What is Celiac Disease?
May is National Celiac Disease Awareness Month, so to bring awareness to the disease we are looking at what it is, how it is diagnosed, and what are the treatment options available. Celiac disease only affects about 1% of all Americans based on proper diagnostic tests. In fact, many people self-diagnose themselves as having celiac disease, so you may hear of more people than this 1% saying they have the disease. Those people who have diabetes, autoimmune disorders, or have family members with celiac disease are at higher risk of developing it.
Celiac disease affects the small intestine and causes the lining of intestine to become damaged and less effective in digesting nutrients. Because this is an autoimmune disease, the body is triggering an immune response to gluten, therefore causing damage to the lining of the intestine. Over time, the damage to the lining of the intestine prevents the absorption of nutrients causing diarrhea, fatigue, weight loss, bloating, and anemia. If left untreated, it can lead to serious complications.
How is celiac disease properly diagnosed?
Diagnosis is based on the presence of predisposing genetic factor human leukocyte antigen (HLA) DQ2/8 through a biopsy of the small intestine, and an antibody test completed when the person is on a gluten containing diet. Many of the symptoms of celiac disease match those of other gastrointestinal diseases like irritable bowel syndrome, Crohn’s disease, ulcerative colitis, or other food allergy. When people are experiencing these symptoms and start a gluten free diet, they usually find relief to their symptoms. This is why there are so many people who believe that they have celiac disease and self-diagnose themselves as such. However, the other gastrointestinal diseases that are mentioned above also recommend limiting gluten, since it is likely one of the causes of disease exacerbation. However, gluten is not the only reason that they are experiencing symptoms, like celiac disease.
It is important to talk with your doctor if you are experiencing any of the symptoms above for a long period of time. They will be able to determine if you need to undergo further testing for the disease, or if you are likely to have another issue.
Celiac disease treatment: the gluten free diet
A gluten free diet has been a hot “diet trend” in the last few years due to the presence of the media and social media around new and exciting gluten free foods. Gluten is a protein found in wheat, barley, rye, or triticale (a cross between wheat and rye). A gluten free diet is a diet plan that avoids anything with these ingredients or derivatives of them. It is important to understand that products can contain gluten if they are wheat free, so looking for “wheat free” on a product label isn’t enough to say it is gluten free. The best way to ensure that something is gluten free is by making sure it says gluten free somewhere on the label or has the seal of certified gluten free. By stating certified gluten free then that product has undergone testing at multiple stages of production to ensure that the product and its ingredients are free from gluten, ensuring that you are going to be safe to consume it if you have celiac disease. In someone with celiac disease, even cross-contamination or the slightest amount of gluten can cause a reaction or symptom flare up, so it is important to read labels and understand what foods contain gluten.
When most people hear gluten free food, they immediately think that it is a healthier option than its gluten counterpart. However, this is not always the case. When manufacturers are making a gluten free alternative, they must remove anything that is gluten, a gluten derivative, or anything that has come into contact with gluten while being processed. When they do this, this usually takes away a huge part of the product, leaving the manufacturer with the decision on what ingredients to add to make the taste and texture similar to the original product. Most of the time this means adding additional fat, sugar, or sodium. This makes the product taste better, but it is also making the product less healthy than the original. In fact, most gluten free foods are not healthier due to the increased amount of fat, calories, sugar, and/or sodium in the product. Because of this, it is not recommended that anyone, other than those people with celiac disease or another gastrointestinal disease, follow a gluten free diet. Again, it is important to talk with a dietitian when starting a new diet, especially one that relies heavily on understanding and knowing what foods contain gluten to avoid an adverse reaction.
- Definition & facts for celiac disease. National Institute of Diabetes, Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease. Accessed May 4, 2021.
- Gujral N, Freeman HJ, Thomson AB. Celiac disease: prevalence, diagnosis, pathogenesis, and treatment. World J Gastroenterol. 2012;18(42):6036-6059. doi:10.3748/wjg.v18.i42.6036
- Elli L, Ferretti F, Orlando S, Vecchi M, Monguzzi E, Roncoroni L, Schuppan D. Management of celiac disease in daily clinical practice. Eur J Intern Med. 2019 Mar;61:15-24. doi: 10.1016/j.ejim.2018.11.012. Epub 2018 Dec 5. PMID: 30528262.