Celiac disease describes an autoimmune condition that causes small intestine damage when gluten is eaten. It differs from an allergy or nonceliac disese gluten intolerance in that it involves the immune system and it can cause permanent damage. Symptoms often affect the digestive system. They include abdominal cramping, bloating and gastrointestinal distress. Not everyone with celiac disease experiences these symptoms. A study by the Center for Celiac Research at the University of Maryland School of Medicine, published in the February 2003 issue of the “Archives of Internal Medicine,” estimates that celiac disease affects 1 in 133 Americans.
About Gluten
Gluten refers to a type of storage protein found in grains. Its specific name depends upon the grain. For example, this protein is called gliadin and glutenin in wheat and secalin in rye. Proteins consist of chains of chemicals called amino acids. The storage proteins in wheat, barley and rye have the same amino acid chain. The presence of these proteins in a person with celiac disease causes the small intestine damage associated with the disease.
Small Intestine Damage
The actions of your immune system are responsible for the damage. Gluten triggers the formation of a specific antibody as part of the immune system response. Your body ultimately attacks itself, perforating and destroying the villi in the small intestine. These tiny projections into the cavity of the small intestine increase the surface area to more effectively absorb nutrients. Once they become damaged, the ability of the small intestine to absorb deteriorates. This condition leads to some of the complications of celiac disease, including nutrient deficiencies.
Diagnosis
Diagnosis of celiac disease consists of blood tests followed by a biopsy of the small intestine. Blood tests screen for antibodies associated with celiac disease. Your body produces antibodies specific to the antigen or substance that triggers the immune response. Their presence indicates that gluten has caused a reaction. An endoscopic biopsy confirms the diagnosis. For this procedure, a special tube is inserted in the mouth and guided to the small intestine. Tissue samples are taken and examined for microscopic perforations and damage that may not be visible by simply viewing the intestine. Damage appears as lesions under the microscope.
Treatment
The biopsy shows the extent of damage to the small intestine. To treat celiac disease, you must eliminate gluten from your diet. This is the only known treatment. Without gluten, your body won't initiate the immune system response that leads to small intestine damage. Your body will have time to heal and resume normal nutrient absorption. Early diagnosis can help prevent the onset of other autoimmune diseases such as diabetes or thyroid conditions. By going gluten free, you can manage your condition and live a normal life.
References
- University of Chicago Celiac Disease Center: Allergies and Intolerance
- "Archives of Internal Medicine"; Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States; A. Fasano, et al.; February 2003
- Celiac Sprue Association: Treatment of Celiac Disease
- Celiac Disease Foundation: What Happens With Celiac Disease
- University of Chicago Celiac Disease Center: How Is Celiac Disease Diagnosed?
- Celiac Sprue Association: Signs & Symptoms of Celiac Disease
