic fibrosis combined”.

Celiac disease (CD) is triggered when gluten causes an immunologically toxic reaction which damages the mucosal surface of the small intestine. Gluten is the common name for the offending proteins in specific cereal grains that are harmful to persons with CD. These proteins are found in all forms of wheat (including durum, semolina, spelt, kamut, einkorn, and faro), and related grains, rye, barley, tritcale and possibly oats.

The cause of celiac disease, also called celiac sprue, or gluten sensitive enteropathy (GSE), is unknown. However, the University of Maryland’s Center for Celiac Research indicates that the genes HLA DQ2 and/or DQ8 are absolutely necessary to develop the disease. But just because people have this gene does not guarantee celiac disease. “The disease is often inherited,” says MayoClinic.com. “Many times, for reasons that aren’t clear, the disease emerges after some form of trauma: an infection, a physical injury, the stress of pregnancy, severe stress or surgery.”

Many patients are asymptomatic for years, with the disease becoming active for the first time after surgery, viral infection, severe emotional stress, or pregnancy and childbirth. Celiac disease may appear at any time in the life of a person with a hereditary pre-disposition. Symptoms of CD are as varied as the nutritional deficiencies caused by the malabsorption. Infants, toddlers and children may exhibit growth failure, vomiting, bloated abdomen and behavioral changes.

Classic symptoms may include:
Abdominal cramping/pain
Intestinal gas,
Distention and bloating
Chronic diarrhea or constipation (or both)
Steatorrhea — oily stools
Anemia –folate, B12, B6, or iron deficiency (or all)
Weight loss with large appetite
Weight gain

Other Possible Symptoms:
Dental enamel defects
Osteopenia, osteoporosis bone or joint pain fatigue,
Weakness and lack of energy
Infertility
Depression
Dermatitis Herpetiformis (DH), is the associated skin condition characterized by blistering, intensely itchy skin. The rash has a symmetrical distribution and is most frequently found on elbows, knees and buttocks. DH patients can have gastro-intestinal damage without perceptible symptoms.

Some content provided by: Kids with Celiac Disease: A Family Survival Guide to Raising Happy, Healthy,
Gluten-Free Children, Danna Korn,,Woodbine House, 2001

A person seeking preliminary diagnosis must be consuming gluten. Specific antibody blood tests are used to identify the possibility of celiac disease and are the initial step in screening individuals who are at risk (first-degree relatives of biopsy diagnosed celiacs). Certain antibodies are produced by the immune system in response to substances that the body perceived to be threatening, i.e. gluten.

Research shows that people with CD have higher than normal levels of these antibodies in their blood. It is recommended that patients with positive antibody tests have a small-bowel biopsy to confirm the diagnosis and assess the degree of mucosal damage. If you have been gluten-free for some time before the blood test and small-bowel biopsy, the chance is good the test results could come back negative.

Dermatitis Herpetiformis (DH), a complication of celiac disease which manifests in the form of a skin rash, is diagnosed by a biopsy of a skin lesion and staining for IgA in the tissues. More than 85% of DH patients have small-bowel sensitivity to gluten. An experienced CD/DH pathologist is essential to establish these diagnoses. The diagnosed celiac should have medical follow-up to monitor the clinical response to the gluten-free diet.

Some content provided by: Kids with Celiac Disease: A Family Survival Guide to Raising Happy, Healthy,
Gluten-Free Children, Danna Korn,,Woodbine House, 2001