What Is Celiac Disease? Is Gluten to Blame?

When people with celiac disease eat gluten, their immune system reacts by attacking the lining of the small intestine. This causes inflammation and damage to the small intestine, specifically the area responsible for absorbing nutrients from food.

 “There’s no cure for gluten intolerance but people find relief by adhering to a strict gluten-free diet,” says Jackie Lui, DO, a family medicine physician at Scripps Coastal Medical Center San Marcos.

Experts estimate about two million people have celiac disease in the United States, including many who have not been diagnosed.

The disease can develop at any age, from early childhood well into senior adulthood. It’s unclear why some children become ill early in life while others get sick only after years of exposure. Sometimes surgery, a pregnancy, childbirth, a viral infection or severe mental stress can trigger celiac disease symptoms.

Most people have one or more symptoms. Digestive symptoms are more common in children than adults and can include:

• Bloating
• Gas
• Chronic diarrhea
• Constipation
• Pale, foul-smelling stool
• Lactose intolerance
• Stomach pain
• Nausea and vomiting
• Pain in the abdomen

Failure to absorb nutrients during the critical years of growth and development for a child can lead to health issues, including:

• Delayed puberty in teens
• Delayed growth and short stature
• Irritability
• Weight loss

Some people with celiac disease have symptoms that affect other part of the body, including joint or bone pain, fatigue and dermatitis herpetiformis, a blistering skin rash.

Research suggests celiac disease is a genetic condition, meaning it runs in families. You are at higher risk of developing celiac disease if someone in your family has it.

Doctors can diagnose celiac disease based on symptoms, family history and a physical exam.

During the exam, a doctor may check for signs of weight loss or growth problems, examine the skin for rashes, listen to sound in the abdomen and tap on it to check for pain or swelling. If the patient is a child or teen, the physician may also check for signs of growth problems.

Doctors often use blood tests and biopsies of the small intestine to diagnose or rule out celiac disease. Health conditions that cause symptoms similar to celiac disease include irritable bowel syndrome and lactose intolerance.

“Untreated celiac disease can negatively impact one’s health and potentially lead to various nutritional deficiencies, anemia and/or osteoporosis,” says Dr. Lui. “Hence, if one experiences any symptoms of the disease, they should consult their doctor for further evaluation.”

Celiac disease is treatable simply by avoiding foods with gluten. However, this can be challenging since gluten is found in so many foods and even non-food products.

Gluten is used as a thickening agent and filler in many common products, such as ketchup and ice cream. Many lip balms and lipsticks, hair and skin products, toothpastes, vitamin and nutrient supplements and some medications contain gluten.

In recent years, grocery stores and restaurants have added more gluten-free foods and products, making it easier to stay gluten free.

“It’s now easier to find gluten-free options at eateries and grocery stores, however, it’s still pertinent to read product labels to be certain,” Dr. Lui says. “Let your server or chef at restaurants know if you have special dietary restrictions.”

The U.S. Food and Drug Administration (FDA) requires that gluten-free claims on food labels must be accurate and meet FDA standards. Gluten-free labels mean that the food contains less than 20 parts per million of gluten, the lowest level that can be reliably detected in foods.

Many foods, without additives or some seasonings, are naturally gluten-free, including meat, fish, fruits and vegetables, rice and potatoes.

In recent years, more people without celiac disease have started to avoid gluten, thinking that it is healthier. Researchers have not found evidence that a gluten-free diet offers health benefits to the general population.