Celiac disease can be a debilitating condition, but is there a cure? Celiac disease is an immune reaction to eating gluten, a protein found in wheat, barley, and rye. When the body comes in contact with gluten, it responds by attacking the lining of the small intestine. Over time, this reaction damages the intestine and prevents absorption of some essential nutrients.
Celiac disease affects 1% of healthy, average Americans, but it is estimated that two and one-half million Americans are undiagnosed and are at risk for long-term health complications. Celiac disease is hereditary—people with a first-degree relative with celiac disease (parent, child, sibling) are at risk of developing this condition.
Signs of Celiac Disease
Celiac disease affects people differently, so it can be difficult to diagnose. There are more than 200 known celiac disease symptoms which may occur in different parts of the body. Some people develop celiac disease when they are adults, others when they are children.
According to the World Gastroenterology Organization, celiac disease may be divided into three types: classical, non-classical, and silent.
In classical celiac disease, celiac signs are related to malabsorption in the gastrointestinal system—symptoms include diarrhea and steatorrhea (pale, foul-smelling, fatty stools).
In non-classical celiac disease, patients experience other seemingly unrelated symptoms such as iron deficiency anemia, fatigue, migraine, tingling or numbness in hands or feet, depression, anxiety, and itchy skin rash.
Silent celiac is asymptomatic, but patients still experience damage to their small intestine.
Celiac Disease Causes
The precise cause of celiac disease is unknown. Infant feeding practices, gastrointestinal infections, and gut bacteria might contribute to developing celiac disease. Surgeries, pregnancy, viral infections, and severe stress might also be triggers. Risk factors include:
- A first-degree relative with celiac disease
- Down syndrome or Turner syndrome
- Autoimmune thyroid disease
- Rheumatoid arthritis
- Microscopic colitis
- Addison’s disease
- Type 1 diabetes
Treatments for Celiac Disease
The best way to manage celiac disease is diet. The first step is to eliminate all foods that contain gluten such as:
- Graham flour
- Spelt (a form of wheat)
Removing gluten from your diet reduces inflammation in the small intestine. You may start to feel better in just a few days, but the regrowth of the lining in the intestine may take several months to several years.
If you accidentally eat a product that contains gluten, you may experience abdominal pain and diarrhea. It is crucial to read labels while shopping because hidden gluten can be present in foods, medications, and non-food products, including modified food starch, preservatives, vitamin and mineral supplements, herbal and nutritional supplements, lipstick products, toothpaste, and mouthwash.
If you have severe nutritional deficiencies, your doctor may recommend vitamin and mineral supplements such as calcium, folate, iron, vitamin B-12, vitamin D, vitamin K, and zinc. If your small intestine is severely damaged, your doctor may prescribe steroids to control inflammation. A small percentage of patients with celiac disease experience persistent or recurring symptoms even if they follow a gluten-free diet—in this case, the condition takes the name of refractory celiac disease. When this happens, the patient requires evaluation in a specialized center because there may be several causes for this condition.
Keep in mind that certain grains, such as oats, may be contaminated with wheat during growing and processing. Oats are not naturally harmful for most people with celiac disease, but in the United States, doctors generally recommend avoiding them unless they have been specifically labeled gluten-free. Outside of the United States, there are different labeling laws and growing techniques, so you might have a different experience.
Processed foods are not recommended unless they are labeled gluten-free or have no gluten-containing ingredients. Packaged foods that may contain gluten include beer, candies, imitation meats or seafood, salad dressings and sauces, and soups. If you are a pasta lover, there are several gluten-free products available. If you cannot find options at your local grocery store, check online—there are gluten-free substitutes for many foods that contain gluten. You do not have to cut your favorite dishes from your diet—you can simply modify the recipes in ways that can be beneficial to your health.