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Sign and Symptoms of Celiac Disease
- People with celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley.
- Untreated celiac disease damages the small intestine and interferes with nutrient absorption.
- Without treatment, people with celiac disease can develop complications such as osteoporosis, anemia, and cancer.
- A person with celiac disease may or may not have symptoms.
- Diagnosis involves blood tests and, in most cases, a biopsy of the small intestine.
- Since celiac disease is hereditary, family members of a person with celiac disease may have to be tested.
- Celiac disease is treated by eliminating all gluten from the diet.
Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food
When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi—the tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats.
Celiac disease is both a disease of malabsorption and an abnormal immune reaction to gluten. Celiac disease is genetic. Sometimes the disease becomes active for the first time—after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.
Symptoms of celiac disease vary from person to person. Symptoms may occur in the digestive system or in other parts of the body. Digestive symptoms are more common in infants and young children and may include
- Abdominal bloating and pain
- Chronic diarrhea
- Pale, foul-smelling, or fatty stool
- Weight loss
Irritability is another common symptom in children. Malabsorption of nutrients during the years when nutrition is critical to a child's normal growth and development can result in other problems such as failure to thrive in infants, delayed growth and short stature, delayed puberty, and dental enamel defects of the permanent teeth.
Adults are less likely to have digestive symptoms and may instead have one or more of the following:
- Unexplained iron-deficiency anemia
- Bone or joint pain
- Bone loss or osteoporosis
- Depression or anxiety
- Tingling numbness in the hands and feet
- Missed menstrual periods (in females)
- Infertility or recurrent miscarriage (in females)
- Ulcers inside the mouth
- An itchy skin rash called dermatitis herpetiformis
People with celiac disease may have no symptoms but can still develop complications of the disease over time. Long-term complications include malnutrition—which can lead to anemia, osteoporosis, and miscarriage, among other problems—liver diseases, and cancers of the intestine.
Why are celiac disease symptoms so varied?
The length of time a person was breastfed, the age a person started eating gluten-containing foods, and the amount of gluten-containing foods one eats are three factors thought to play a role in when and how celiac disease appears. Some studies have shown that the longer a person was breastfed, the later the symptoms of celiac disease appear.
People with celiac disease tend to have other diseases in which the immune system attacks the body's healthy cells and tissues. They include
- Type 1 diabetes
- Autoimmune thyroid disease
- Autoimmune liver disease
- Rheumatoid arthritis
- Addison's disease, a condition in which the glands that produce critical hormones are damaged
- Sjögren's syndrome, a condition in which the glands that produce tears and saliva are destroyed
- Dermatitis Herpetiformis:
Dermatitis herpetiformis (DH) is an intensely itchy, blistering skin rash that affects 15 to 25 percent of people with celiac disease. The rash usually occurs on the elbows, knees, and buttocks. Most people with DH have no digestive symptoms of celiac disease.
DH is diagnosed through blood tests and a skin biopsy. If the antibody tests are positive and the skin biopsy has the typical findings of DH, patients do not need to have an intestinal biopsy. Both the skin disease and the intestinal disease respond to a gluten-free diet and recur if gluten is added back into the diet.
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