- Barrett's Esophagus
- Celiac Disease
- Colon Cancer
- Crohn's Disease
- Diverticular Disease
- E. coli Infections/Traveler's Diarrhea
- Esophageal Cancer
- Inflammatory Bowel Disease (IBD)
- Irritable Bowel Syndrome (IBS)
- Lactose Intolerance
- Peptic Ulcers
- Ulcerative Colitis
Celiac disease is a life-long medical condition in which the absorptive surface of the small intestine is damaged by a substance called gluten, a protein found in wheat, rye and barley. Celiac disease is also known as gluten-sensitive enteropathy (GSE) or celiac sprue. When people with celiac disease, eat foods or use products containing gluten, their immune systems react against the gluten and cause damage to villi thereby reducing the surface area in the small intestine available for absorbing nutrients.
More than 110,000 Canadians are believed to be affected by celiac disease and another 220,000 suspected to have this disease. Rates of celiac disease have nearly doubled in the last 25 years in western countries.
Understanding Celiac Disease
Celiac disease is a life-long medical condition in which the absorptive surface of the small intestine is damaged by a substance called gluten, a protein found in wheat, rye and barley. Celiac disease is also known as gluten-sensitive enteropathy (GSE) or celiac sprue.► View Guide
Blood screening tests (EMA or tTG) are fairly reliable indicators of whether or not you have celiac disease. A simple blood test can be done at your doctor's office or home kits can now be purchased at the pharmacy.
It is important to note that celiac disease can only be confirmed -- or ruled out -- by obtaining a tissue sample (biopsy) from the small intestine during gastroscopy. This is a safe procedure in which a slim, flexible telescope is swallowed under sedation. In recent years, blood tests have become more available as a screening test, but small intestinal biopsy is still the most accurate test.
Both biopsy and blood test results may be difficult to interpret if patients have been on a gluten-free diet for a period of time so it is important that you do not stop ingesting gluten prior to these tests.
Celiac disease can be difficult to recognize because the symptoms vary from person to person, can affect adults and children, and can occur in the digestive system or in other parts of the body. The symptoms of celiac disease may include:
- Oily, fatty or frothy stools
- Inability to gain weight
- Abdominal pain
Many adults with celiac disease do not suffer from "classic" symptoms but you may experience anemia, unexplained fatigue, mouth cancers, arthritis or joint pain, osteoporosis, missed periods, recurrent miscarriages, or depression. About 10% of people living with celiac disease also have dermatitis herpetiformis. This is an intensely itchy, burning skin rash that is usually found on the elbows, knees and buttocks. It appears as groups of small blisters that erupt and form small red lesions.
Although some people live with the disease for decades before being diagnosed, getting diagnosed as soon as possible is critical. The longer a person goes undiagnosed and untreated, the greater the chance he or she has of developing long-term complications such as malnutrition, liver diseases, and cancers of the intestine.
Living With Celiac Disease
Celiac disease is a life-long medical condition. Following a gluten-free diet will improve your symptoms and may reverse some of the complications of celiac disease. Living gluten-free for life is imperative if you have the disease.
Gluten can be found in foods, medications, and lipsticks. If you have celiac disease, you need to learn how to carefully read labels to avoid accidentally ingesting gluten so that you protect your small intestines and reduce the risk malnutrition and other illnesses
Managing Your Symptoms
Unfortunately, there are no medications to treat celiac disease. If you are living with celiac disease, it is imperative that you commit to following a gluten-free diet. This will relieve your symptoms and protect your future good health. If you are living with celiac disease and continue to ingest gluten, you risk damaging the absorptive surface of the small intestine which may result in malnutrition, anemia, increased risk of autoimmune diseases, and some cancers.
It is important that you continue to eat a gluten-free diet even once your symptoms disappear. If you don't, those debilitating symptoms and health risks will return once gluten is re-introduced.
You don't have to avoid social situations because you have celiac disease. Be open with friends and family. They can help you eat gluten-free if they understand the disease and the importance of your remaining gluten-free. Many restaurants and stores now offer gluten-free foods. Don't be shy to ask a waiter or associate if they have gluten-free options. In instances where gluten-free eating is simply not possible, you may want to eat before going out or bring gluten-free snacks with you.
There are no medications for treating celiac disease. Symptoms and damage to your small intestines are reduced by following a strict gluten-free diet.
Frequently Asked Questions
Can celieac disease lead to more serious illnesses?
30% of celiac disease patients may develop a malignancy, therefore adhering to a gluten-free diet is critical for preventive purposes.
Can children get celiac disease?
In children, stunted growth and an inability to gain weight are important clues to diagnosis. More unusual features of celiac disease appear to be related to an altered immune system. These include a skin condition called dermatitis herpetiformis, insulin-dependent diabetes, thyroid disease and underactivity of the adrenal glands.
I am anemic and have heard that I may have celiac disease. Could this be true?
Today, many patients have minor symptoms or none at all and the disease is only discovered after routine testing reveals anemia (low red blood cell count) or osteoporosis. In hindsight, many patients will realize that they have had minor symptoms that they ignored.
Is celiac disease genetic?
The risk for developing celiac disease is increased 20 times for those who have a first degree relative with the disease.
What causes celiac disease?
It is not known why certain people have this allergy to gluten but studies suggest that there are both genetic and environmental components. Traditionally, this disease was found to be more common in patients with northern European backgrounds, such as Ireland and Scotland. However, more recent reports suggest that celiac disease occurs in other racial and ethnic groups.
My son has Type I diabetes. I have heard that this may put him at increased risk for developing celiac disease. What I can do to reduce his risk of developing celiac disease? What risk(s ) should be aware of as a diabetic living with celiac disease?
Yes there it is recognized that there is an increased risk of celiac disease associated with those living with Type I diabetes. There is likely a genetic basis and hence it is improbable that there is anything you can do to decrease the risk. A serology blood test (tissue transglutaminase antibody) is very useful to screen for celiac disease and if the test is positive a endoscopic duodenal biopsies should be arranged to confirm the diagnosis and assess any damaged to the villi that may have already occurred. Once diagnosed with celiac disease, following a strict gluten free diet for life is recommended to prevent the risk of malabsorption and the development of hypoglycemia (low blood sugar) complicating the management of your son’s diabetes.
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Celiac disease is a specific digestive disorder of the nutrient absorbing part of the gut called the small intestine. Celiac disease is a form of food allergy. In celiac disease, the immune system is reacting against gluten, a protein found in wheat, causing damage to villi and loss of surface area for absorbing nutrients.
More than 330,000 Canadians are believed to be affected by celiac disease with only approximately 110,000 diagnosed.
Each year, families affected by celiac disease spend $150 million to obtain gluten-free foodstuffs; the primary therapeutic option for the disease.
Gluten-free products are 2.5 times more expensive than regular items making the overall cost of the disease for individuals and their families enormous.
Access to gluten-free foods prevents families with celiac disease from traveling, dining out, and taking part in social activities thereby decreasing their quality of life while increasing the indirect costs associated with the disease.
From the first recognizable onset of symptoms, it takes an average time of 1 year to obtain a diagnosis of celiac disease. In some cases, the time to diagnosis may take as long as 12 years.
Due to under-recognition of celiac disease in pediatric patients, $2.5 million has been spent in the health care system as families consulted 2 or more physicians before receiving a diagnosis for their child.
Delayed diagnosis of celiac disease increases the individual's risk for the development of serious chronic medical issues which, in turn, will increase their use of the health care system and reduce their ability to contribute to society.
Rates of celiac disease have nearly doubled in the last 25 years in western countries.
The risk for developing celiac disease is increased 20 times for those who have a 1st degree relative with the disease.
Nearly 30% of Canadian children with celiac disease are initially misdiagnosed.
As 30% of celiac disease patients may develop a malignancy (e.g, non-Hodgkin's lymphoma), adhering to a gluten-free diet is critical for preventive purposes in spite of the personal costs.