Patient education: Celiac disease (The Basics)

What is celiac disease? — Celiac disease is a condition that makes it hard for your body to break down certain foods. People who have celiac disease get sick if they eat anything that contains gluten. Gluten is a protein that is found in wheat, rye, barley, and (sometimes) oats. Gluten is found in foods like bread, pasta, pizza, and cereal. It is also in many other foods, including some sauces and dressings.

In people with celiac disease, gluten damages the intestines (figure 1). As a result, their bodies can't absorb nutrients from food. The disease can affect both children and adults.

What are the symptoms of celiac disease? — Celiac disease can cause different symptoms in different people. Some people have no symptoms, and only learn they have the disease when they get tests for other reasons.

When symptoms do happen, they commonly include:

●Pain in the belly

●Diarrhea

●Bowel movements that are oily and float

●Weight loss

●Feeling bloated, or too full all the time

●Low appetite

●Bad gas

●Itchy skin rashes

●Invisible symptoms, such as weak bones or low iron levels

●Slow growth in children

What if I think my child might have celiac disease? — Celiac disease can develop in children of any age.

Your child should see a doctor if they:

●Have diarrhea that lasts for weeks

●Have constipation that won't go away

●Have brown or yellow teeth with pits or grooves in them

●Are too small or light for their age

●Are close to becoming a teenager but does not seem to be going through the changes that teenagers go through (doctors call this "delayed puberty")

●Have other family members with celiac disease

Is there a test for celiac disease? — Doctors use 2 tests to diagnose celiac disease. If possible, these tests should be done before you stop eating foods containing gluten:

●Blood test – This is the first step in testing for celiac disease. A blood test looks for proteins that some people's bodies make after eating gluten. People who have celiac disease have lots of these proteins, called antibodies.

●Biopsy – If a blood test shows a lot of antibodies, the doctor will do a biopsy. For this test, the doctor will put a thin tube with a tiny camera down your throat. When the tube is in your small intestine, they will take a small sample of tissue. Then, they will look at the tissue under a microscope and see if eating gluten has damaged the intestine.

If you are already on a gluten-free diet, your doctor might do other tests to see if you are likely to have celiac disease.

How is celiac disease treated? — The only treatment is to stop eating gluten completely. But don't try to cut out gluten on your own. It's important to work with a dietitian (food expert) or doctor before changing your diet. They can help you learn how to change your eating habits and still be healthy. You will also need to learn how to read and understand labels on foods.

On a gluten-free diet, you will need to avoid rye, wheat, barley, and maybe oats. These ingredients appear in many common foods, including:

●Bread, pasta, pastries, and cereal

●Many sauces, spreads, and condiments

●Beers, ales, lagers, and malt vinegars

You should also avoid milk, cheese, and other dairy foods at first. These foods can be hard for your body to break down. You will want to wait to eat these foods until after your intestines have a chance to heal.

Foods that do not contain gluten (and are fine to eat) include:

●Rice, corn, potatoes, buckwheat, and soybeans

●Fruits and vegetables

●Flours, pasta, and other products made from these ingredients that have a label on them that says "gluten free"

●Wine and distilled alcoholic drinks, such as rum, tequila, vodka, and whiskey

Your doctor might also prescribe vitamins to make up for nutrients that you have not been getting from food.

What will my life be like? — Most people feel a lot better within 2 weeks of starting a gluten-free diet. Still, people often need to make huge changes in their lives to completely avoid gluten.

If you have celiac disease, you will need to avoid gluten for the rest of your life. Your doctor will most likely suggest getting a blood test at least once a year. This is to see how your body is responding to a gluten-free diet.

The hardest part about the disease is getting used to eating in a whole new way. The good news is, there are plenty of gluten-free foods as well as resources for people with celiac disease. Some people also find that it helps to get support from other people living with celiac disease.

More on this topic

Patient education: Gluten-free diet (The Basics)

Patient education: Celiac disease in adults (Beyond the Basics)
Patient education: Celiac disease in children (Beyond the Basics)