Ghastly Gluten: Everything You Need to Know About Celiac Disease
Lifestyle Though it doesn’t occur as quickly as toasting bread, for people with celiac disease, gluten found in grains causes damage and discomfort throughout the small intestine.
Celiac disease is an autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. Gluten is a general name for the proteins found in wheat, rye, barley, and triticale.
Epidemiology suggests that celiac disease affects 1 in 100 people worldwide, and as many as 3 million Americans, with 2.5 million still undiagnosed.
Celiac disease can develop at any age, and there is no cure other than to adhere to a strict gluten-free diet.
What’s at stake?
There are approximately 300 known celiac disease symptoms that may occur in the digestive system or other parts of the body, but some people are completely asymptomatic. However, all people with celiac disease, whether or not they display any symptoms, are still at risk for long-term complications, including: Type 1 diabetes, multiple sclerosis (MS), dermatitis herpetiformis (an itchy skin rash), anemia, osteoporosis, infertility and miscarriage, neurological conditions like epilepsy and migraines, short stature, intestinal cancers among others. The prevalence of celiac disease is doubling approximately every 15 years.
"If test results suggest celiac disease, your physician should recommend a biopsy of your small intestine (endoscopy) to confirm diagnosis."
There are two steps to finding out if you have celiac disease: blood screening and diagnosis. Given the low diagnosis rate, it is clear that most healthcare professionals are not connecting the dots between symptoms and the disease. If your physician isn’t, you must ask for a celiac disease blood-screening test.
The most commonly used serologic (blood) test for celiac disease is the tTG-IgA test. If test results suggest celiac disease, your physician should recommend a biopsy of your small intestine (endoscopy) to confirm diagnosis.
It is important to note that you must not be on a gluten-free diet before your blood test or endoscopy; otherwise your test results will be invalid. Celiac Disease Foundation’s Medical Advisory Board recommends eating the equivalent of four slices of wheat bread daily for 1-3 months prior to celiac disease testing to ensure valid test results.
A gluten-free diet heals villous atrophy in the small intestine, causing symptoms to resolve. After diagnosis, you should meet with a Registered Dietitian who can recommend safe, nutritious foods for your body, and follow-up with your physician three to six months after diagnosis.
There is new research indicating that adherence to a gluten-free diet alone may not be enough to successfully treat celiac disease. And while there is still no cure, there are a number of therapies in the pipeline that hope to make living with celiac disease less of a burden.