The popularity of gluten-free diets has grown rapidly in the last few years as people are incorporating this approach to diet with the belief that it will lead to quick weight loss.
However, for some people – perhaps as many as 3 million Americans – a gluten free-diet is not a new weight-loss strategy but a necessary, lifelong treatment to relieve the often painful symptoms of celiac disease.
What is Celiac Disease?
Celiac disease (also known as gluten-sensitive enteropathy, sprue, or coeliac) is an autoimmune disorder that affects the digestion of any food containing the protein gluten (e.g., wheat, rye, barley) and can lead to damage of the small intestine.
When a person with celiac disease digests even the smallest trace of gluten, their body sends an immune response that attacks the small intestine. These attacks then damage the villi, the small fingerlike projections that line the small intestine and absorb nutrients. Once the villi are damaged, nutrients can no longer be adequately absorbed by the body.
Causes
The exact cause of celiac disease is not known, but there are several identified contributing factors, such as genetic interaction, digestion of large quantities of gluten, environmental factors, the age when gluten is introduced into a child’s diet, gastrointestinal infections, and gut bacteria. Another possibility is that celiac disease can be triggered by stress-induced events such as a surgery, pregnancy, viral infection, and severe emotional stress.
Risk Factors
There are certain factors that can increase your risk of developing this condition, such as type I diabetes, Down syndrome or Turner syndrome, autoimmune thyroid disease, microscopic colitis, Addison’s disease, or rheumatoid arthritis.
Symptoms
Symptoms can vary greatly and are quite different among adults and children.
For adults, many of the most common symptoms are related to digestive and gastrointestinal issues, such as diarrhea, bloating and gas, abdominal pain or cramping, nausea, constipation, vomiting, and possibly acid reflux and heartburn. Fatigue and weight loss are related and also very common.
Additionally, many adults may experience seemingly unrelated symptoms, such as:
- Iron deficiency anemia
- Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
- A blistery skin rash known as dermatitis herpetiformis which is linked with a gluten intolerance
- Dental enamel defects such as grooves, pits or discoloration
- Problems of the nervous system, such as numbness or tingling in the feet and hands and cognitive decline
- Reduced functioning of the spleen
For younger children under 2 years of age, the most common symptoms are:
- Vomiting
- Chronic diarrhea
- Swollen belly
- Poor appetite
- Muscle atrophy (or a decrease in normal muscle mass)
For children 2 years and older, the most common symptoms are:
- Diarrhea
- Constipation
- Weight loss
- Irritability
- Short stature
- Delayed puberty
- ADHD or other learning disabilities
- Headaches
- Lack of muscle coordination
- Seizures
If you experience digestive discomfort or diarrhea that lasts for more than two weeks, you should consult your primary care clinician and have the symptoms evaluated. Consult your child’s pediatrician if he or she is pale, has stopped growing, has severe bloating and a distended belly, or has large, bulky stools.
Since celiac disease tends to run in families, inform your clinician if a first degree relative (mother, father, sister, brother) has been diagnosed with celiac disease so you can discuss whether you should be tested.
How is Celiac Disease Diagnosed?
There are many blood tests available that can screen for celiac disease antibodies. The most commonly used procedure is the tTG-IgA class test. In order for this test to be as accurate as possible, you should not alter your diet and continue to consume gluten as usual in your diet.
If this test shows that you have signs of celiac disease you will need to receive a biopsy of your small intestine (endoscopic biopsy) to confirm the diagnosis. The endoscopic biopsy is performed by a gastroenterologist who takes a small tissue sample from your small intestine and to determine if there is damage that resembles celiac disease.
Treatment
The only known treatment is following a strict gluten-free diet for the rest of your life. This removes the source of inflammation and allows the villi to regrow, healing the small intestine. Some people notice relief and symptom improvement right away, while for others, it can take years to fully heal.
Gluten-Free Diets
For more information on gluten-free diets for celiac disease, please visit these websites:
Gluten Free Living (http://www.glutenfreeliving.com/gluten-free-foods/diet/basic-diet/)
Beyond Celiac (http://www.beyondceliac.org/gluten-free-diet/overview/)