Celiac disease is an autoimmune disorder that triggers the immune system whenever gluten is ingested. The immune system then attacks the small intestine, destroying the intestinal lining and causing health issues over time. In a healthy gut, the small intestine is lined with villi, microscopic hairs that resemble shag carpeting. These villi help the body to absorb nutrients, vitamins, and minerals from food.
In a person with celiac disease, these villi are destroyed, and the wall of the small intestine is made smooth and has difficulty absorbing nutrition. Long-term health issues that can arise from celiac disease include:
- Multiple sclerosis
- Neurological disorders
- Malnutrition or failure-to-thrive in children
- Gall bladder malfunction
- Anemia due to iron deficiency
The causes, risk factors, and treatments of celiac disease are not exactly definitive, but there are ways that you can minimize your risk or manage your symptoms.
Diagnosing celiac disease is difficult because it is hard to pinpoint one cause. Celiac disease has a strong genetic component. People with a first degree relative (sibling or parent) with celiac disease have a one in ten chance chance of developing this condition (as compared to a one in 141 chance in people without a first degree relative with celiac disease).
Genetics are not a guarantee that someone will develop celiac disease, though. Some believe that celiac disease may be a result of who you live with. Louise Emilsson, MD, PhD, from the Primary Care Research Unit, Vårdcentralen Värmlands Nysäter, Värmland County, Sweden, and the Department of Health Management and Health Economy, Institute of Health and Society, University of Oslo in Norway, and colleagues conducted a longitudinal study of nearly 431,000 people over 39 years in Sweden. These researchers found that spouses of those with celiac disease were also at an elevated risk for developing the disease. Their risk for developing other autoimmune disorders was also elevated.
The risk for spouses developing any autoimmune disorder was highest in the first two years after diagnosis of the primary patient. Researchers believe that this might be due to the type of foods that the household consumes, indicating that the gut microbiome of the two spouses may be similar.
Environmental factors, such as living with someone who has been diagnosed with celiac disease, is not the only non-genetic potential cause. Other researchers have noted the correlation between a triggering event that may be the cause. In women, celiac symptoms may arise after pregnancy and childbirth. In both men and women, another unrelated illness may occur before celiac disease is diagnosed. This connection may be circumstantial, and a genetic link or environmental factor may still contribute to the development of the disease.
Risk factors are difficult to pinpoint simply because the cause of celiac disease is imprecise. People living in the U.S. and other western, industrialized countries are at higher risk because they tend to consume more gluten. Caucasians are diagnosed with celiac disease at higher rates than any other race. Those with first-degree relatives who have celiac disease are at a higher risk, as are those who have another autoimmune disorder.
There are over 300 potential symptoms of celiac disease, many of which may not seem related to the gut. The most common symptoms of the disease in children are gastrointestinal in nature and can include:
- Chronic diarrhea
- Nausea and vomiting
- Extreme fatigue
- Attention deficit hyperactivity disorder (ADHD)
- Abdominal pain
- Failure to thrive
In addition to the above symptoms, adults may also experience:
- Bone density loss
- Mood disorders, such as depression and anxiety
- Missed menstrual periods
- Dermatitis herpetiformis (itchy rash)
It is crucial to note that these symptoms are extreme. There are many different causes of nausea and vomiting, missed periods, and migraines, but in those with celiac disease, these symptoms are daily, prolonged, and severe. Regular treatments such as pain relievers for migraines may not eliminate symptoms because the person who is suffering is still ingesting gluten. Symptoms will continue as long as gluten is in the body.
Not knowing the precise cause of celiac disease or what risk factors increase the chances of developing the disease makes it very difficult to diagnose and treat. This can be tremendously frustrating for those who suffer from the disease or who are watching a loved one deal with their symptoms.
If you have a first-degree relative or spouse who has been diagnosed with celiac disease, the best prevention plan for you is to follow their diet and eliminate gluten completely. Because environmental factors and genetics seem to be the most viable potential causes of celiac disease, prevention of symptoms seems to be the best option.
Dr. Peter Osborne of the Gluten-Free Society notes that gluten can remain in the system for three to four months, so if celiac disease is diagnosed, it may be awhile before symptoms begin to subside. He suggests the following to help speed up the process of eliminating gluten from the body:
- Hydrate: Water helps the kidneys process toxins, including gluten, and also helps with digestion.
- Eliminate constipation: Increase fresh fruits and vegetables to clear out the bowels.
- Be aware of “hidden” gluten: Gluten is used as an additive in many food products and even medications. Read labels carefully, and ask if you are unsure.
A gluten-free diet remains the only real treatment for celiac disease. Scientists at the University of Alberta are working on a pill that allows celiac sufferers to eat gluten, but that is at least three years away from being available to the public. A carefully managed diet of fresh, whole, gluten-free foods is the best way to prevent and treat celiac disease.
Because celiac disease can be difficult to diagnose, many people in the U.S. remain undiagnosed. Dr. Alessio Fasano, medical director of the Center for Celiac Research, estimates that nearly three million people in the U.S. have symptoms of celiac disease but have not been diagnosed. Gluten sensitivity may affect up to 6% of the population.
If you or someone you love has symptoms of celiac disease, talk to your doctor today.
Image by Jon Bunting via Flickr