Celiac Disease Support Group

Celiac disease is an auto-immune disorder of the digestive system that occurs in genetically-predisposed individuals. It is characterised by damage or flattening to all or part of the villi lining the small intestine, which interferes with the absorption of nutrients. This damage is caused by eating anything with gluten (gliadin), a protein found in wheat, rye, and barley (as hordein). A small number of coeliacs (people with coeliac disease) may also react negatively to oats, possibly to the protein in them (avenin). Wheat grain varieties under the names triticale, spelt and kamut also contain gluten.

The diverse range of coeliac disease symptoms may make it difficult to diagnose. There are over two hundred symptoms that have been identified; not all people have the same symptoms; some people have no symptoms at all; and the symptoms may mimic other diseases. Comprehensive lists are available.[1] [2].

Gastrointestinal or digestive problems occur in some coeliacs. It used to be thought that all coeliacs had diarrhea, weight loss, and nutritional deficiencies, but it is now known that only a small percentage have these symptoms. The wide range of digestive symptoms include everything from canker sores to diarrhea to constipation to nausea. Many of the symptoms may mimic other diseases such as irritable bowel syndrome, reflux, or even Crohn's disease and coeliac may be misdiagnosed as any of these. Other symptoms that may occur are bulky, pale, offensive-smelling stools which may float in the toilet bowl, excess flatulence, infrequent, minor rectal bleeding, or persistent pain in the abdomen.

Some symptoms appear to be caused because the villi are unable to absorb nutrients. Some examples are osteoporosis, damage to teeth enamel, anemia, fatigue, rapid or unexplained weight loss, overweight, failure to thrive or stunted growth in children, etc. Yet other symptoms appear to be emotional, such as depression and irritability. Dermatitis herpetiformis is an itchy blistering skin disease that occurs in some coeliacs and is considered to be an external manifestation of coeliac disease.

While some untreated coeliacs may be symptom-free, they are still doing damage to their small intestines. Regardless of the presence or absence of symptoms, the disorder is associated with an increased risk of osteoporosis, miscarriage, certain types of intestinal cancers, and other auto-immune disorders.

The only treatment is a life-long gluten-free diet. At this time no medication will prevent damage, nor prevent the body from attacking the gut when gluten is present. The disease is controlled by strict adherence to a gluten-free diet, which allows the intestines to heal and resolves all symptoms in the vast majority of cases and, depending on how soon the diet is begun, can also eliminate the heightened risk of osteoporosis and intestinal cancer.

In the vast majority of patients, a strict gluten-free diet will relieve the symptoms. A tiny minority of patients suffer from refractory sprue, which means they do not improve on a gluten-free diet. This may be because the disease has been present for so long that the intestines are no longer able to heal. In other patients, the intestinal damage of coeliac disease may have been aggravated by other problems, such as intolerance to the dietary proteins found in eggs, milk, or soy. Just as a person who is allergic to cats may also happen to be allergic to pollen, a patient with coeliac disease may also happen to have other food intolerances that cause similar symptoms. In rare cases only the complete removal of members of the Gramineae family of plants from the diet will bring about recovery from symptoms.