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Celiac Disease

Celiac disease is an autoimmune reaction to eating gluten.

If you have celiac disease, eating gluten causes your body’s immune system to attack your small intestine. This damages the lining of your small intestine and prevents your body from absorbing required nutrients. Over time, untreated celiac disease can lead to malnutrition, intestinal damage and other serious health complications.1

Celiac disease occurs in about 1% of the world’s population, but most people with the condition are undiagnosed.2 It can develop at any age: some people develop it as a child, and others as an adult. Celiac disease is an under-diagnosed, under-managed condition associated with serious long-term complications, including the development of osteoporosis, neurologic disorders, gastric ulcers, and cancer (such as lymphoma).3,4 It often runs in families: If someone in your family has celiac disease, talk to your healthcare professional to see if you should also be tested for celiac disease.

 
if you have celiac disease, eating gluten causes your body's immune system to attack your small intestine infographic
 

Common symptoms of celiac disease

If you have celiac disease, it might be a long time before you figure it out because the symptoms that people think of—diarrhea, weight loss and bloating—are just part of the picture. Some people with celiac disease may exhibit other, non-digestive symptoms or sometimes people have no symptoms at all.3
 

Symptoms in adults

More than half of adults with celiac disease have signs and symptoms that are not related to the digestive system, including:

  • Itchy, blistery skin rash (dermatitis herpetiformis)
  • Iron-deficiency anemia
  • Loss of bone density (osteoporosis)
  • Damage to dental enamel
  • Mouth ulcers
  • Headaches and fatigue
  • Joint pain
  • Acid reflux and heartburn
  • Missed menstrual periods
  • Infertility or miscarriage3 
     

  

Symptoms in children

Infants and children tend to experience digestive problems like: 

  • Abdominal bloating and pain
  • Chronic diarrhea
  • Vomiting
  • Constipation

Children can also experience other, non-digestive symptoms, including fatigue, irritability, behavioral issues, delayed growth and puberty and failure to thrive.2,5

 
 

Common celiac disease triggers

Wheat isn’t the only gluten-containing grain. Other culprits are barley, bulgur, rye and seitan. And although oats don’t contain gluten, they are often processed in facilities that also produce gluten-containing grains and can be contaminated; so many people with celiac disease avoid oats, too.

Some common foods, drinks, and sauces that could contain gluten and trigger an autoimmune response in someone with celiac disease include:

Pasta

Pasta

Noodles

Noodles

Bread

Breads and pastries

Baked goods

Baked goods

Cereal

Cereal and granola
 

Breakfast waffle

Breakfast foods like pancakes, waffles, French toast and biscuits

 
Breading on fried food

Breading and coating mixes
 

 
Crackers

Crackers
 

 
Croutons

Croutons

 
Bowl of soy sauce

Soy sauce6

 
Salad dressing

Sauces & gravies, since many use wheat flour as a thickener

 
Beer, malt

Beer and malt beverages

 


Gluten can be hidden in many foods—that’s why it’s important to read the label or ask before buying or eating a food. Some more surprising examples of where you might find gluten include:

Granola

Energy and granola

 
French fries

French fries and potato chips

 
Processed deli meat

Processed lunch meats

 
Candy

Candy and candy bars

 
Soups

Soups

salad dressings

Salad dressings and marinade5

 

Gluten can also be found in non-food items like lipstick, lip-gloss and lip balm, herbal or nutritional supplements, drugs and over-the-counter medications, vitamins and supplements, and play-dough.
 

How do I know for sure?

If you’ve noticed that eating foods containing gluten causes problems, talk to your healthcare professional about getting tested. On average, it takes 5-11 years from symptom onset for celiac disease to be diagnosed.3 This is because many of the symptoms of celiac disease are so similar to other diseases, such as Irritable Bowel Syndrome (IBS), Irritable Bowel Disorder (IBD), or even lactose intolerance. Similar symptoms that overlap between common intestinal conditions may mean that healthcare professionals might not consider testing for celiac disease right away.

Many people are so used to living with—and being embarrassed by—their uncomfortable gastrointestinal issues that they never consider asking for help. 

But learning what causes your symptoms now may also help you avoid more serious issues in the future. A missed or incorrect diagnosis of celiac disease can delay treatment and lead to an increased risk of other serious health complications including:

  • Bone disease, like osteoporosis
  • Reproductive problems, including infertility
  • Some intestinal cancers
  • Inadequate nutrient absorption
  • Delayed growth in children
  • Development of additional autoimmune diseases4
 
testing icon

I THINK I MAY HAVE CELIAC DISEASE

Be sure to talk to your healthcare professional before trying a gluten-free diet: If you stop or even reduce the amount of gluten you eat before you're tested, it could change your test results and result in misdiagnosis or in a falsely negative test. If you think you or a loved one has a gluten-related disorder, don’t try to manage the problem on your own. A simple blood test—together with your medical history—can help your healthcare professional differentiate between allergy, celiac disease, and other conditions.

 

Get answers

References
  1. Celiac Disease Foundation. Long-Term Health Conditions. https://celiac.org/celiac-disease/understanding-celiac-disease-2/what-is-celiac-disease/24477-2/. Accessed September 2017.
  2. Lebwohl B, Ludvigsson JF, Green PHR. Celiac disease and non-celiac gluten sensitivity. The BMJ. 2015;351:h4347.
  3. Ruiz AR. Celiac disease. The Merck Manual website. www.merckmanuals.com . Updated May 2014
  4. Green PHR, Stravropoulos SN, Goldstein S, et al. Characteristics of adult celiac disease in the USA: results of a national survey. Am J Gastroenterol. 2001;96:126 -131
  5. Schuppan D, Zimmer KP. The Diagnosis and Treatment of Celiac Disease. Dtsch Arztebl Int. 2013; 110(49): 835–846.
  6. Celiac Disease Foundation. Sources of Gluten. https://celiac.org/live-gluten-free/glutenfreediet/sources-of-gluten/. Accessed September 2017.