Celiac Disease

What is Celiac disease?
Celiac disease is also known as gluten-sensitive enteropathy. Those who suffer from Celiac disease are gluten intolerant, meaning they cannot tolerate gluten proteins found in wheat, rye, barley, and oats. Gluten can also be found is certain medications, vitamins, and even lip balms. When someone with Celiac disease ingests gluten, their immune system is triggered to attack the intestinal villi. These are tiny protrusions that line the small intestine and are responsible for absorbing nutrients from your food through the walls of the small intestine into the bloodstream. You can become quickly malnourished if your villi are damaged or unhealthy.

What are the symptoms of Celiac disease?
Symptoms vary for each individual and may include:
  • Bloating
  • Diarrhea
  • Vomiting
  • Constipation
  • Stool with unusually strong odor
  • Weight loss
Other problems associated with Celiac disease are:
  • Iron-deficiency anemia
  • Arthritis
  • Osteoporosis
  • Numbness in hands and/or feet
  • Seizures
  • Canker sores
  • Skin rash (known as Dermatitis herpetiformis)
  • Liver disease
  • Thyroid disease
  • Addison’s disease
  • Sjogren’s syndrome

Some people may have no physical symptoms but will still develop complications of the disease over time. Symptoms also vary depending on a person's age and the degree of damage to their small intestine. Many adults have the disease for a decade or more before they are diagnosed. The longer a person goes undiagnosed and untreated, the greater the chance of developing long-term complications. Roughly 15-25% of people with Celiac disease may develop an itchy blistering skin rash called Dermatitis herpertiformis.

What causes Celiac disease?
Celiac disease develops because the immune system attacks the intestinal lining. Some people may have a family history or familial predisposition to Celiac disease. The first time presentation is sometimes triggered by certain events such as pregnancy and childbirth, surgery, specific viral infections, or severe emotional stress.

How common is Celiac disease?
Celiac disease is now known to be a relatively common disorder. More than 2 million people in the United States have the disease, which amounts to roughly 1 in 133 people. Celiac disease is more common among people with other genetic disorders including Down syndrome and Turner syndrome.

How is Celiac Disease diagnosed?
Celiac disease can be at times difficult to diagnose since it has symptoms similar to other digestive disorders such as irritable bowel syndrome and inflammatory bowel disease. Dr. Khorrami will first consider your symptoms and your family medical history. Afterwards, he may suggest further testing procedures which include:

Afterwards, Dr. Khorrami may opt for further testing procedures which include:
    Blood Tests
    The Celiac blood test will check for abnormal levels of antibodies in the blood. Those with Celiac disease typically have higher levels of certain antibodies. Some patients may have milder forms of gluten sensitivity where the blood tests are normal but the individual still shows signs of gluten intolerance.

    An intestinal biopsy involves taking a small sample of tissue from your small intestine, which helps to confirm the diagnosis. The biopsy is obtained during a procedure known as an upper endoscopy.

    Dermatitis Herpetiformis
    This is an itchy, blistering skin rash which can afflict those with Celiac disease, that is diagnosed through blood tests and/or a skin biopsy. Roughly 15-25% of people with Celiac disease will develop this skin condition.
How is Celiac disease treated?
Gluten is the trigger for the disease, which is why the main course of action for treating Celiac disease is to maintain a gluten-free diet. For most people, this will be enough to drastically improve symptoms and relieve pain. Abstinence from foods and products that contain gluten results in healing of the small intestine and also helps reverse the symptoms associated with this disorder.

If you are gluten sensitive or you have celiac disease, you should look for product labels that state the food is “Gluten-Free”. As of 2006, The Food Allergen Labeling and Consumer Protection Act require food labels to clearly identify any allergens that are found in the ingredients. Generally, “Plain” meat, fish, rice, fruits, and vegetables do not contain gluten. Those with Celiac disease should have no problems with these foods, but it is always good habit to read the label and list of ingredients to make absolutely sure.

Discuss Your Options with Dr. Khorrami
Dr. Khorrami has been in practice since 1996 as a double-board certified gastroenterologist, has experienced a variety of patient cases, and is well trained to solve your digestive problems. Get in touch to learn more about Celiac disease and how you can successfully diagnose and treat it.

Source contains material from the National Digestive Diseases Information Clearinghouse (NDDIC).


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About Dr. Khorrami

Dr. Payman Khorrami is a UCLA graduate, has been in practice since 1996, and is double board certified. Undergraduate Education at University of California, Berkeley, Medical School at University of California, San Francisco, Internal Medicine Training at University of California, San Diego Read Full Bio