Celiac Disease (Celiac Sprue)
Celiac disease is an inherited autoimmune disease that causes the body's immune system to respond to the protein gluten by damaging the lining of the small intestine. Gluten is found in wheat, rye and barley and a few other grains.
The normal intestinal lining is covered with tiny, finger-like structures called villi that help the intestine absorb food. In celiac disease, the villi are flattened instead of being long and narrow, which decreases the intestine's ability to absorb nutrients. As a result, stomach pain and diarrhea may develop along with anemia, malnutrition, infertility, a certain skin rash and other health problems. It may also affect several other organ systems.
Celiac disease is also called celiac sprue, sprue, nontropical sprue and gluten-sensitive enteropathy.
The exact cause of celiac disease is unknown. Once thought rare, celiac disease recently has been estimated to affect one of every 133 Americans. However, only a small fraction of people living with celiac disease in the United States has been diagnosed at this time.
Those with a family member with celiac disease are at greater risk for developing the disease. The disorder is most common in Caucasians and those of European ancestry. The disease can develop at any point in life, from infancy to late adulthood.
The symptoms of celiac disease can vary significantly from person to person and include:
- Slowed growth
- Weight loss
- Diarrhea (rarely, constipation)
- Stomach pain
- Feeling very tired or low mood
- A very itchy skin rash with blisters
Most people with celiac disease have one or more symptoms, but not all have digestive problems. Some people with the disease don't have any symptoms. Having one or more of these symptoms does not mean a person has celiac disease because many other disorders include these symptoms.
Exams and Tests
If your pediatric GI specialist thinks your child has celiac disease, he or she will probably do a blood test. People with celiac disease have higher than normal levels of certain antibodies in their blood. Antibodies are produced by the body in response to substances that the body thinks are a danger. If the blood work results show increased antibodies, your child's doctor will then perform an endoscopy procedure to get biopsies (tissue samples) of the intestine to prove the diagnosis. Your child will need to follow a regular diet that includes gluten before and during testing to ensure accurate results.
Since the disease runs in families, immediate family members of patients with celiac disease need to have blood tests done.
The only treatment for celiac disease is to avoid eating foods that contain gluten. Even tiny amounts of gluten can damage the intestine. A dietitian can work with you to help you learn how to select gluten-free foods. You will learn to check labels of foods and other items for gluten. The small intestine will heal once gluten is eliminated from the diet, though celiac disease is a life-long condition.
What to Eat If You Have Celiac Disease
The following chart lists examples of foods you can eat and foods you should stay away from if you have celiac disease. This list is not complete. A dietitian can help you learn what other foods you can and can't eat when following a gluten-free diet.
|Indian rice grass||Sorghum|
Foods to Avoid
Triticale (a cross between wheat and rye)
Other Wheat Products to Avoid
|Bromated flour||Phosphated flour|
|Durum flour||Plain flour|
|Enriched flour||Self-rising flour|
|Graham flour||White flour|
Processed Foods that May Contain Wheat, Barley or Rye*
|Candy||Seasoned tortilla chips|
|Cold cuts, hot dogs, salami, sausage||Self-basting turkey|
|French fries||Soy sauce|
|Gravy||Vegetables in sauce|
|* Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer.|
From the following resource: Thompson T. Celiac Disease Nutrition Guide, 2nd ed. Chicago: American Dietetic Association; 2006. © American Dietetic Association. Adapted with permission. For a complete copy of the Celiac Disease Nutrition Guide, please visit eatright.org.
Points to Remember
- People with celiac disease shouldn't eat foods or use items with gluten in them.
- Celiac disease harms the small intestine.
- People with untreated celiac disease can't get needed nutrients.
- Without treatment, people with celiac disease can develop other health problems.
- Celiac disease is diagnosed by blood tests and a biopsy of the small intestine.
- A gluten-free diet should be followed for life.
- A dietitian can help people choose the right foods.
For More Information
Celiac Disease Awareness Campaign
Gluten-Free Indy Celiac Support Group