In our society, gluten-free diets are trendy and increasingly more common. Many restaurants now offer gluten-free menus or substitutions. Those with celiac disease welcome the growing increase in options, yet their dietary restrictions come from sheer necessity, not just preference. This is a common misconception of celiac disease. Many understand it to be a severe gluten intolerance when in actuality, it is a chronic autoimmune disease affecting 1 in 100 people. As we recognize Celiac Disease Awareness Month, we want to educate you on the signs, risks, and details of celiac disease so that you better understand what celiac is—and what it isn’t.
If it’s not an allergy, what is it?
Celiac disease is not simply an extreme allergic reaction to gluten — a protein found in wheat, barley, and rye products. It is an autoimmune disease that lasts a lifetime. When someone has celiac disease, the presence of gluten in the body causes the immune system to attack the small intestine. Over time, the constant attack on the small intestine damages the villi, the parts of the small intestine that absorb fats, proteins, and sugars. When damaged, the small intestine cannot properly absorb nutrients from food. Even the tiniest exposure to gluten can cause the immune system to malfunction and trigger the symptoms associated with celiac.
Signs of celiac
When the immune system breaks down and the food is not absorbed properly, uncomfortable symptoms are sure to follow. However, there are over 200 symptoms of celiac disease — affecting every person differently. This is one of the reasons celiac disease is so difficult to diagnose. In children, you can expect to see digestive complications as a result of celiac. This includes abdominal pain or bloating, diarrhea, vomiting, constipation, and weight loss. Irritability and behavioral issues, Attention Deficit Hyperactivity Disorder (ADHD), fatigue, short stature, and delayed puberty are also signs of celiac in children. Celiac can often present itself in adults even if no symptoms are recognized throughout childhood and adolescence. In adults, the symptoms rarely include digestive issues but do affect other parts of the body. Unexplained iron-deficiency, fatigue, arthritis, osteoporosis, peripheral neuropathy, liver disorders, anxiety and depression, canker sores in the mouth, and infertility are all signs linked to celiac disease.
If you have an immediate family member who has celiac disease, you have a 1 in 10 chance of diagnosis. If your chances of celiac are higher than the average person and you or your child are showing symptoms, a blood test may indicate whether or not you have celiac disease. However, the best way to receive clear results is an upper endoscopy — an outpatient procedure performed by your gastroenterologist. A small portion of your intestine will be biopsied to discover whether or not celiac has caused damage. If your results are positive, you will need to maintain a strict gluten-free diet for the remainder of your life. This will keep your symptoms at bay and ensure your intestine stays healthy. You will need to do intensive research on food products and manufacturing procedures to avoid all gluten products. Besides the obvious bread and pasta restrictions, barley is found in many food coloring products and wheat is often in vitamins, supplements, and various medications. There are many people who are diagnosed with non-celiac gluten sensitivity (NCGS) or non-celiac wheat sensitivity (NCWS). In this case, you do not test positive for celiac but your symptoms are associated with a gluten or wheat intolerance. Therefore, restricting your diet will improve your quality of life.