Celiac disease is an autoimmune disorder that primarily affects the small intestine. When a person with celiac disease eats gluten (a protein found in wheat, barley, and rye), their immune system responds by attacking the lining of the small intestine. This immune reaction damages the villi, which are small finger-like protrusions in the mucosal lining that are responsible for nutrient absorption.
As a result, people with celiac disease can experience a large variety of symptoms, including diarrhea, abdominal pain, bloating, weight loss, fatigue, and nutrient deficiencies. However, symptoms can vary widely among individuals, and some may not experience any digestive symptoms at all. This is why working with a doctor who understands gastrointestinal disorders and having proper lab diagnosis is important.
Celiac disease testing is done with a simple blood test to check for specific IgA antibodies against gluten. It is important though that patients are eating gluten regularly when they are tested though, as we only make these antibodies in the presence of gluten. This is why at our clinic we like to rule out Celiac disease before any patient removes gluten for other reasons. Once someone is feeling very good on a gluten free diet, it is hard to convince them to go back to eating gluten for weeks in order to have accurate celiac testing done.
The long-term complications of undiagnosed celiac disease do vary greatly from the complications of a simple gluten intolerance. Because celiac disease causes malabsorption of nutrients, celiac patients are at much higher risk of anemia, B12 and folate deficiencies, and osteoporosis. Because this is an autoimmune disease, patients with celiac disease are also more likely to develop other autoimmune disorders. This can include diseases like lupus, rheumatoid arthritis, type 1 diabetes, and autoimmune liver disease. Celiac patients are also at a higher risk of neurological disorders, infertility, and intestinal cancer.
The main treatment for celiac disease is a very strict gluten-free diet. For most patients, the intestinal damage typically heals and symptoms improve after 3-6 months of avoiding gluten. However, in contrast to patients with gluten intolerance, it is essential for those with celiac disease to be vigilant about cross-contamination and hidden sources of gluten to effectively manage their condition and prevent long-term complications.
There are many incredible websites that patients with celiac disease can access to help them understand the gluten free diet. Some of the top resources that I recommend are:
Celiac Disease Foundation: www.celiac.org
Beyond Celiac: www.beyondceliac.com
National Celiac Association: www.nationalceliac.org
Gluten Intolerance Group: www.gluten.org
Dr. Katie Nuckolls is a naturopathic physician and owner of Thrive GI: Natural Digestive Medicine. Thrive GI serves patients who reside in Oregon and Washington using a combination of in-office care and telemedicine. For more information, visit our contact page or schedule a free 15-minute consultation online.