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What you need to know about celiac disease

It’s estimated 1 in 133 Americans has celiac disease.

What is it?

Celiac disease is an immune response that takes place when a person ingests gluten. The body forms antibodies which attack the intestinal lining. This causes damage which can prevent the body from absorbing the nutrients it needs.

Who is at risk?

It was previously believed that certain groups were pre-disposed to celiac disease, but Dr. Todd Sheer, a gastroenterologist at ADC, says it is found across the globe and can affect women and men of all ages and races.

“I have diagnosed people in their 60’s and 70’s, and I’ve diagnosed people in their late teens, so it can be at any time,” he said. “I never use age as a reason to say this cannot be celiac disease.”

There is a genetic predisposition to celiac disease. It’s estimated that up to 22 percent of patients have an immediate family member who also has celiac disease. This is why doctors will recommend screening first-degree relatives after a formal diagnosis is made.

What are the symptoms?

Symptoms can show up in a person as soon as infancy, but they can manifest any age. They include:

  • Diarrhea
  • Abdominal bloating
  • Weight loss
  • Migraines or headaches
  • Fertility issues or miscarriages
  • Skin rashes
  • Iron deficiency
  • Osteoporosis

How is celiac disease screened?

Dr. Sheer says screening for celiac disease involves a simple blood test that is about 95 percent accurate and relatively inexpensive. However, the person needs to have gluten in their diet  in order to accurately detect the disease.

If the test is positive, Dr. Sheer will order an upper endoscopy and biopsy of the small intestine to confirm the test.

“You are talking about a major dietary change for the rest of someone’s life as well as screening family members, so we would like to confirm that initial positive,” he said.

How is celiac disease treated?

The treatment for celiac disease is removing all gluten from the diet for the rest of one’s life.

“No small amounts, no trace amounts, no occasional gluten treats — 100 percent gluten-free,” Dr. Sheer said.

Gluten is found in wheat, rye, and barley, and it can also be found in products as an additive, such as salad dressings, soy sauces and even lip balms.

“You even have to go so far as you shouldn’t share the same grill or toaster that someone has previously used to cook gluten — like bread,” he said.

Without removing gluten, celiac disease causes malabsorption, which can lead to vitamin and mineral deficiencies. Complications can include vision problems and even osteoporosis.

What about other gluten disorders?

Dr. Sheer says gluten intolerance is potentially a misnomer.

“It’s probably wheat intolerance, or — at best — we can say we’re not sure if it’s gluten intolerance,” Dr. Sheer said. “Everybody equates wheat with gluten, but they are not one in the same. There are other components of wheat which actually may be causing symptoms in people.”

He prefers the terms “wheat intolerance” and “non-celiac wheat sensitivity.”

Dr. Sheer says currently not a lot is known about wheat sensitivity, but it does not appear to accumulate any intestinal damage. There is also not a definite inherited characteristic.

If you think you have an issue with gluten or wheat. Dr. Sheer recommends seeing a doctor and being tested for celiac disease, rather than immediately going on a gluten-free diet.

“For the antibody tests to have any value, they have to be done on a gluten-containing diet,” he said. “People say, ‘It doesn’t matter, I’ll never eat gluten again,’ and that’s fine, but there are other issues, too. There are family screenings. If you have first-degree family members, you are not necessarily doing them a service by not formally making this diagnosis. We would also screen for all of the complications in someone who truly has celiac disease versus someone who was intolerant to wheat.”

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