What Is Celiac Disease?

Celiac disease is a digestive condition caused by eating gluten, which is a protein found in bread, pasta, cookies, pizza crust, and many other foods containing wheat, barley, or rye. If you have celiac disease and eat foods containing gluten, an immune reaction occurs in your small intestine, causing damage to the surface of your small intestine and an inability to absorb certain nutrients. Eventually, the decreased absorption of nutrients may lead to vitamin deficiencies that cause damage to the brain, peripheral nervous system, bones, liver, and other organs. If someone in your immediate family has celiac disease, chances are 5–15% that you may have it as well.

The dis-ease often manifests after some form of trauma such as an infection, a physical injury, pregnancy, severe psychologic stress, or surgery. The most common symptoms consist of intermittent diarrhea, abdominal pain, and bloating. Other diseases that may also present with these symp-toms include irritable bowel syndrome, gastric ulcers, Crohn’s disease, and parasitic infections of the intestines. Occasionally, people with celiac disease may have no gastrointestinal symptoms at all, and may present in less obvious ways, including anemia, skin rash, weight loss, general weakness, stunted growth (in children), and osteoporosis.

People with celiac disease carry higher than normal levels of certain antibodies, including anti-gliadin, anti-endomysium, and anti-tissue transgluta-minase. Blood tests are routinely available, which can detect the levels of these antibodies and can be used to initially detect people who are most likely to have celiac disease and who may need further testing. To confirm the diagnosis, your doctor may need to microscopically examine a small portion of intestinal tissue to check for damage to the intestinal lining.

This procedure is called a biopsy. To do this, your doctor inserts a thin, flexible tube (endoscope) through your mouth, esophagus, and stomach into your small intestine and takes a sample of intestinal tissue. A trial of a gluten-free diet can also confirm a diagnosis, but it is important that you not start such a diet before seeking a medical evaluation. Doing so may change the results of blood tests and biopsies so that they appear to be normal.