Over time, this reaction damages your small intestine's lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.
In a survey among 1,900 Swedish celiac disease patients there was a 4.4-fold increased risk for hypothyroidism compared with the general population.
Chronic or systemic diseases, malabsorption and gastrointestinal diseases, intestinal disorders that impair absorption of calories or protein cause growth failure, for many of the same reasons as malnutrition. Growth retardation may predate other manifestations of malabsorption or chronic inflammatory bowel disease. Celiac disease (gluten-induced enteropathy) and regional enteritis (Crohn disease) should be considered in the differential diagnosis of unexplained growth failure.
In celiac disease, an immune-mediated disorder in which the intestinal mucosa is damaged by dietary gluten, impaired linear growth may be the first manifestation of disease.
There's no cure for celiac disease — but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing.
The signs and symptoms of celiac disease can vary greatly and differ in children and adults. Digestive signs and symptoms for adults include:
- Weight loss
- Bloating and gas
- Abdominal pain
- Nausea and vomiting
However, more than half the adults with celiac disease have signs and symptoms unrelated to the digestive system, including:
- Anemia, usually from iron deficiency
- Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
- Itchy, blistery skin rash (dermatitis herpetiformis)
- Mouth ulcers
- Headaches and fatigue
- Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment
- Joint pain
- Reduced functioning of the spleen (hyposplenism)
Your genes combined with eating foods with gluten and other factors can contribute to celiac disease, but the precise cause isn't known. Sometimes celiac disease becomes active after surgery, pregnancy, childbirth, viral infection or severe emotional stress.
When the body's immune system overreacts to gluten in food, the reaction damages the tiny, hair-like projections (villi) that line the small intestine. Villi absorb vitamins, minerals and other nutrients from the food you eat. If your villi are damaged, you can't get enough nutrients, no matter how much you eat.
Untreated, celiac disease can cause:
- Anemia and weight loss. This occurs if your small intestine can't absorb enough nutrients. Malnutrition can lead to anemia and weight loss.
- Bone weakening. Malabsorption of calcium and vitamin D can lead to a softening of the bone (osteomalacia or rickets) in children and a loss of bone density (osteopenia or osteoporosis) in adults.
- Infertility and miscarriage. Malabsorption of calcium and vitamin D can contribute to reproductive issues.
- Lactose intolerance. Damage to your small intestine might cause you abdominal pain and diarrhea after eating or drinking dairy products that contain lactose. Once your intestine has healed, you might be able to tolerate dairy products again.
- Cancer. People with celiac disease who don't maintain a gluten-free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer.
- Nervous system problems. Some people with celiac disease can develop problems such as seizures or a disease of the nerves to the hands and feet (peripheral neuropathy).
- Serology testing looks for antibodies in your blood. Elevated levels of certain antibody proteins indicate an immune reaction to gluten.
- Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can be used to rule out celiac disease.
It's important to be tested for celiac disease before trying a gluten-free diet. Eliminating gluten from your diet might make the results of blood tests appear normal.
If the results of these tests indicate celiac disease, your Health Guardian will likely order one of the following tests:
- Upper endoscopy. This test uses a long tube with a tiny camera that's put into your mouth and passed down your throat (upper endoscopy). The camera enables your doctor to view your small intestine and take a small tissue sample (biopsy) to analyze for damage to the villi.
- Capsule endoscopy. This test uses a tiny wireless camera to take pictures of your entire small intestine. The camera sits inside a vitamin-sized capsule, which you swallow. As the capsule travels through your digestive tract, the camera takes thousands of pictures that are transmitted to a recorder.
If your Health Guardian suspects you have dermatitis herpetiformis, he or she might take a small sample of skin tissue to examine under a microscope (skin biopsy).
A dietitian who works with people with celiac disease can help you plan a healthy gluten-free diet. Even trace amounts of gluten in your diet can be damaging, even if they don't cause signs or symptoms.
Gluten can be hidden in foods, medications and nonfood products, including:
- Modified food starch, preservatives and food stabilizers
- Prescription and over-the-counter medications
- Vitamin and mineral supplements
- Herbal and nutritional supplements
- Lipstick products
- Toothpaste and mouthwash
- Communion wafers
- Envelope and stamp glue
- Play dough
Removing gluten from your diet will gradually reduce inflammation in your small intestine, causing you to feel better and eventually heal. Children tend to heal more quickly than adults.
Vitamin and Mineral Supplements
If your anemia or nutritional deficiencies are severe, your doctor or dietitian might recommend that you take supplements, including:
- Vitamin B-12
- Vitamin D
- Vitamin K
Vitamins and supplements are usually taken in pill form. If your digestive tract has trouble absorbing vitamins, your doctor might give them by injection.
Herbal approaches to Celiac Disease are well suited to help prevent, reduce damage and even obliviate damage and causes by providing a systems approach using long term hormonal treatments.