Celiac Disease – Symptoms, Causes, and Treatment

Celiac disease is also known as celiac sprue, gluten-sensitive enteropathy, or nontropical sprue, which are genetic autoimmune illnesses brought on by eating gluten-containing foods. It is caused by gluten, triggering the white blood cells that attack the lining of the small intestine till it reaches the inner membrane. When a person with celiac disease consumes gluten, their body reacts to the protein, causing damage to their villi, which are little finger-like projections found along the wall of the small intestine. When the villi are damaged, the body reduces its ability to absorb the nutrients from food (malabsorption) and other health complications like diarrhoea, fatigue, bloating, abdominal pain, anaemia, irritations, and also depression.

Gluten is a protein in wheat, barley, and rye, giving them a chewy, elastic texture. People with a risk of celiac disease must refrain from foods having gluten and only prefer gluten-free products which are widely available in the market. 

Foods to Avoid in Celiac Disease

Foods that contain gluten, even in traces, must be avoided. Wheat, barley, rye, malt, durum, semolina, spelt, wheat berries, farro, graham, Khorasan, emmer, etc., are few that contain significant amounts of gluten. You must avoid food products made with these ingredients as well.

Some examples are beer (especially wheat-based), baked goods like bread, cakes, cookies, pasta, noodles, cereals, crackers, pancakes, etc. Understanding the importance of reading nutrition labels that give you the list of ingredients used and their proportions is crucial. 

Food products that contain gluten include

• Beverages: Beer, wine coolers, drink mix, premade coffee drinks, dessert wines, etc. 
• Snacks: Potato chips, oats products, graham crackers, brownie mix, dumplings, cornbread, etc. 
• Baked products: Cookies, bread, doughnut, pretzels, pastries, bagels, waffles, french toast, muffins, cupcakes, etc. 
• Other foods: Candies, meat substitutes, energy bars, fries, cake mix, seafood, veg sausages, flour thickeners for soups, ice creams, croutons, flour coatings on fritters, processed cheeses, canned soup, meat and egg substitute, flavoured tofu, flatbreads, various sauces like ketchup, soy sauce, barbecue sauce, cream sauce, spice blends, gravy mixes, etc.

The HealthifyMe Note:

Eliminating gluten products may seem difficult. Fortunately, there are various gluten-free products conveniently available. Millet, eggs, dairy, nuts, beans, legumes, vegetables, fruits, and lean, unprocessed meat are naturally gluten-free and can be a part of your gluten-free diet. In addition, amaranth, arrowroot, buckwheat, chia, corn, flax, quinoa, nut flour, teff, yucca, and sorghum are also gluten-free. You can also include fruits and vegetables like avocado, apples, berries, kale, spinach, carrots, zucchini, sweet potatoes, plums, and mushrooms.

Symptoms of Celiac Diseases

Some general symptoms associated with celiac disease are as follows:

• Vomiting
• Bloating
• Diarrhoea
• Constipation
• Fatigue
• Abnormal weight loss
• Joint pains
• Heartburns
• Hyposplenism (dysfunctional spleen)
• Headaches
• Irritability
• Itchy skin, also blister rashes
• Loss of bone density and softening
• Anaemia
• Tingling feet

Symptoms of Celiac Diseases for Children and Adults 

Celiac disease symptoms and indicators vary dramatically between children and adults. The symptoms of this disease for children are mostly digestive. The most predominant ones, as per Celiac Disease Foundation, are:

Children

Nausea, swollen belly, gastric problems, damaged tooth enamel, lack of energy, irritability, constant headaches, and mood swings

Adults

Abdominal pain, nausea, smelly stool, bloating, heartburn, itchy skin and rashes, hyposplenism, and fatigue

Note: The Celiac Disease Foundation advises getting tested if three or more of the above symptoms appear simultaneously or continuously. 

Causes and Risk Factors 

The exact cause of celiac disease is not known yet; however, it is an autoimmune disease. It triggers white blood cells to attack the linings of the small intestine, which has villi, and small protrusions, which are responsible for the absorption of nutrients from foods. When they are depleted due to the attack, the food you eat is of no substantial use as your body hardly absorbs any nutrition.

The risk factors contributing to celiac diseases are as follows:

• Genes- Several genetic research findings suggested that celiac disease may have a very strong influence on genes. Approximately 31% have the celiac disease due to genetics. In addition, a family member or a close relative with celiac disease, especially dermatitis herpetiformis (DH), may contribute to causing this disease. 

• Other autoimmune diseases- Type-1 diabetes, thyroid diseases, rheumatoid arthritis, autoimmune liver diseases, lactose intolerance, Addison’s disease, and lymphocytic or collagenous colitis may contribute to celiac disease. According to research, people with one autoimmune disease are prone to other autoimmune diseases. Therefore, patients with celiac disease have greater chances of developing other autoimmune disorders. 

• Products containing gluten- Food intolerance to gluten is another major cause of this disease. Therefore, avoiding foods containing gluten can assist in managing the symptoms and curbing its adverse outcomes. It is also important to be alert; for example, going out to a restaurant or attending parties and eating foods that contain gluten will aggravate the condition. Since the body cannot absorb nutrients that will lead to malnutrition, making necessary dietary changes is vital. It is best to meet a dietician for advice. 

Getting Tested for Celiac Diseases

The following tests can diagnose the celiac disease: 

Serology Test

This antibody test takes count of the antibodies in your blood. In a patient’s blood with celiac disease, there is an excess of a particular type of antibodies, which results in an immune reaction towards gluten. Before the test, the patient is asked to consume minimal amounts of gluten to identify the reacting antibodies easily.

Blood Test

A blood test identifies the body’s immunoglobulin (IgA) levels and tissue transglutaminase or tTG-IgA test. Like serology tests, patients should consume limited amounts of gluten for the blood test to be valid. Once these tests find the IgA and tTG-IgA levels in the blood, the doctor determines how strong the suspicion of celiac disease is.

Genetic Test

The specific genes associated with the disease are HLA-DQ8 and HLA-DQ2, human leukocyte antigens. The test determines if you possess one among them or both genes. However, it can only notify you if you’re at risk.

Treatment of Celiac Disease

Relying on gluten-free products is the key. Complete research or knowledge is necessary on the foods available to you, whether they have gluten, even in minor amounts, or not. Sometimes, gluten-containing foods like wheat or barley do not come in their generic names.

Furthermore, the healing period for children is around six months, whereas, for adults, it can take years. However, there is a massive market for gluten-free products, so it is easy to find and adapt to them.

The HealthifyMe Note: 

The only effective way to manage celiac disease symptoms is to follow a gluten-free diet. The signs and symptoms include several abdominal or digestive conditions, skin issues, malnutrition or nutritional deficiencies, inflammation, bloating, osteoporosis, diarrhoea, abdominal pain, headaches, irritability, and fatigue. Eating gluten-free foods allows your intestine to heal and prevents future complications. Knowing restaurants, grocery stores, and the foods you eat is essential.

Summary

Celiac disease is an autoimmune reaction caused by gluten consumption which triggers the white blood cells to act aggressively against the linings of the small intestine that contain small protrusions called villi that are responsible for nutrient absorption from the food you eat.

When the white blood cells attack, the villi being delicate, are damaged, leading to a condition that does not allow you to acquire any essential nutrients from the food you eat, no matter what the amount is. Gluten mainly comes from wheat, barley, and rye and is found in many processed foods. So, it is always better to check the labels of the foods. 

Vegetables and fruits are gluten-free. Non-celiac gluten sensitivity and celiac diseases are entirely different and should not be confused. Celiac disease symptoms and indicators vary significantly between children and adults. 

When experiencing multiple common symptoms like nausea, constipation, foul-smelling stool, lack of energy, irritability, fatigue, etc., it is better to get a diagnosis for celiac disease. The testing includes blood, antibody, and gene testing, which determine the degree of the risks leading to celiac diseases—the prevention and treatment of the disease deals with abstaining from foods containing gluten altogether. 

Frequently Asked Questions (FAQs)

Q. What are the symptoms of celiac disease in adults?

A. Common symptoms of celiac disease in adults are abdominal pain, nausea, smelly stool, heartburn, anaemia, abnormal weight loss, bloating, loss of bone mass, constipation, hyposplenism, rashes, and itchy skin. These symptoms may or may not appear at once, but some will appear simultaneously. Upon suspicion, you should always go for a celiac disease test. 

Q. Is celiac disease serious?

A. Celiac disease is a serious health ailment that can cause serious conditions like lactose intolerance, vitamin deficiencies, osteoporosis, osteopenia, lymphoma, iron deficiency, nervous system disorders, infertility, miscarriage, erosion of tooth enamel, stunted growth and development in children, and cancer.

Q. How do I know if I am a celiac?

A. To know if you have celiac disease, you should get tested. There are tests like the serology test, which takes count of trouble-causing antibodies in your blood; genetic testing, which identifies leukocyte antigens, specifically, HLA-DQ8 and HLA-DQ2 are the genes that transfer celiac disease; blood testing determines immunoglobulin and tissue transglutaminase level in your body. These tests determine if you are at risk of celiac disease. 

Q. Can you suddenly become celiac?

A. It is rare to suddenly become affected by the celiac disease as it is a genetic disorder. However, the symptoms and risks are visible when you consume foods containing gluten while already having celiac disease.

Q. What does celiac pain feel like?

A. Celiac disease affects the small intestine and causes discomfort to your digestive system. As a result, your body is unable to absorb nutrients from meals. If you’re gluten intolerant, you might have celiac disease. When you have celiac disease and consume gluten-containing foods, your immune system attacks your small intestine, causing it to become damaged.

Q. What are the first signs of being gluten intolerant?

A. Some early symptoms of gluten intolerance include nausea, vomiting, stomach discomfort, headaches, diarrhoea, joint pain, exhaustion, rashes, fatigue, low blood count, bloating, digestive issues, irritability, and brain fog. 

Q. What can trigger celiac disease?

A. The consumption of gluten triggers an abnormal immune response due to genetic reasons, which propels white blood cells to attack the linings of the small intestine. As a result, it depletes the villi, which are responsible for nutrient absorption, and the body cannot assimilate all the essential nutrients for healthy functioning. 

Q. What foods trigger celiac disease?

A. The foods that contain gluten trigger celiac disease. Foods containing wheat, barley, and rye are the main perpetrators. Also, packaged foods like potato chips, fries, soups, meat substitutes, energy bars, candies, chocolates, pasta, noodles, beer, cakes, pancakes, etc., contain considerable amounts of gluten. The good news is that most of these foods are available in gluten-free forms and taste the same. A habit of checking the nutrition labels is vital as it is the only way to figure out if the food contains gluten or not.

Q. Does celiac disease shorten life expectancy?

A. Celiac disease takes out your body’s ability to absorb all the nutrients and minerals your food offers. As a result, it promotes the risk of many diseases, which can further contribute to ill health in the long run. Still, no substantial evidence suggests that celiac disease can shorten life expectancy. Moreover, you can easily control the symptoms of celiac disease with proper diet and medication. 

Q. Can celiac go away?

A. You can treat celiac disease by avoiding all the gluten-containing foods in your diet. It revives the villi and makes it fit again to absorb nutrients. Hence, a major disease-causing factor is nulled. However, note that the risk of celiac disease does not go away. The patient still has to maintain no or significantly less gluten in their diets for as long as a lifetime, as there is no cure for it. If done otherwise, the disease can come back stronger.