General Description

What is Celiac Disease?

 Celiac Disease, also known as Celiac Sprue, is an autoimmune intestinal disorder that affects the way the body reacts to ingested gluten, a protein found in wheat, rye and barley. The body mistakenly attacks intestinal tissue due to the presence of gluten, causing the lining of the intestines to become damaged and permeable, allowing gluten and other toxins to escape the intestinal tract and enter into the blood stream.  This causes an even more pronounced immune response as white blood cells try to remove the foreign elements, leading to even more physical discomfort and fatigue. When there is no gluten in the system, such attacks on healthy tissue do not occur and the body functions normally.

The condition is characterized by a host of symptoms including diarrhea, abdominal pain, bloating, and weight loss.  If left untreated for long periods of time, Celiac Disease will also lead to other more serious symptoms including nutrient deficiency, osteoporosis, arthritis, infertility, and tooth decay. Unlike other gastrointestinal disorders, like Irritable Bowel Syndrome, Celiac Disease is a progressive condition that causes serious damage over time.

According to the National Digestive Diseases Clearinghouse, it is estimated that 1 in 133 people, or approximately 2 million Americans, suffer from Celiac Disease.  However, among individuals who have an immediate family member who also suffers from the condition, the incidence is approximately 1 in 22 people. Like many autoimmune conditions, while the exact cause of Celiac Disease is unknown it is suspected that genetics play a significant role in the development of the condition.  

What is Gluten?

Gluten is a protein found naturally in wheat, rye, and barley, as well as all of the products made from these grains, such as cereals, breads, cookies, pizza, and pasta. There are several common grain products that do not include gluten such as varieties of rice, corn, millet, oats, and soybeans.

For more valuable information on gluten, check out our full length report!

Symptoms

While there are several characteristic symptoms of Celiac Disease that are common among most patients, there are a host of other symptoms associated with the condition that are seemingly unrelated to the digestive process.  Some individuals may experience only non-digestive related symptoms, making the identification and diagnosis of Celiac Disease at times challenging.  Why Celiac Disease manifests in such a diverse way person to person is still largely unknown to researchers. The symptoms of Celiac Disease also tend to vary by age of onset. 

Childhood Onset Symptoms

Children who develop Celiac Disease tend to experience the characteristic digestive problems of Celiac Disease, including:

• Chronic diarrhea
• Unintentional weight loss
• Frequent nausea or vomiting
• Abdominal bloating
• Abdominal tenderness, pain, or discomfort
• Abnormal amounts of flatulence
• Pervasive constipation
• Grayish, pungent stools
• Stools that contain visible traces of fat

Children with Celiac Disease also exhibit stunted growth, delayed puberty, discoloration of teeth, and bones that are susceptible to fractures and breaks due to weakness. These symptoms are the result of malnutrition due to improper digestion.  

Adult Onset Symptoms

Ironically, many adults with Celiac Disease do not exhibit any digestive symptoms at all. They are less focused on digestive issues and more the result of prolonged nutrient depletion.  While some do note chronic diarrhea, weight loss, and increased flatulence as symptoms, there are few reports of patients experiencing notable abdominal distention, bloating, constipation, or cramping.

More common symptoms of Celiac Disease in adults include:

• Chronic fatigue
• Arthritis (especially young onset of arthritis)
• Memory loss
• Difficulty concentrating
• Osteoporosis
• Iron deficiency and iron deficiency anemia
• Chronic headaches
• Unexplained depression
• Muscle pain
• Chronic anxiety
• Irregular or missed menstrual periods
• Chronic miscarriages or infertility
• Canker sores inside the mouth
• Lactose intolerance

Another symptom that develops as the result of prolonged and untreated Celiac Disease is the condition dermatitis herpetiformis, a skin disease that is also aggravated by gluten.  Dermatitis herpetiformis is characterized by a blistering skin rash that is itchy and located on the elbows, buttocks, and knees.  In addition to causing visible sores on the skin, dermatitis herpetiformis also causes rashes on the lining of the intestines which can hinder nutrient absorption even more.

For more valuable information on the symptoms of Celiac Disease check out our full length report!

Causes

As with many autoimmune disorders, the exact cause of Celiac Disease remains elusive to members of the medical community.  However, there is strong evidence to suggest that genetics, as well as several other factors, play a significant role in the development of the condition.

• Genetics - There is a strong indication that genetics play heavily into the cause of Celiac Disease.  The evidence for this assertion is based on the number of individuals with an immediate family member who already has Celiac who also develop the disease.  According to the Celiac Disease Foundation, up to 15% of individuals with an immediate family member with Celiac Disease will develop the condition.  Also, 30% of fraternal twins both develop the condition, and 70% of individuals with an identical twin who has the condition will also develop it.

•  Viral Exposure -One of the potential causes for Celiac Disease is viral exposure.  A variety of studies have indicated that the rotavirus or adenovirus can trigger the development of Celiac Disease in individuals who are predisposed to the condition.  Candidiasis infection, or the overgrowth of yeast in the body, may also be a cause of Celiac Disease. A 1993 study on the effects of candida states that when it overgrows it, “incites disease in hosts whose local or systemic immune system attributes have been impaired, damaged, or innately dysfunctional.”

• The Introduction of Gluten – A factor that may contribute to the development of Celiac Disease is the age at which gluten is introduced into an individual’s diet. A 2005 study published in the Journal of the American Medical Association reported that babies who ingested gluten containing products (wheat, barley, and rye) before three months of age were five times more likely to develop Celiac Disease during life than those who ingested gluten for the first time between four and six months of age.

• Pre-Existing Autoimmune Condition - The development of another autoimmune condition can also contribute to the development of Celiac Disease. People who have conditions like autoimmune thyroid disease, Type 1 diabetes, lupus, or rheumatoid arthritis, or have an immediate family member with one of these conditions are 25% more likely to develop Celiac Disease.

• Emotional Stress - While the physical stresses mentioned above, like viral infection and already compromised immune response, have been shown to trigger Celiac Disease in predisposed individuals, it has been shown that instances of emotional or psychological stress can also provoke the development of Celiac Disease.  What is perhaps the most intriguing about the emotional/psychological cause factor is that it can cause an individual without a genetic predisposition to develop the condition.

For more valuable information on the causes of Celiac Disease check out our full length report!

Traditional Treatments

In their 2002 book entitled Dangerous Grains, James Braly, M.D. and Ron Hoggan, M.D. note that “The treatment for Celiac Disease has changed very little since the 1930s…a strict gluten-free diet remains the only proven means of controlling this disease.”  While the most effective means of treatment for Celiac Disease is to adhere to a strict gluten-free diet, there are other types of treatment available that can help the Celiac digestive system handle gluten if it must be ingested. 

• Gluten-free Diet - Adopting a gluten-free diet is the most effective means of eliminating the symptoms and long term effects of Celiac Disease. Damage done to the intestinal tract from Celiac Disease can be healed within several years of eliminating gluten from the diet. When looking at nutritional labels, Celiac patients should be wary of several phrases which can signify gluten is present in the product regardless of whether or not an identifiable gluten ingredient is listed.  Some key phrases to be on alert for include “modified food starch,” “texturized vegetable protein (TVP),” “natural flavorings,” any unidentified starches, and anything labeled as a filler, extender, or binder.

• Enzyme Therapy - There has been some recent research to suggest enzyme therapy may help individuals with Celiac Disease process gluten before it can damage the intestinal lining. Dr. Chaitan Khosla, founder of the Celiac Sprue Research Foundation, published an article in a 2007 edition of Science magazine reporting that Aspergillus oryzae, a plant-based enzyme, can rapidly break down gluten in the stomach before it can damage the lining of the intestines or enter into the bloodstream. 

• Papaya Leaf - Another treatment for the symptoms of Celiac Disease that has been used by alternative healers for centuries is papaya leaf.  Papaya leaf has long been utilized for the treatment of digestive disorders due to the active enzyme in the plant, Papain.  Papain works in much the same way that Aspergillus oryzae does by breaking down proteins in the stomach before they enter the intestinal tract.  However, like Aspergillus oryzae, papaya leaf only treats the symptoms of Celiac Disease and does not address the underlying condition.

For more valuable information on the treatments for Celiac Disease, as well as an extended gluten-free diet guide, check out our full length report!

Misdiagnosis of Symptoms

One of the most challenging elements of Celiac Disease is that its symptoms are broad and common among a variety of conditions.  Therefore, it is easy to misdiagnose the symptoms of Celiac Disease in patients of all ages. Left untreated or undiagnosed, Celiac Disease has been shown to lead to several intestinal cancers, as well as severe nutrient deficiencies. To help you understand your symptoms more clearly so you can seek the appropriate medical attention, below is a list of the most common conditions Celiac Disease can be mistaken for including what their symptoms are and how they can be distinguished from Celiac Disease. As the symptoms common for children and adults are so different, the list has been broken up into two sections for your convenience.

Misdiagnosis of Common Celiac Disease Symptoms in Children

• Food allergies - Food allergies are immune system reactions to chemical compounds found in certain types of food such as lactic acid (in dairy) and gluten (in wheat products).  Reactions are triggered when even just a small amount of the offending compound is ingested. In children and adolescents, food allergies and Celiac Disease may be hard to differentiate between due to the similarity in symptoms.  Both conditions are immune responses to foreign particles, however the immune cell that is released during an allergic reaction, immunoglobin E, differs significantly from the anti-gluten antibodies produced as a result of Celiac Disease. The best way to distinguish between a food allergy and Celiac Disease is through blood tests which can identify the specific immune cell that is being provoked.   

• Food intolerances - Food intolerances are physical reactions to chemical compounds found in certain types of food, such as lactic acid (in dairy) or glucose (in wheat).  Unlike a food allergy, food intolerances are not caused by immune system responses but instead by a variety of issues, ranging from the absence of necessary digestive enzymes to sensitivity to synthetic preservatives. In children and adolescents, food intolerances exhibit similar gastrointestinal symptoms as Celiac Disease.  A common method used to definitively differentiate between the two is by performing a breath test which can identify whether or not an individual is lacking proper stomach enzymes to digest common proteins. If these tests do not isolate one specific food type as the cause of symptoms, then tests for Celiac-specific antibodies will likely be the next step in diagnosing the symptoms.

• Crohn’s Disease - Crohn’s Disease is a type of inflammatory bowel disease (IBD) that is characterized by an inflammation of the intestines. Symptoms include diarrhea, abdominal pain, cramping bloody stools, undesired weight loss, and ulcers. Children with Celiac Disease may experience abnormal stools, however they are characterized by excessive mucus or fatty deposits, not blood.  To definitively differentiate between the two conditions is to perform tests such as a fecal analysis, blood tests, and small bowel imaging to check for ulcers or scalloping of the intestinal tissue.

• Ulcerative Colitis - Ulcerative Colitis (UC) is a type of inflammatory bowel disease (IBD) which is characterized by continual inflammation of the lining of the large intestine and rectum. The basic symptoms of UC are abdominal pain and diarrhea.  While Ulcerative Colitis shares symptoms with Celiac Disease, it is easily distinguished from it through bloody stools and side-specific pain. If you are experiencing any symptoms of bleeding or pain, contact your health care provider immediately.

Misdiagnosis of Common Celiac Disease Symptoms in Adults

• Hypothyroidism - Hypothyroidism is a dysfunction of the thyroid gland that is characterized by a reduced production of thyroid hormones. Symptoms of hypothyroidism are broad due to the effect the thyroid has on the whole body.  Common symptoms include chronic fatigue, depression, constipation, sensitivity to cold, hair loss, weight gain, frequent headaches, and brittle nails. On the surface, many of the symptoms of hypothyroidism may match up with symptoms for Celiac Disease. Brittle nails, chronic fatigue, and depression are also common in Celiac patients due to nutrient deficiencies.  However, a simple blood test examining the amount of thyroid hormones in the blood can simply distinguish whether an individual may be suffering from hypothyroidism. Click here to read more about the relationship between Celiac Disease and autoimmune thyroid disease.

• Anemia - Anemia is a condition that occurs when an individual does not have enough red blood cells in their body. The symptoms of all types of anemia include chronic fatigue, chest pain, irregular heartbeat, poor circulation to extremities, dizziness, and headache. Some of the symptoms of iron deficiency anemia are common in patients with Celiac Disease. While the two are completely separate conditions, they overlap significantly as anemia is often a symptom of Celiac Disease due to improper iron absorption.  If an individual is diagnosed with iron deficiency anemia, it is important that a medical investigation continues to identify the source of the deficiency which should include testing for Celiac Disease.

• Irritable Bowel Syndrome -Irritable Bowel Syndrome, known better simply as IBS, is an intestinal disorder characterized by a host of gastrointestinal symptoms.  While IBS is an uncomfortable condition, it does not cause serious or long term damage. Symptoms of Irritable Bowel Syndrome include increased flatulence, diarrhea, constipation, abdominal bloating, and cramping. Some of the symptoms of Irritable Bowel Syndrome are similar to some of the symptoms an adult with Celiac Disease might exhibit after consuming gluten.  However, Celiac Disease in an adult will cause a host of other symptoms that are not typically reported by individuals with Irritable Bowel Syndrome, such as nutrient deficiencies, anemia, depression, infertility problems, and skin rash. Click here to read more about Irritable Bowel Syndrome.

• Chronic Fatigue Syndrome - Chronic Fatigue Syndrome is a condition that is characterized by an individual experiencing constant serious fatigue that is not relieved by rest or sleep. This fatigue gets worse after physical exertion or stress.  The condition is not fully understood by the medical community at this time, and both a cause and cure have yet to be identified. Chronic Fatigue Syndrome, while a totally separate condition, is often seen as a symptom of Celiac Disease due to the high number of patients who suffer from both conditions. Typically, a patient will first be diagnosed with Chronic Fatigue Syndrome, and during the further investigation of that condition elevated antibodies to gluten will be identified.  While the two conditions may be related in some cases, they are unique disorders that can be easily distinguished with an antibodies test.  

For more valuable information on the misdiagnosis of Celiac Disease, check out our full length report

Companion Conditions

Because of its crucial role in digestion and nutrient absorption, dysfunctions of the gastrointestinal system like Celiac Disease can affect other systems in the body, causing not only a host of side effects but also an increased risk for developing several other conditions. There are a few common “companion conditions” that often develop in tandem with Celiac Disease as a result of the condition.

If you are being treated for Celiac Disease, be sure to ask your health care provider to frequently test and keep an eye out for the following companion conditions.  In many cases, eliminating gluten consumption and halting the damage the immune system is doing to the intestinal tract will reduce risk and improve the symptoms of the following companion conditions. 

• Autoimmune Thyroid Disease - There is a growing body of research which has linked Celiac Disease with autoimmune thyroid dysfunction. It has been reported that almost 20% of individuals who suffer from Celiac Disease develop an autoimmune thyroid disease.

• Type 1 Diabetes - A correlation between Celiac Disease and Type 1 Diabetes has emerged, with one indicating a higher risk of developing the other. The specific cause of the relationship between Celiac Disease and Type 1 Diabetes is yet to be fully understood.  However, both conditions are autoimmune diseases, and it has been shown that once the immune system mistakenly attacks one gland it is more likely to attack another. The Juvenile Diabetes Research Foundation reports that Celiac Disease occurs in 1 out of every 10 Type 1 Diabetes patients.

• Autism - Over the past five years, medical researchers have concluded there is a definite link between Celiac Disease and Autism.  A 2009 study which reported that children who have mothers with Celiac Disease have more than three times the risk of developing Autism as other children. Further evidence that speaks to the link between Autism and Celiac Disease is the recent discovery that placing children with Autism on a gluten-free diet may drastically improve the symptoms of their condition.

• Chronic Fatigue Syndrome - While there have been reports that allergies, autoimmune conditions, emotional stress, nutrient deficiencies, and physical trauma can trigger Chronic Fatigue Syndrome, there is a portion of the medical community who place the blame on Celiac Disease.  A study done in 1996 reported that out of the 53 Chronic Fatigue Syndrome patients who participated in the test, over 30 had gluten-specific antibodies in their blood. Furthermore, while none of those patients had been previously diagnosed with Celiac Disease, more than 20 showed signs of inflammation and scalloping in their intestinal tract.

• Other Autoimmune Conditions - In addition to autoimmune thyroid disease and Type 1 Diabetes being highly prevalent among individuals with Celiac Disease, a variety of other autoimmune conditions can also be common companion conditions.  Other autoimmune conditions that have been reported in notable numbers among Celiac Disease patients include Addison’s Disease, Lupus, Rheumatoid Arthritis, autoimmune liver disease, and Sjogren’s Syndrome.

 For more valuable information on the companion conditions for Celiac Disease, check out our full length report!

Talk with your Doctor

To make sure you get the treatment and solutions you need to experience digestive function at optimal levels, it is vital that you advocate for your own intestinal health through asking questions of your health care professional and educating yourself.  If you suspect you may be suffering from Celiac Disease, use the guide below to start getting the information and treatment you need from your health care providers.

Remember, if you believe you are suffering from Celiac Disease, do not stop consuming gluten containing products until after your health care provider has had a chance to thoroughly examine you for symptoms.      

• Keep a Symptoms Journal - The Symptoms Journal is essentially a record of your observations regarding the nature, severity, frequency, and duration of intestinal symptoms you experience.  You should also include a daily record of all the food you eat and note any correlations you see between specific foods and gastrointestinal reactions. After you have 2-3 weeks of data recorded in your Symptoms Journal, review what you have observed and, if you feel something is out of the ordinary, call your health care provider and make an appointment to investigate.  Be sure to take your Symptoms Journal with you to the appointment!

• Ask The Right Questions - Help direct the examination with your health care provider and also advocate for yourself by asking specific questions regarding what they are noticing.  Here are a few questions to ask as they are performing a physical exam:

• Are you noticing bloating in my abdomen?
• Do you suspect a food allergy?
• Does my skin have a different consistency than normal to you?
• Have I gained or lost weight since my last visit?
• Do I appear to have any symptoms of nutrient deficiency?
• Do you suspect Celiac Disease as a cause of my symptoms? Why or why not?

• Request Certain Tests - When you are at your appointment with your health care provider, insist they order blood tests for gluten-specific antibodies as well as intestinal endoscopies to check for any indication of inflammation or scalloping of the bowel walls.  Remember, the symptoms of Celiac Disease are similar to many less sinister conditions, like Irritable Bowel Syndrome, and in-depth tests such as these are the ways to truly distinguish between the two. Don’t be afraid to ask for these tests to be performed!

For more valuable information on talking about Celiac Disease, check out our full length report!

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