What is Celiac Disease and How do I Know if I Have it?

What is Celiac Disease?

Celiac disease is more than just a gluten sensitivity. It’s a serious autoimmune disorder that affects approximately 1 in 100 people worldwide. Despite its prevalence, up to 70% of cases remain undiagnosed, leaving millions at risk of long-term health complications. Let’s dive into what celiac disease is and how to determine if you or a loved one has it.

Celiac disease occurs in genetically predisposed individuals when the immune system reacts abnormally to gluten, a protein found in wheat, rye, and barley. This reaction damages the small intestine, specifically the villi, tiny fingerlike projections that absorb nutrients. When the villi become damaged, the body can't absorb essential nutrients properly, leading to a range of health issues.

This condition is hereditary. If you have a first-degree relative (parent, sibling, or child) with celiac disease, your risk jumps to 1 in 10.

Celiac disease can develop at any age after gluten is introduced into the diet, and if left untreated, it can lead to severe complications such as:

• Type 1 diabetes

• Multiple sclerosis (MS)

• Infertility and miscarriage

• Osteoporosis

• Dermatitis herpetiformis (a blistering skin condition)

• Neurological issues like seizures, migraines, and neuropathy

• Intestinal cancers

Symptoms of Celiac Disease

One of the challenges in diagnosing celiac disease is the vast array of symptoms. In fact, there are over 200 possible symptoms, and they vary widely between individuals.

In Children

Digestive symptoms are more common in children. Look out for:

• Chronic diarrhea or constipation

• Abdominal pain and bloating

• Fatigue

• Failure to thrive or delayed growth

• ADHD, learning disabilities

• Iron-deficiency anemia

• Damage to tooth enamel

• Delayed puberty

• Pale, foul-smelling stools

• Nausea and vomiting

• Short stature

• Weight loss

In Adults

Adults may experience both digestive and non-digestive symptoms:

• Abdominal pain, bloating, gas

• Diarrhea or constipation

• Fatigue

• Headaches or migraines

• Iron-deficiency anemia

• Depression and anxiety

• Osteoporosis or osteomalacia

• Joint pain

• Infertility or missed periods

• Mouth ulcers

• Peripheral neuropathy

• Weight loss

• Itchy skin rash (dermatitis herpetiformis)

Diagnosing Celiac Disease

Who Should Be Tested?

• Anyone over age 3 with symptoms

• Anyone with a first-degree relative with celiac disease

• Anyone with an associated autoimmune disorder or conditions such as type 1 diabetes mellitus, autoimmune thyroid disease, autoimmune liver disease, Down syndrome, Turner syndrome, Williams syndrome or selective immunoglobulin A (IgA) deficiency

Testing and Diagnosis

Step 1: Blood Test
A simple blood test looks for elevated levels of specific antibodies produced in response to gluten. It's crucial to be consuming gluten at the time of testing to ensure accurate results.

Step 2: Intestinal Biopsy
If antibody levels are elevated, the next step is an endoscopic biopsy. This outpatient procedure involves taking small samples of tissue from the small intestine to look for damage and inflammation. Doctors typically take 4–6 samples for an accurate diagnosis.

Living with Celiac Disease: The Gluten-Free Life

Currently, the only treatment for celiac disease is a strict, lifelong gluten-free diet. This means avoiding all foods containing wheat, rye, and barley including bread, pasta, beer, and many processed foods.

Even tiny amounts of gluten from shared toasters, cutting boards, or food cross-contact can trigger damage. Adhering to a gluten-free diet helps heal the intestine and prevent further complications.

Final Thoughts

Celiac disease is a serious condition, but with proper diagnosis and dietary changes, people with celiac can lead full, healthy lives. If you or someone you love is experiencing symptoms or has a family history of celiac disease, don’t wait, get tested. Your gut (and your future self) will thank you.