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Celiac Disease

What is celiac disease?

Traditionally, celiac disease was believed to be a children’s disease characterized by malabsorption. Today we know that celiac disease is an autoimmune disease that affects people of all ages, triggered by ingestion of gluten.  Gluten is a dietary protein found in wheat, rye, and barley.

When a genetically susceptible person eats foods that contain gluten, it triggers an immune reaction that damages the lining of the small intestine and prevents the absorption of nutrients from food. It is common affecting nearly 1% of the world population; and the incidence is increasing. It impairs quality of life.

Celiac disease is a serious condition that increases the risk of developing heart disease 2X, and small bowel cancer 4X. Untreated it can lead to Type 1 diabetes, multiple sclerosis, and thyroid disease among other autoimmune conditions. There is no cure for celiac disease, but the symptoms can be managed by following a gluten-free diet.

If you think you may have celiac disease, it is important to see a doctor for a diagnosis. A blood test can confirm celiac disease, and a biopsy of the small intestine can be done to check for damage. Once celiac disease is diagnosed, following a gluten-free diet is the only treatment.

The symptoms of celiac disease vary from person to person. Some people have very mild symptoms, while others have more severe symptoms. The most common symptom of celiac disease is digestive problems, such as diarrhea, bloating, gas, and abdominal pain. Other common symptoms include chronic fatigue, nutritional deficiencies, iron deficiency anemia, osteoporosis, and skin rashes.

In children, symptoms may also include malnutrition, ADHD, poor growth and development, delayed puberty, damage to dental enamel, reduced bone density, oral ulcers, liver, and gallbladder disease, and a chronic itchy, blistering skin disease.

The cause of celiac disease is dysregulation of the normal immune response, an autoimmune disorder that causes the body to attack its own healthy tissues. It is triggered by the ingestion of in gluten in genetically predisposed individuals.

Celiac disease is hereditary. People with a first degree relative (a parent, child, or sibling) with celiac disease have a 1 in 10 chance of developing the disease. Other genetic and environmental factors may also play a role.

Your clinician will review your medical and family history, look for other disorders that are related to immune function, ask about your symptoms and when they began, and conduct a physical exam and a dental exam. They will diagnose celiac disease based on blood tests and biopsies of the small intestines. Blood tests will show levels of antibodies that are higher than normal in people who have untreated celiac disease.

To perform a biopsy, your clinician will perform upper GI endoscopy of the small intestines using an endoscope, a flexible tube with a camera, that helps them see the lining of the small intestines and small instruments are used to take small pieces of the tissue. The tissue samples are sent to a lab for diagnosis. Sometimes genetic testing may be recommended.

There is no cure for celiac disease. The only treatment is to follow a gluten-free diet. This means avoiding all foods that contain wheat, rye, and barley. Following a gluten-free diet can be difficult, but there are many resources available to help you make the transition.

Contact Gastroenterology Associates of Brooklyn to schedule a consultation where you will find a compassionate doctor who can help you live well with celiac diseases.