Celiac disease
Celiac diseaseArticle Sections
DefinitionCeliac (SEE-lee-ak) disease is a digestive condition triggered by consumption of the protein gluten, which is primarily found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye. People with celiac disease who eat foods containing gluten experience an immune reaction in their small intestines, causing damage to the inner surface of the small intestine and an inability to absorb certain nutrients. Celiac disease can cause abdominal pain and diarrhea. Eventually, the decreased absorption of nutrients (malabsorption) that occurs with celiac disease can cause vitamin deficiencies that deprive your brain, peripheral nervous system, bones, liver and other organs of vital nourishment. No treatment can cure celiac disease. However, you can effectively manage celiac disease by changing your diet. Celiac diseaseYour small intestine is lined with tiny hair-like projections called villi, which work to absorb vitamins, minerals and other nutrients from the food you eat. Celiac disease results in damage to the ...  SymptomsThere are no typical signs and symptoms of celiac disease. Most people with the disease have general complaints, such as:
Sometimes people with celiac disease may have no gastrointestinal symptoms at all. Celiac disease symptoms can also mimic those of other conditions, such as irritable bowel syndrome, gastric ulcers, Crohn's disease, parasite infections and anemia. Celiac disease may also present itself in less obvious ways, including:
Some indications of malabsorption of nutrients that may result from celiac disease include:
Another gluten-related condition
When to see a doctor Seek medical attention for a child who is pale, irritable and fails to grow, and who has a potbelly and foul-smelling, bulky stools. Other conditions can cause these same signs and symptoms, so discuss it with your child's doctor before trying a gluten-free diet. CausesIt's not clear what causes celiac disease, which is also known as celiac sprue, nontropical sprue and gluten-sensitive enteropathy. Doctors know that something happens in people with celiac disease to cause the body's immune system to overreact in response to gluten in food. Normally, your small intestine is lined with tiny, hair-like projections called villi. Resembling the deep pile of a plush carpet on a microscopic scale, villi work to absorb vitamins, minerals and other nutrients from the food you eat. Celiac disease results in damage to the villi. Without prominent villi, the inner surface of the small intestine becomes less like a plush carpet and more like a tile floor, and your body is unable to absorb nutrients necessary for health and growth. Instead, nutrients such as fat, protein, vitamins and minerals are eliminated with your stool. While the exact cause of celiac disease is unknown, doctors have discovered that it often runs in families. If someone in your family has been diagnosed with celiac disease, you may have an increased risk of the disease. Researchers have discovered that some gene mutations seem to increase the risk of celiac disease, but having those gene mutations doesn't mean you're certain to have celiac disease. This means that other risk factors play a role in whether you'll develop celiac disease. Celiac diseaseYour small intestine is lined with tiny hair-like projections called villi, which work to absorb vitamins, minerals and other nutrients from the food you eat. Celiac disease results in damage to the ... Risk factorsAlthough celiac disease can affect anyone, it tends to be more common in people who have:
ComplicationsLeft untreated, celiac disease can lead to several complications:
Preparing for your appointmentMake an appointment with your family doctor or general practitioner if you have signs or symptoms that worry you. If you're thought to have celiac disease, you may be referred to a doctor who treats diseases of the digestive tract (gastroenterologist). Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready and know what to expect from your doctor. What you can do
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For celiac disease, some basic questions to ask your doctor include:
What to expect from your doctor
Tests and diagnosisTests and procedures used to diagnose celiac disease include:
Some people try a gluten-free diet on their own, to see if that helps relieve their signs and symptoms. But doing so may change the results of blood tests so that they appear to be normal. So see your doctor for testing first, before you try a gluten-free diet. Endoscopy
An endoscopy procedure involves inserting a long, flexible tube (endoscope) down your throat and into your esophagus. A tiny camera on the end of the endoscope lets your doctor examine your ...  Capsule endoscopy cameraDuring a capsule endoscopy procedure, you swallow a tiny camera that's about the size of a large vitamin pill. The capsule contains lights to illuminate your digestive system, a camera to take images ...  Treatments and drugsCeliac disease has no cure, but you can effectively manage the disease through changing your diet.
Changes to your diet to avoid gluten
Your doctor may refer you to a dietitian, who can help you plan a healthy gluten-free diet. Once you've removed gluten from your diet, inflammation in your small intestine will begin to subside, usually within several weeks, though you may start to feel better in just a few days. Complete healing and regrowth of the villi may take several months, or as long as two to three years. Healing in the small intestine tends to occur more quickly in children than it does in adults. If you accidentally eat a product that contains gluten, you may experience abdominal pain and diarrhea. Some people experience no signs or symptoms after eating gluten, but this doesn't mean it's not harmful. Even trace amounts of gluten in your diet can be damaging, whether or not they cause signs or symptoms.
Vitamin supplements to combat malnutrition
Vitamin supplements can be taken in pill form. But in some situations, your digestive tract may have trouble absorbing vitamins. In these cases, your doctor may give the vitamins by injection.
Medications to control intestinal inflammation Lifestyle and home remediesIf you've been diagnosed with celiac disease, you'll need to avoid all foods that contain gluten. Ask your doctor for a referral to a dietitian, who can help you plan a healthy gluten-free diet. Here's an overview of foods that contain gluten and gluten-free foods that are safe to eat.
Always avoid
Avoid unless labeled 'gluten-free'
Certain grains, such as oats, can be contaminated with wheat during growing and processing stages of production. It's not clear whether oats are harmful for most people with celiac disease, but doctors generally recommend avoiding oats unless they are specifically labeled gluten-free. The question of whether people eating a gluten-free diet can consume pure oat products remains a subject of scientific debate.
Allowed foods Grains and starches allowed in a gluten-free diet include:
Other gluten-free foods include:
Fortunately for bread and pasta lovers with celiac disease, there are an increasing number of gluten-free products on the market. If you can't find any at your local bakery or grocery store, check with a celiac support group or the Internet for availability. In fact, there are gluten-free substitutes for many gluten-containing foods. Coping and supportLiving with celiac disease can be difficult. Every day can be a challenge. Over time, however, managing your disease will become second nature. In the meantime, these suggestions may help you manage more easily:
RelatedLast Updated: 2011-09-13 © 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.
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