Gluten intolerance, also known as celiac disease or non-tropical sprue, is a chronic, autoimmune, genetic disorder that can develop at any age from infancy to late adulthood. When someone with celiac disease eats even small amounts of gluten, his immune system reacts by destroying the villi, which are tiny, finger-like protrusions in the lining of the small intestine. The symptoms of gluten intolerance can vary from person to person, thus often delaying diagnosis.
Digestive Symptoms in Infants and Children
Gluten is a protein found in wheat, rye and barley, which means it typically is ingested through food products made from these three grains. However, gluten also can be found in medicines, vitamins and lip balms. Gluten intolerance is both an autoimmune disorder and a malabsorption disease. The villi in the small intestine allow nutrients from food to be absorbed, but with celiac disease, the immune system damages or destroys the villi, so regardless of how much food a person eats, she becomes malnourished. Early symptoms include irritability; failure to thrive in infants; pale, foul-smelling stools; chronic diarrhea; constipation; and vomiting. Young children can suffer from the classic digestive symptoms of abdominal bloating, cramping and intestinal gas, and chronic diarrhea or constipation, or both. They often exhibit weight loss, delayed growth and short stature, delayed onset of puberty and dental enamel defects of the permanent teeth.
Symptoms in Adults
The disorder can become active for the first time in adulthood. Surgery, pregnancy, childbirth, viral infections or severe emotional stress can initiate gluten intolerance. According to the National Digestive Diseases Information Clearinghouse, adults are less likely to have the classic digestive symptoms than children. Instead, they might experience unexplained iron-deficiency anemia, fatigue, bone and joint pain, arthritis, and bone loss or osteoporosis. Adults also might have one or more additional symptoms, such as anxiety or depression, seizures, migraine headaches and tingling numbness in the hands and feet. Women with gluten intolerance are more likely to experience missed periods, infertility or recurrent miscarriages. Male infertility is a symptom. Canker sores in the mouth, mouth ulcers and an itchy skin rash called dermatitis herpetiformis are other symptoms.
Signs of Untreated Gluten Intolerance
The Celiac Disease Foundation says that untreated celiac disease can lead to long-term conditions. Signs include iron-deficiency anemia, which is indicated by a low hemoglobin and hematocrit level in the blood; vitamin K deficiency; and, less commonly, vitamin B12 and folate deficiency, or both. Malabsorption leads to central and peripheral nervous system disorders, early onset osteoporosis, pancreatic insufficiency, intestinal lymphomas, and gastrointestinal cancers and malfunction of the gallbladder.
Diagnostic Signs
Blood tests can reveal signs such as low albumin, elevated alkaline phosphate, low cholesterol and higher than normal levels of autoantibiotics called antitissue transglutaminase antibodies, or anti-endomysium antibodies.
