Celiac Disease: Living a Gluten-Free Life
Celiac disease is a chronic autoimmune disorder that affects millions of people worldwide. Despite its prevalence, it remains widely misunderstood. For those who are celiac, even a tiny amount of gluten—a protein found in wheat, barley, and rye—can trigger an immune response that damages the small intestine. If left untreated, this damage can lead to a host of symptoms and long-term health complications. This blog will explore celiac disease, its symptoms, diagnosis, treatment, and tips for living a healthy, gluten-free life.
Table of contents
What is Celiac Disease?
Celiac disease is an autoimmune condition, not a food allergy or intolerance. When someone who is celiac consumes gluten, their immune system mistakenly attacks the lining of the small intestine. This attack damages the villi—tiny, finger-like projections that line the intestine and are responsible for nutrient absorption. Over time, this damage can lead to malnutrition, osteoporosis, and other serious health issues.
Celiac disease is genetic, meaning it runs in families. If you have a first-degree relative (parent, sibling, or child) with the disease, you have a 1 in 10 chance of developing it yourself. It can develop at any age, from infancy to late adulthood, and affects people of all ethnicities.
What are the Causes of Celiac Disease?
The exact cause of celiac disease is unknown, but it’s likely a combination of genetics and environmental factors:
- Genetics Celiacs inherit a gene from their parents that makes them susceptible to the disease. However, many people have the gene but don’t develop the disease, so other genes may also play a role.
- Gluten Celiac disease occurs when the immune system attacks gluten, a protein in bread, pasta, cereals, and biscuits.
- Other factors that may contribute to celiac disease include infant-feeding practices, gastrointestinal infections, gut bacteria, surgery, pregnancy, childbirth, viral infection, or severe emotional stress.
What Can Trigger Celiac Disease Beyond Childhood?
Celiac disease can be triggered later in life by several factors, including:
- Physical or emotional stress: A significant physical event, such as surgery, pregnancy, or childbirth, or a severe emotional event can trigger the disease.
- Changes in gut bacteria: A triggering event can alter the makeup of the gut biome, activating dormant genes that lead to celiac disease.
- Gene changes: People with specific gene changes (mutations) are more likely to develop the disease. However, not everyone with the mutation will get the disease.
- Aging: As people age, their immune systems age, and autoimmune diseases like celiac disease become more common.
Celiac disease can appear at any age, but it’s most commonly seen in early childhood and mid-life. People who are celiac can live for many years without knowing they have the condition because they may not experience symptoms or may be misdiagnosed. However, even without symptoms, the disease can damage the gut over time.
Symptoms of Celiac Disease
The symptoms of celiac disease vary widely and can affect different parts of the body. Some people experience severe digestive issues, while others have no gastrointestinal symptoms at all. This variability often makes the disease difficult to diagnose. Common symptoms include:
- Digestive Issues: Diarrhea, constipation, bloating, gas, abdominal pain, and nausea.
- Fatigue: Persistent tiredness, often due to malnutrition.
- Weight Loss: Unintentional weight loss despite regular eating habits.
- Skin Problems: Dermatitis herpetiformis, an itchy, blistering rash.
- Neurological Symptoms: Headaches, brain fog, and peripheral neuropathy (tingling in the hands and feet).
- Joint Pain: Inflammation and pain in the joints.
- Mood Disorders: Anxiety, depression, and irritability.
- Anemia: Iron deficiency anemia due to poor nutrient absorption.
What Conditions Mimic Celiac Disease?
Several conditions can mimic celiac disease, including:
- Irritable bowel syndrome (IBS): IBS can have similar symptoms to celiac disease, such as bloating, gas, and gastrointestinal upset. Because there are no tests for IBS, it can be difficult to tell the difference.
- Non-celiac gluten sensitivity (NCGS): NCGS is a gluten-related disorder that has similar symptoms but is a different condition.
- Wheat allergy: A wheat allergy is a gluten-related disorder with similar symptoms but is a different condition.
- Inflammatory bowel disease (IBD): IBD is an autoimmune and/or inflammatory condition that can cause clinical features that mimic celiac disease.
- Microscopic colitis: Microscopic colitis is an autoimmune and/or inflammatory condition that can cause clinical features that mimic celiac disease.
- Thyroid dysregulation: Thyroid dysregulation can cause clinical features that mimic celiac disease.
- Adrenal insufficiency: Adrenal insufficiency can cause clinical features that mimic celiac disease.
- Viral enteritis: Viral enteritis is a histological mimic of celiac disease.
- Tropical sprue: Tropical sprue is a histological mimic of celiac disease.
- Small intestinal Bacterial overgrowth (SIBO): SIBO is a histological mimic of celiac disease.
How Do You Diagnose Celiac Disease?
Doctors typically use blood tests and biopsies of the small intestine to diagnose celiac disease:
- Blood tests: A health care professional takes a blood sample and checks for antibodies often higher than expected in celiacs. The tTG and DGP antibody tests are the main blood tests to diagnose celiac disease.
- Biopsy: A gastroenterologist uses an endoscope to pass a tiny biopsy tool through the throat and into the small intestine to take samples of the lining. The sample is then examined under a microscope for signs of the disease.
Other tests that may be used to diagnose celiac disease include:
- Genetic testing: A blood test, saliva test, or cheek swab can test for human leukocyte antigens (HLA-DQ2 and HLA-DQ8).
- Capsule endoscopy: A tiny camera that contains lights and an antenna that sends images to a recorder worn on a belt.
What Happens if Celiac Disease Remains Untreated?
Celiac disease can lead to several complications, including:
Nutritional deficiencies
Celiac disease can cause malabsorption, so the body doesn’t fully absorb nutrients. This can lead to deficiencies in vitamins and minerals, which can cause conditions like anemia and osteoporosis.
Malnutrition
You can become malnourished if your small intestine can’t absorb enough nutrients. This can lead to weight loss, fatigue, dizziness, and confusion. In children, malnutrition can cause delayed growth and development.
Lactose intolerance
If you have untreated celiac disease, you might develop lactose intolerance, which means your body can’t digest lactose, the sugar found in dairy products. Symptoms include bloating, diarrhea, and abdominal discomfort.
Bone weakening
If you don’t get enough calcium and vitamin D, your bones can become brittle and weak, leading to conditions like osteopenia and osteoporosis.
Dermatitis herpetiformis
About 15% of people with the disease have this chronic skin condition, which causes an itchy rash that looks like clusters of bumps or blisters.
Cancer
People who are celiac who don’t maintain a gluten-free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer.
Nervous system conditions
Some people who are celiac can develop conditions such as seizures or peripheral neuropathy.
Other complications include infertility, miscarriage, and psychological issues like depression and anxiety.
Share your experiences and tips in the comments below! Let’s build a supportive community and help others navigate this journey.
Treatment: The Gluten-Free Diet
The only effective treatment for celiac disease is a strict, lifelong gluten-free diet. This means avoiding all foods and products containing wheat, barley, rye, and derivatives. While this may seem daunting initially, many people find their symptoms improve significantly within weeks of starting the diet.
Here are some tips for transitioning to a gluten-free lifestyle:
- Read Labels Carefully: Gluten can be hidden in unexpected places, such as sauces, soups, and cosmetics. Look for certified gluten-free labels.
- Focus on Naturally Gluten-Free Foods: Fruits, vegetables, lean meats, fish, dairy, and gluten-free grains like quinoa, rice, and corn are safe options.
- To avoid Cross-Contamination, Use separate utensils, cutting boards, and toasters for gluten-free foods. Even a tiny amount of gluten can trigger symptoms.
- Explore Gluten-Free Alternatives: Many gluten-free versions of bread, pasta, and baked goods are available in stores and online.
- Educate Yourself: Learn about hidden sources of gluten and stay informed about safe dining options when eating out.
What Foods Must Celiacs Avoid?
Celiacs must avoid foods that contain gluten, a protein found in wheat, barley, rye, and some oats:
- Bread, pasta, and baked goods
- Cereals
- Beer
- Coffee substitutes with barley, malt, or beer
- Some processed foods
- Seasoning packets
- Soup, stock, broth, and bouillon
Celiacs can still eat many foods, including:
Meat, Fish, Rice, Fruits, Vegetables, and Prepared foods labelled gluten-free.
A dietitian or functional medicine health coach can help you identify which foods are safe.
Living with Celiac Disease
Living with celiac disease requires vigilance, but it doesn’t have to limit your quality of life. With the growing availability of gluten-free products and increased awareness, managing the condition is easier than ever. Here are some additional tips for thriving with celiac disease:
- Join a Support Group: Connecting with others who have celiac disease can provide emotional support and practical advice.
- Work with a Dietitian: A registered dietitian can help you create a balanced, gluten-free meal plan and ensure you get all the necessary nutrients.
- Stay Positive: Adjusting to a gluten-free lifestyle can be challenging, but many people find that their health improves once they eliminate gluten.
- Advocate for Yourself: Don’t be afraid to ask questions at restaurants or social gatherings to ensure your food is safe.
The Importance of Awareness
Celiac disease is often underdiagnosed or misdiagnosed, leading to unnecessary suffering for many individuals. Raising awareness about the condition is crucial to improving diagnosis rates and ensuring those affected receive the necessary care. If you suspect you or a loved one may be celiac, don’t hesitate to speak with a healthcare provider.
Final Thoughts
Celiac disease is a lifelong condition, but with the proper knowledge and support, it’s entirely manageable. Celiacs can lead healthy, fulfilling lives by adopting a gluten-free diet and making informed choices. If you’ve been recently diagnosed, remember that you’re not alone. There’s a vibrant community of people who understand what you’re going through and are here to help.
Let’s continue to spread awareness and support those living with celiac disease. Together, we can make the world a safer, more inclusive place for everyone.
Disclaimer: This blog is for informational purposes only and should not replace professional medical advice. Always consult a healthcare provider for diagnosis and treatment.