Celiac Disease - Symptoms, Diagnosis, Treatment

Signs and symptoms:

It is important to remember that celiac disease affects different people in different ways. Symptoms may occur in the digestive system or in other parts of the body. For example, one person may be experiencing depression and irritability while another may be experiencing recurring abdominal bloating and pain. Some of the symptoms of celiac disease include:

  • Diarrhea
  • Gas
  • Recurring abdominal bloating and pain
  • Pale, foul smelling, bulky, or fatty stools
  • Loss of appetite
  • Weight loss / weight gain
  • Missed menstrual periods (often because of excessive weight loss)
  • Itchy skin rash called dermatitis herpetiformis
  • In children, failure to grow
  • Muscle cramps
  • Irritability (sometimes the only symptom in children)
  • Fatigue
  • Unexplained anemia (a low count of red blood cells causing fatigue)
  • Bone or joint pain
  • Osteoporosis, osteopenia
  • Depression
  • Anemia
  • Skin rash
  • And for people with diabetes, unexplained low blood sugar (hypoglycemia)

To further complicate things, a person with celiac disease may have no symptoms at all. People without symptoms are still at risk for the complications of celiac disease, including malnutrition. The longer a person goes undiagnosed and untreated, the greater the chance of developing malnutrition and other complications. Anemia, delayed growth and weight loss are all signs that the body is not getting enough nutrients (malnutrition). Malnutrition is an especially serious problem for children because they need adequate nutrition to develop and grow properly.

How is celiac disease diagnosed?

Recognizing celiac disease can be very difficult because its symptoms very closely reflect those of other diseases. In fact, sometimes celiac disease is confused with irritable bowel syndrome, iron-deficiency anemia (due to menstrual blood loss), Crohn’s disease, diverticulitis, intestinal infections, and chronic fatigue syndrome. As a result, celiac disease is commonly under or misdiagnosed.

Researchers have discovered that those with celiac disease have higher than normal levels of certain autoantibodies in their blood. Whereas antibodies are protective proteins produced by the immune system in response to substances that the body perceives to be threatening, autoantibodies are proteins that react against the body’s own molecules or tissues. To diagnose celiac disease, physicians will usually test blood to measure levels of immunoglobulin A (IgA), anti-tissue transglutaminase (tTGA), and/or IgA anti-endomysium antibodies (AEA).

Before being tested, one should continue to eat a regular diet that includes foods with gluten. If the person stops eating foods with gluten before being tested, the results may be negative for celiac disease even if it is actually present. If the tests and symptoms suggest celiac disease, the doctor will perform a small bowel biopsy. During the biopsy, the doctor removes a tiny piece of tissue from the small intestine to check for damage.

What is the treatment?

Unfortunately there is no magic pill to cure celiac disease. The only treatment is to follow a gluten-free diet. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. The small intestine is usually completely healed in 3 to 6 months in children and younger adults and within 2 years for older adults.

In order to stay well, people with celiac disease must avoid gluten for the rest of their lives. Eating any gluten, no matter how small an amount, can damage the small intestine. The damage will occur in anyone with the disease, including people without any noticeable symptoms. Depending on the person’s age at diagnosis, some problems will not improve, such as delayed growth.

Some people with celiac disease show no improvement on the gluten-free diet. The condition is called unresponsive celiac disease. The most common reason for poor response is that small amounts of gluten are still present in the diet. Advice from a dietitian who is skilled in educating patients about the gluten-free diet is essential to achieve best results.

Camp Ho Mita Koda

Diabetes Partnership of Cleveland

3601 S. Green Rd., #100
Beachwood, OH 44122
Phone: 216-591-0800 | Fax: 216-591-0320



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