Celiac Disease

Gluten, a protein present in wheat, barley, and rye, causes celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, which is an immunological response to consuming it. Eating gluten sets off an immunological reaction in your small intestine if you have celiac disease. This response wears down the lining of your small intestine over time and prevents some nutrients from being absorbed (malabsorption). Intestinal injury frequently results in diarrhea, exhaustion, weight loss, bloating, and anemia and can have catastrophic consequences.

In addition to generating the symptoms experienced in adults, malabsorption in children can impede growth and development.

Although there is no known treatment for celiac disease, most patients find that adhering to a strict gluten-free diet can help control their symptoms and encourage intestinal recovery.

Celiac Disease: Causes

Celiac disease may be caused by your genes, consuming gluten-containing foods, and other things, but the exact reason is unknown. Moreover, infant feeding patterns, gastrointestinal diseases, and gut flora may be involved. After an operation, a pregnancy, delivery, viral illness, or a period of intense mental stress, celiac disease can occasionally become active.

The fine, hair-like projections (villi) that line the small intestine are harmed when the body's immune system overreacts to gluten in the diet. Vitamins, minerals, and other nutrients are absorbed by villi from the food you ingest. No matter how much you eat, you can't obtain enough nutrients if your villi are destroyed.

Celiac Disease: Symptoms

Adults' digestive warning signs and symptoms include −

  • Diarrhea

  • Fatigue

  • Loss of weight

  • Gas and bloating

  • Continent pain

  • Nausea and diarrhea

  • Constipation

The following signs and symptoms are present in more than 50% of individuals with celiac disease but are not connected to the digestive system −

  • Anemia, mainly caused by a lack of iron

  • Osteoporosis, a loss of bone density, or weakening of the bone (osteomalacia)

  • Blistering, itchy skin rash (dermatitis herpetiformis)

  • Oral sores

  • Weariness and headaches

  • A damaged nervous system that may cause tingling and numbness in the hands and feet, balance issues, and cognitive decline

  • Aching joints

  • Decreased splenic function (hyposplenism)

Digestive issues in children with celiac disease are more prevalent than in adults and include −

  • Nausea and diarrhea

  • Persistent diarrhea

  • Abdominal bloating constipation

  • Gas

  • Pale, pungent stools

The consequences of inadequate nutrition absorption might be −

  • Babies' failure to thrive

  • Erosion of the tooth enamel

  • Loss of weight

  • Anemia

  • Irritability

  • Short height

  • Postponed puberty

  • Neurological signs such as cognitive difficulties, headaches, poor motor coordination, attention deficit hyperactivity disorder (ADHD), and seizures

Celiac Disease: Risk Factors

The major risk factors include −

  • A family member suffering from herpes herpetiformis or celiac illness

  • Diabetes type 1

  • Turner syndrome, Down syndrome

  • Thyroid autoimmune disease

  • Colitis (lymphocytic or collagenous colitis)

  • Addison's illness

Celiac Disease: Diagnosis

Many celiac disease sufferers are unaware of their condition. It may be detected using two blood tests −

  • During a serology test, your blood is examined for antibodies. A gluten-induced immune response is shown by elevated levels of certain antibody proteins.

  • To rule out celiac disease, a genetic test for the human leukocyte antigens HLADQ2 and HLA-DQ8 can be employed.

Before experimenting with a gluten-free diet, it's crucial to get tested for celiac disease. Removing gluten from your diet may cause blood test results to show as normal.

Your doctor will likely request one of the following tests if the results of these tests show celiac disease −

  • Endoscopy. This test involves passing a long tube down your throat while having a small camera attached to it placed in your mouth (upper endoscopy). Your doctor can inspect your small intestine using the camera and obtain a little tissue sample (biopsy) to check for damage to the villi.

  • Endoscopy with a capsule. In this examination, your whole small intestine is photographed using a tiny wireless camera. You ingest a capsule the size of a vitamin that contains the camera. The camera records hundreds of images as the capsule passes through your digestive system and sends them to a recorder.

Celiac Disease: Treatment

The only treatment for celiac disease is a rigorous, permanent gluten-free diet. In addition to wheat, the following foods contain gluten −

  • Barley

  • Bulgur

  • Durum

  • Farina

  • Malted rye, gram flour, and semolina

  • Spelt (a type of wheat) 

  • Triticale

You can get assistance from a dietician who specializes in celiac disease in creating a nutritious gluten-free diet. Even if you don't have any indications or symptoms from gluten in your diet, even minimal quantities might be harmful.

Foods, pharmaceuticals, and nonfood items can all contain gluten, including −

  • Altered food starch, food stabilizers, and preservatives

  • Medication, both prescribed and over-the-counter

  • Mineral and vitamin supplements

  • Nutritional and herbal supplements

  • Lipstick items

  • Mouthwash and toothpaste

  • Eucharistic wafers

  • Ink and envelope glue

  • Toy dough

Your small intestine's inflammation will progressively decrease as you cut out gluten from your diet, improving your symptoms and allowing your body to recuperate. Children often recover faster than adults do.

If you have significant nutritional deficiencies or anemia, your doctor or dietician may advise you to take supplements, such as −

  • Copper

  • Folate

  • Iron

  • B-12 vitamin

  • Vitamins D, K, and Zinc

Most vitamins and supplements are taken orally as pills. Your doctor may inject vitamins if your digestive system has difficulties absorbing them.

Your doctor might advise using steroids to reduce inflammation if your small intestine is significantly damaged or if you have celiac disease that is not responding to treatment. When the intestines recover, steroids can help with severe celiac disease symptoms.

It is possible to utilize additional medications like budesonide or azathioprine.

Celiac Disease: Prevention

This particular disorder can be prevented by taking the following measures −

  • Avoid any food that contains wheat, barley, or rye.

  • Foods produced or processed in the same facility as wheat, barley, or rye should be avoided. Some foods could contain trace levels of gluten or have come into touch with it.

  • Consume only gluten-free oats. Oats are frequently processed with wheat, barley, and rye in the same facility.

  • After receiving a celiac diagnosis, refrain from ingesting milk and milk products for a while.

  • To make sure you stay away from items that include wheat, rye, and barley, think about following a clean diet. Several “clean” whole foods are nutritious and gluten-free, including fruits, vegetables, eggs, dry beans, fish, chicken, nuts, and seeds.

  • Learn which grains and starches you may eat when adhering to a gluten-free diet. With celiac disease, you can consume corn, quinoa, rice, buckwheat, and amaranth.


Due to the risk of small intestine damage, patients with celiac disease are unable to consume gluten. When a person with celiac disease consumes gluten-containing foods, their immune system reacts by injuring the small intestine. Wheat, rye, and barley all contain the protein known as gluten.

Both adults and children can suffer from celiac disease. The range of clinical manifestations is broad, and extraintestinal abnormalities such as anemia or short stature are now more prevalent than the traditional signs of malabsorption.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 29-Mar-2023


Kickstart Your Career

Get certified by completing the course

Get Started