What is it?
Celiac disease is an
autoimmune disease characterized by an inappropriate immune response to dietary proteins found in wheat, rye, and barley (gluten and gliadin). This response leads to inflammation of the small intestine and to damage and destruction of the villi that line the intestinal wall. These villi are projections (small folds) that increase the surface area of the intestine and allow nutrients, vitamins, minerals, fluids, and electrolytes to be absorbed into the body. When the villi are destroyed, the body is much less capable of absorbing food and begins to develop symptoms associated with
malnutrition and malabsorption.
The damage and inflammation seen with celiac disease is associated with autoantibodies. When the body is exposed to the gluten and gliadin proteins, it forms antibodies that recognize and act against not only the grain proteins, but also against constituents of the intestinal villi. As long as the patient continues to be exposed to the proteins, he will continue to produce these autoantibodies.
Celiac disease is found throughout the world but is most prevalent in those of European descent. It can affect anyone at any age and is more common in women. It is thought to be an inherited tendency that is triggered by an environmental, emotional, or physical event – although the exact mechanism is not fully understood. According to the National Digestive Diseases Information Clearinghouse, about 5 to 15% of close family members of a celiac disease patient will also have the condition.
The symptoms of celiac disease include:
- Abdominal pain and distension
- Anemia
- Bleeding tendency
- Bloody stool
- Bone and joint pain
- Changes in dental enamel
- Diarrhea
- Fatigue
- Greasy foul-smelling stools
- Oral ulceration
- Weakness
- Weight loss
Some of these symptoms are seen in other conditions, including food allergies.
Children with celiac disease may experience delayed growth, development, and onset of puberty as well. Adults with celiac disease may also experience infertility. Many patients with celiac disease have dermatitis herpetiformis, a disease that causes itchy blisters on the skin. There is also an increased risk for developing osteoporosis and intestinal lymphoma, a form of cancer.
It has been estimated that 1 in 133 people in the U.S. have celiac disease, but only about 3% of this group have been diagnosed. In part, this is because symptoms may vary widely from person to person. According to the Celiac Sprue Association, only about 10% of those with celiac disease will have typical malabsorption symptoms. About 40% will have less typical symptoms and as many as 33% may not have any associated symptoms. The manifestations of celiac disease tend to vary with a person’s age and stage of development. Since the same symptoms are present in a variety of other conditions, a diagnosis of celiac disease may be missed or delayed -- sometimes for years.
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