Celiac disease is a genetic autoimmune disorder in which the ingestion of gluten (a protein found in wheat, rye, and barley) triggers an abnormal immune response causing severe damage to the small intestine. The intestinal villi (small fingerlike projections lining the small intestine) are damaged during these immune attacks, making it difficult or impossible for patients with celiac disease to properly absorb appropriate levels of nutrients into the body. Common symptoms include diarrhea, nausea or vomiting, abdominal pain, malabsorption, weight loss, anemia, joint and muscle pain, fatigue, skin rashes, irregular menses, and irritability or mood changes. Celiac disease is estimated to affect approximately 1% of the population worldwide. It is a hereditary condition, meaning it is passed down in families. In patients who have a parent, child, or sibling with celiac disease, the risk for developing the disease is 10 times greater than in the general population. The only current treatment is a strict gluten-free diet, and most patients report an improvement in symptoms within just a few weeks.
Gluten sensitivity is not the same as celiac disease. People with gluten sensitivity experience many of the symptoms associated with celiac disease as a result of gluten consumption, but there is no physical evidence of abnormal immunity or injury to the small intestine. The treatment for gluten sensitivity is also a gluten-free diet, but it may not need to be as strict as for a celiac patient.
Making a Diagnosis
If celiac disease is suspected, Dr. Treyzon will recommend checking a celiac blood panel. This will test a number of different antibodies in the blood, and a positive result can point toward a diagnosis of celiac disease. The diagnosis is confirmed by a biopsy of the small intestine, which is performed by Dr. Treyzon during an upper endoscopy. A positive biopsy result is more definitive than the blood test, and it is necessary to confirm the diagnosis. Both the blood test and the biopsy will only be accurate if the patient’s diet contains a sufficient amount of gluten before testing (a gluten-free diet beforehand can lead to a false negative result). If the above tests are negative for signs of celiac disease, but a gluten-free diet relieves the patient’s symptoms, the patient is diagnosed with non-celiac gluten sensitivity.
Ask Dr. Treyzon for more information about celiac disease and gluten sensitivity at your next office visit.
Author Natalie Bransky Assistant to Dr. Treyzon