A careful diet does the trick, and gluten-free can mean symptom-free for millions of Americans afflicted with this genetic disease of the small intestine.
It’s not a food allergy or a sensitivity to certain grains. Celiac disease (CD) is a chronic inflammatory or immune disease of the small intestine that interferes with absorption of nutrients from food. People with CD can’t tolerate gluten, a protein found in wheat, rye and barley. When they do consume gluten, their immune systems respond by damaging or destroying the villi—tiny, fingerlike protrusions lining the small intestine— which normally allow nutrients to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food he or she consumes.
Celiac disease was once thought to be a rare childhood syndrome, but is now recognized as a common genetic disorder that can first appear at any age. About 5–10 percent of people who have a first-degree relative diagnosed with CD —a parent, sibling, or child—are likely to have it as well. In the U.S., it’s estimated that close to 3 million people have CD, but the majority haven’t been diagnosed.
The problem is that, even for people who don’t experience symptoms, long-term celiac disease can cause complications, including malnutrition— leading to anemia, osteoporosis, and miscarriage, etc.—liver diseases, and cancers of the intestine.
Testing can tell
Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases. CD can be confused with irritable bowel syndrome, iron-deficiency anemia caused by menstrual blood loss, inflammatory bowel disease, diverticulitis, intestinal infections, and chronic fatigue syndrome. The National Institutes of Health has launched a Celiac Disease Awareness Campaign and, as doctors are alerted to the many varied symptoms of the disease, diagnosis rates are increasing.
Recently developed blood tests are making the process easier. People with celiac disease have higher than normal levels of certain autoantibodies— proteins that react against the body’s own cells or tissues—in their blood. If blood tests and symptoms suggest CD, endoscopy is used to perform a biopsy of the small intestine and confirm the diagnosis by checking for damage to the villi.
Doing it with diet
Currently, the only treatment for celiac disease is a gluten-free diet. For most people, this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvement begins within days of going gluten-free.
To stay well, people with celiac disease must avoid gluten for the rest of their lives, as even a small amount can damage the small intestine.
Luckily, CD sufferers aren’t on their own: these days, supermarket shelves bulge with gluten-free products, restaurants rise to the challenge of providing tasty alternatives, and your physician can help you eat your way to good health.