On The Table

A collection of knowledge-based articles to inspire overall wellness.

What Is Celiac Disease? Causes, Symptoms & Management

Celiac disease is an autoimmune disorder where the body reacts to gluten. The symptoms are unpleasant and if left undiagnosed or untreated, it can further impair health. Look out for these celiac symptoms to prevent long-term consequences!

What Is Celiac Disease? Causes, Symptoms & Management

According to the National Institute of Diabetes and Digestive and Kidney Diseases, experts estimate about 2 million people in the United States have celiac disease. Experts also estimate one percent of people around the world have celiac disease.

While one percent seems minuscule, consider over 7.7 billion people live on this Earth. That “small” one percent now accounts for over 77,000,000 people! What’s more, experts suggest many more people live with celiac disease but are not diagnosed and accounted for. 

But what exactly is celiac disease? What are celiac disease causes and symptoms? Learn the answers to these common questions here! 

What Is Celiac Disease?

Celiac disease is an inherited, autoimmune disorder characterized by an abnormal response to ingested gluten, a protein found in wheat, rye, barley, and sometimes oats. It is also known as coeliac disease, celiac sprue, non-tropical sprue, and gluten sensitivity enteropathy. 

When people with celiac disease eat gluten, it disturbs the gastrointestinal (GI) tract and the "toxic" fragments stimulate an immune response. The body’s immune system believes and comprehends gluten is a harmful substance, thus attacking its own GI lining. 

More specifically, the villi in the small intestine are damaged. Villi are fingerlike projections that essentially grip and absorb nutrients from foods. Damage to the villi causes unpleasant digestive symptoms and can lead to long-term health risks, especially if the damage is prolonged.

Is Celiac Disease the Same as Gluten Intolerance, Sensitivity & Allergy?

While used interchangeably, celiac disease and gluten intolerances and sensitivities are different from one another. An allergy is often used to describe symptoms of gluten intolerance, though allergies trigger a different, and sometimes severe/fatal, body response.

People with gluten sensitivity show nonspecific symptoms without showing intestinal damage and immune responses characteristic of celiac disease. Gluten intolerance symptoms tend to relate more to digestive symptoms following gluten intake with or without celiac disease.

Sensitivities/intolerances are often also used to describe a gluten “allergy”. However, the term “gluten allergy” is misleading and commonly confused with wheat allergy, or sometimes celiac disease. Knowing the difference between the terminology is vital, as an immune reaction is triggered and immediate action is often required with a food allergy.

Seeking out medical assistance is critical to properly diagnose and treat the condition at hand. For instance, if someone assumes gluten intolerance and starts following a gluten-free diet, they might actually have another underlying condition causing their symptoms. While a gluten-free diet can be safe, it can likewise be harmful without proper guidance. 

Celiac Disease Causes & Risk Factors

The exact cause of celiac disease is not fully understood. What health experts do know, though, is that celiac disease occurs from genetic, food, and other environmental factors. 

Again, celiac disease is an inherited condition, meaning it runs in family history. Interestingly, despite having a genetic predisposition, celiac disease might not surface until triggered by illness or inflammation. Many factors can trigger celiac disease, including but not limited to:

• A viral infection 
• Early childhood infections
• Certain digestive tract infections
• Changes in the microbiome, or the bacteria in the gut
• Following surgery, pregnancy, childbirth, and stress

Additional risk factors for developing celiac disease include:

• Type 1 diabetes
• Autoimmune thyroid disease
• Rheumatoid arthritis

In the United States, celiac disease is more common among white Americans than other racial or ethnic groups. More females are diagnosed with celiac disease than males as well. 

Celiac Disease Symptoms & Signs

According to the Celiac Disease Foundation, there are more than 200 known celiac disease symptoms! This array of symptoms can impact the gastrointestinal system and other parts of the body.

Celiac disease symptoms can also vary based on age. For instance, children are more likely to experience digestive symptoms than adults.

Classic Digestive Symptoms: 

• Diarrhea
• Steatorrhea (fat in the stool, causing loose, greasy, and foul-smelling stools)
• Constipation
• Nausea or vomiting
• Abdominal pain and gas

Other Body System Symptoms:

• Loss of energy
• Vitamin deficiencies
• Unintentional weight loss
• Iron deficiency anemia
• Dermatitis herpetiformis
• Joint or bone pain
• Mental health problems such as depression
• Nervous system symptoms, such as headaches, balance problems, seizures, or peripheral neuropathy NIH external link
• Infertility in males and females
• Issues with women’s menstrual cycles
• Malnutrition
• Lactose intolerance
• Bone loss

Especially beyond the digestive symptoms, health risks mostly depend on the severity of which the villi are damaged. If the villi are severely flattened and damaged, body processes that rely on nutrients from foods become compromised. This is why diagnosing and managing celiac disease as soon as possible is so important. 

Celiac Disease Diagnosis

Diagnosing celiac disease can be tricky and challenging, as the presentation of symptoms varies from one person to the next. With a widespread of symptoms, it is not uncommon for celiac disease to be misdiagnosed as irritable bowel disease, disease of the gallbladder, and other health conditions. 

However, do not be discouraged! If experiencing symptoms common to celiac disease, consult with a healthcare professional as soon as possible. The sooner the diagnosis and management, the better to prevent long-term complications. 

Clinicians use a myriad of evaluations to help diagnose celiac disease accurately. Prospective patients can expect to be asked about their overall pattern of symptoms and family history. Antibody blood tests and other labs also help detect celiac disease, although a biopsy of the small intestine is the gold standard for diagnosing. 

Eliminating gluten from the diet can also help patients and clinicians to understand if symptoms improve. However, one should absolutely not self-diagnose celiac disease and follow a gluten-free diet without the care of a professional.

Why to NOT Self-Diagnose Celiac Disease 

If speculating celiac disease or gluten intolerance, do not self-diagnose and treat without proper medical advice. People who cut out gluten prior to a true diagnosis can result in a false-positive test, as the antibodies released during a gluten inflammatory response will dissipate. 

Of course, lowering inflammation and villi damage is the goal. However, receiving professional guidance is vital to healthily reach that goal and effective treatment. 

How to Treat Celiac Disease

At this point in time, no cure for celiac disease exists and eliminating gluten is the only known treatment. Fortunately, while gluten is an abundance of food sources, someone with celiac disease can navigate a gluten-free diet with ease.

First and foremost, seeking out medical care and assistance is key for properly diagnosing and managing celiac disease. Working with a healthcare team can manage current health conditions and long-term risks, including anemia and osteoporosis. That said, attend regular check-ups and be involved in and advocate for a personalized treatment plan. 

Also include a registered dietitian in the healthcare plan, particularly when it comes to adopting a gluten-free diet. Since gluten is found in many wholesome foods, cutting them out completely raises the risk of nutritional deficiencies. A dietitian can help navigate a gluten-free diet healthily and safely, including tips to avoid cross-contamination.

In addition to a healthcare team, turn to online or local groups, family members, and others for support. Also continue learning about celiac disease with resources from clinicians, celiac disease organizations, and other online channels. 

Celiac Disease Recap

Celiac disease is an inherited, autoimmune disease often triggered by infection, illness, and other environmental factors. While diagnosing celiac disease can be challenging, seeking medical assistance is key for a proper diagnose and care.

Celiac disease has no present cure. However, intestinal damage and related risks can be lowered and prevented by complying with a gluten-free diet.