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Information from Your Family Doctor
Am Fam Physician. 2002 Dec 15;66(12):2269-2270.
What is celiac disease?
Celiac disease causes your intestines to become swollen and to react badly to a protein called gluten (say: gloo-ten). Gluten is found in wheat, barley, and rye.
Other names for celiac disease are celiac sprue and gluten-sensitive enteropathy.
What causes celiac disease?
Some think that a “trigger” sets off celiac disease in certain people. A trigger might be a virus, major surgery, or extreme stress.
If you have celiac disease, there is a chance that some close relatives (brothers, sisters, or parents) could also have it. Let your family members know if you have celiac disease. Their doctors might run tests to see if they also have the disease.
Gluten sensitivity is not the same thing as wheat allergy, although some people have both conditions.
Celiac disease and other medical problems, such as thyroid disease and diabetes, might be linked.
What are the symptoms of celiac disease?
Babies with celiac disease often have bad diarrhea. They may not grow or gain weight at normal rates.
Older children and adults with celiac disease may have diarrhea or greasy stools. Some people have constipation or hard stools. Some have only gas or bloating. Other symptoms of celiac disease are pain in the lower tummy, an upset stomach, tiredness, mouth ulcers, teeth that break easily, and heartburn.
Some patients with celiac disease get an itchy rash. The rash is usually on their back, buttocks, knees, and elbows. This skin rash is called dermatitis herpetiformis (say: derm-ah-tigh-tis hur-pet-ih-form-is). It is not related to herpes, but sometimes it looks like it.
Many people with celiac disease have anemia, especially iron deficiency anemia. They often have “thinning of the bones,” or osteoporosis (say: os-tee-oh-poor-oh-sis). Other serious medical problems, such as epilepsy and cancer (like T-cell lymphoma and bowel adenocarcinoma), are more common in people with celiac disease.
How can I be sure that I have celiac disease?
Special blood tests can tell your doctor that you have celiac disease.
If you have symptoms of celiac disease and a rash, your doctor might do a skin biopsy. For this test, your doctor numbs your skin and then cuts out a small piece. This skin sample is looked at under a microscope to see if you have dermatitis herpetiformis.
Your doctor might recommend that you see a gastroenterologist. This is a doctor with special training in stomach problems. You might have a biopsy. You will have anesthesia for this test. The doctor puts a flexible tube down your throat, through your stomach, and into your small intestine. The doctor looks at your small intestine through the tube and takes small tissue samples. These biopsy samples are looked at under a microscope to see if you have celiac disease.
How is celiac disease treated?
The main treatment for celiac disease is to remove all gluten from your diet. This means that you should not ever eat foods that contain wheat, barley, or rye. Products made with rice, corn, or soy flour are safe to eat if no gluten has been added to them.
Because there are many sources of hidden gluten in prepared foods, you might want to talk with a dietitian. The dietitian can help you design a diet that meets your needs.
Most people feel much better after they have been on a strict gluten-free diet for a few months. If you stick to this diet, you will probably be able to control all the symptoms of your disease. Staying on this diet can undo most, if not all, of the damage caused by celiac disease. You will have to be on a gluten-free diet for the rest of your life.
If you have the rash with celiac disease, you might need to take a medicine to control the itching. If you stay on a gluten-free diet, you might be able to stop taking that medicine.
If you have iron deficiency anemia, you might need to take an iron pill. You might also need to take other supplements, such as calcium and vitamin D.
Staying on a strict gluten-free diet will reduce your risk of getting osteoporosis, some cancers, and other problems that sometimes follow celiac disease.
Where can I get more information about celiac disease and a gluten-free diet?
For more information, you can contact the following groups:
Celiac Sprue Association/United States of America, Inc.
P.O. Box 31700
Omaha, NE 68131-0700
Telephone number: 1-402-558-0600
National Digestive Diseases Information
Clearinghouse Web site:www.niddk.nih.gov/health/digest/pubs/celiac
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2002 by the American Academy of Family Physicians.
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