Celiac disease conditions

About celiac disease

• Celiac disease is a permanent condition in which the immune system abnormally reacts to gluten, a protein found in wheat, rye, and barley.
• The small intestine is lined with villi, which are tiny fingerlike projections that help digest and absorb nutrients from food.
• In patients with celiac disease, gluten triggers an immune reaction that causes damage to the small intestinal villi and interferes with the body’s ability to digest and absorb nutrients. Simply put, this means that the body views gluten as an "invader," and launches an attack against it. In the process of attacking the gluten, it destroys part of the body itself.

Development of celiac disease

• Celiac disease often develops after age 1, once a baby has transitioned from breast milk/formula to eating more solid foods that contain gluten. However, symptoms of celiac disease can develop at any time during life.
• 20-30% of the population has the genes that puts them at-risk for celiac disease, but just because you have these genes, it does not mean that you will develop the disease.
• The condition affects ~1 percent of the population, making it relatively common.
• Children who have family members with celiac disease, have genetic conditions such as Down syndrome or Turner syndrome, or have an autoimmune condition like a thyroid disorder or diabetes, are at higher risk of developing celiac disease.

Symptoms of celiac disease

Years ago it was thought that only people with classic gastrointestinal symptoms, such as weight loss and IBS-like symptoms, were candidates for a diagnosis of celiac disease. Today, we know that the symptoms of celiac disease can be mild or severe, and can be diverse, often with no gastrointestinal distress at all. Symptoms can include:

• Abdominal pain
• Constipation
• Diarrhea
• Poor weight gain/weight loss
• Vomiting
• Bloating

Extra-intestinal manifestations:

• Iron-deficiency anemia
• Bone/Joint pain
• Headaches/Migraines
• Fatigue
• Poor height gain
• Pubertal delay

Diagnosis and treatment of celiac disease

• Diagnostic evaluation may include laboratory tests or endoscopic procedures (upper scope).
• If a diagnosis of celiac disease is made, the condition requires a strict, lifelong, gluten-free diet. After diagnosis, your child’s doctor will refer you to a dietitian who is knowledgeable about the gluten-free diet.
  
  

• Gluten sensitivity is NOT the same condition as Celiac disease or wheat allergy.
• In gluten sensitivity, you can have many of the same symptoms as Celiac disease – both gastrointestinal or extra-intestinal – but you do not have the positive blood tests or changes in the small bowel on endoscopy (upper scope).
• Currently, there is no blood test to diagnose gluten sensitivity.
• It seems as though many people identify with being sensitive to gluten and there’s much research being done on this condition.
• If you’re considering going gluten-free, please talk with your healthcare provider about getting lab work completed prior to changing your diet.

• This is a traditional food allergy, similar to an egg, nut, or milk allergy.
• Symptoms can include hives, rash, lip or tongue swelling, or vomiting shortly after consuming wheat-containing products. This can be a medical emergency depending upon the severity of your symptoms. You should seek medical treatment as needed.
• To diagnose a wheat allergy, allergy testing would be completed by your allergist or other healthcare provider. Please visit our Asthma, Allergy, and Immunology team page for more information.