 |  |  |
Celiac Disease
Overview
- What is Celiac Disease?
Celiac disease (CeD) is a long-term digestive disease with inflammation or damage to the small intestine. This damage makes it hard to take in nutrients from food. When a person with CeD eats food with gluten it causes this damage. Gluten is the name given to some of the proteins in wheat, barley, rye, and similar grains. Oats do not have gluten but may be packed in the same places as grains with gluten. Unless oats are marked as gluten-free they may not be safe for patients with CeD.
CeD is an autoimmune disease. When food with gluten reaches the small intestine, the immune system reacts to gluten. This causes an inflammatory reaction in the wall of the intestine. The small intestine lining is covered by millions of villi (see figures 1–3). Villi are finger-like projections that increase the surface area of the intestine. They allow the small intestine to take in more nutrients. The small intestine is 16-23 feet (5-7 meters) long but with the villi the surface area is nearly 2700 square feet (250 square meters). This is about the size of a tennis court. The inflammation in CeD damages the villi and decreases food and water absorption. Not eating gluten lowers the inflammation. Taking gluten out of the diet lets the intestine heal. Not every person who eats gluten will get CeD. The time when a patient develops CeD can vary.
Figure 1. Normal Activity Figure 2. Normal Villi Figure 3. Damaged Villi © 1995 Mayo Clinic © 2010 Mayo Clinic. - How common is Celiac Disease?
In the U.S., about 1 out of every 100 people may have CeD. But only 1 out of 5 people with celiac disease may be diagnosed and know that they have it. Some patients may have no symptoms or only mild symptoms. There may be as many as 3-4 million people in the United States and 60 million in the world with CeD.
- Who does Celiac Disease affect?
CeD can happen at any age or stage in life. It affects people across the globe of all colors and backgrounds. Infants and children can have celiac disease, but many patients are diagnosed as adults. Women are more likely to be diagnosed with celiac disease than men. People with type 1 diabetes, thyroid problems, or relatives with CeD are at greater risk for it.
Symptoms
- What are the main symptoms of Celiac Disease?
There are many symptoms or signs of celiac disease. They are not the same for everyone. Symptoms are highly variable. Some people have mild inflammation with few symptoms. Even though they may feel well, there is still damage to the intestine. Other people have more severe inflammation, which causes symptoms bad enough to lead them to visit their doctor. Sometimes people will not have any symptoms at all but their small intestine is badly inflamed.
The most common symptoms and signs (consequences) are: Other symptoms and signs (consequences) are: - Abdominal pains
- Bloating and gas
- Diarrhea
- Stools that may float
- Weight loss
- Poor growth or weight loss in children
- Anemia (low blood count)
- Feeling weak
- Fatigue
- Low vitamin levels—especially iron, calcium and folate
- Bone and joint pains
- Osteoporosis (bone thinning)
- An itchy skin rash that lasts
- Infertility or reproductive difficulties
- Neurological problems(neuropathy)
- Liver enzyme abnormalities
Someone with celiac disease can have any mix of the above symptoms. They may have just one or many symptoms. Different people with celiac disease may have very different symptoms. Celiac disease can act like irritable bowel syndrome (IBS). Since some celiac symptoms mimic IBS some people are misdiagnosed. It is now recommended that all patients with IBS symptoms (especially abdominal pain and diarrhea) are tested for celiac disease.
