Understanding Celiac Disease

Celiac disease is an autoimmune disorder that affects roughly 1 out of every 100 people worldwide. Although one inherits a predisposition for the disease, gluten intolerance is the primary trigger.

When someone with celiac disease ingests gluten, their immune system views this protein as a threat and attacks it, causing damage to the villi of the small intestine and making it hard for the body to absorb nutrients properly. Celiac is both an inflammatory condition and a disease of malabsorption. The goal of treatment is to reduce inflammation so that the small intestine can return to its normal function.

Left untreated, celiac disease can lead to other autoimmune disorders, including type 1 diabetes, neurological diseases such as epilepsy and migraines, short stature, anemia, and certain intestinal cancers.

History of Celiac Disease

Scientists are not sure exactly what causes celiac disease. They do know that individuals have a 1 in 22 chance of developing celiac if a first-degree relative — a child, parent, or sibling — has the disease, suggesting that mutations in either the DQ2 or DQ8 gene are present in people with the disease. Some researchers feel that the rota virus plays a role in triggering the onset of celiac.

The discovery of a link between gluten and celiac disease stems from research originally done by Sidney Hass in 1924, who successfully treated eight children with celiac by putting them on a “banana diet,” which restricted certain forms of carbohydrates, including refined grains. Since that time, researchers have identified gluten as the particular trigger for celiac disease and discovered that sufferers are missing the specific autoantigen called “tissue transglutaminesegen” that allows this common protein in rye, wheat, and barley to be harmlessly broken down during the digestive process.

The fact that some people are sensititve to gluten has led to one interesting theory, that human advances in cultivating food have outpaced our body’s ability to adapt biogenetically. This theory distinguishes ancient grains like quinoa, corn, and spelt from the grains human beings cultivated with advances in modern farming.

The idea is that we have not adapted digestive systems that can break down cultivated grains efficiently is the driving force behind several new diets, including the Wheat Belly Pyramid and the Paleo Diet. These diets stress avoiding cultivated and especially genetically modified grains to reduce inflammation and improve colon health in all people, not just those with celiac.

Although the idea that all people are harmed by eating modern harvest grains is controversial, it is a scientific fact that people with celiac disease cannot ingest even minute quantities of gluten without damaging their small intestines.

Celiac Disease Symptoms

Celiac symptoms can present in children as young two years old. Interestingly, the later the disease is diagnosed, the higher the chance is that a person will develop another autoimmune disorder.

According to a 2010 study, people can develop celiac disease at any age — even if they had previously tested negative for it.

Symptoms of celiac disease in children include

  • Abdominal pain and bloating.
  • Chronic diarrhea, constipation, and/or vomiting.
  • Weight loss
  • Fatigue
  • Irritability or behavioral issues, including ADHD
  • Stunted growth/failure to thrive.

If celiac disease is diagnosed in adulthood, the symptoms may be less focused on the digestive system and include

  • Unexplained iron-deficiency anemia.
  • Bone or joint pain/arthritis.
  • Osteoporosis.
  • Depression or anxiety.
  • Tingling in the extremities.
  • Migraines
  • Dermatitis herpetiformis, and itchy skin rash.

Diagnosis of Celiac Disease

After hearing the symptoms, doctors who suspect the disease typically order the tTG-IgA blood test to confirm whether or not that person has celiac. If the test is positive, the doctor will follow up by recommending a biopsy of the small intestine to see the extent of the damage.

Gluten Free Diet and Non-Celiac Gluten Sensitivity

Once a diagnosis is confirmed, a doctor may prescribe steroids to reduce severe inflammation.

The standard treatment of celiac disease, however, is strict adherence to a gluten free diet. Once the disease is active, even seemingly insignificant amounts of this protein — like the casing of pill, for instance — can trigger symptoms.

Gluten free regimes also are a good way to test whether you are suffering from non-celiac gluten sensitivity, a condition that may affect up to 18 million Americans and causes symptoms ranging from a lack of mental alertness to joint pain, numbness in the hands and feet, and headaches. The theory is that one doesn’t need to lack a specific antigen to have an immune reaction; people with gluten sensitivity have the hallmark inflammation of the disease without the same degree of intestinal damage.

It’s not necessary to sacrifice proper nutrition by eating gluten free. In fact, a diet that focuses on whole fruits and vegetables, nuts, beans and seeds, and quality meat and fish can be not only delicious but also very healthy.