Everything you need to know about Celiac Disease

This guide contains everything you need to know about celiac disease including what it is, how it’s treated, available testing for the condition, and how celiac disease is passed down in families.

What is celiac disease?

Celiac disease is an autoimmune disease that develops over time because of a sensitivity to gluten; a protein found in certain cereal grains including wheat, rye, and barley, and commonly used in food products such as cereal, bread, and pasta.

When a person with celiac disease eats gluten, this causes the body’s immune system to attack its own tissue, causing damage to the gut lining and preventing the body from adequately absorbing nutrients from food.

If left untreated, it can lead to severe complications, which can negatively impact on a person’s quality of life.

Celiac disease affects around 1 in 133 Americans (about 1% of the population). However, it is estimated that up to 83% of Americans who have celiac disease are undiagnosed or misdiagnosed as having another condition, such as irritable bowel syndrome (IBS).

Is celiac disease serious?

Celiac disease can range from mild to severe depending on the person.

Even if the symptoms are mild initially, they can get worse over time if the condition remains undiagnosed or untreated and the person continues to consume foods containing gluten.

Severe complications from undiagnosed/untreated celiac disease can include osteoporosis, anemia, certain neurological diseases (affecting the brain and nerves) and, in rare cases, intestinal lymphoma and bowel cancer.

However, with early diagnosis, the disease can be easily managed with a lifelong gluten-free diet.

What are the symptoms of celiac disease?

Some of the most common symptoms of celiac disease include:

• An itchy rash (dermatitis herpetiformis)
• Anemia
• Bloating and flatulence
• Constipation or hard stools
• Diarrhea or loose stools
• Disorders that affect co-ordination, balance, and speech (ataxia)
• Indigestion
• Nausea, feeling sick and vomiting
• Nerve damage (peripheral neuropathy)
• Stomach aches and cramping
• Tiredness (fatigue) due to not getting enough nutrients from food (malnutrition)
• Unintentional weight loss

What causes celiac disease?

Celiac disease is caused by an adverse reaction of the immune system to gluten, a protein found in certain cereals including wheat, barley, and rye.

Research into the condition has shown that celiac disease runs in families, and those who have a first-degree relative with the condition (i.e. parent, sibling, child) have a higher risk of developing celiac disease in the future.

Expert geneticists have found that the HLA-DQ2 and HLA-DQ8 genes are the most common genes observed in celiac disease patients, making genetic testing an effective method for determining the likelihood of developing celiac disease in the future.

Is celiac disease genetic?

Celiac disease can be inherited and often runs in families. Research shows that people with celiac disease have a higher risk of passing it down to first-degree relatives (i.e. parents to their children).

People with the disease typically have the Human Leukocyte Antigen (HLA) DQ2 and DQ8 genes.

Human Leukocyte Antigen (HLA) generates a protein in the body that binds to any foreign material on the surface of a cell. When people have defective HLA genes, their bodies see gluten peptides as foreign, resulting in an autoimmune reaction.

The HLA-DQ2 and/or HLA-DQ8 genes are always found in people who have been diagnosed with celiac disease.

However, simply having these genes does not guarantee that a person will develop celiac disease or indicate that they are currently suffering from it.

Is celiac disease the same as an allergy?

No, celiac disease is not the same as a wheat allergy or gluten intolerance/sensitivity.

Celiac disease is a serious autoimmune condition that develops over time, typically runs in families, and can only be treated by adhering to a strict gluten-free diet.

A wheat allergy occurs when your body produces antibodies to the proteins found in wheat, causing a different kind of immune system reaction. In severe cases, it can lead to anaphylaxis.

A gluten sensitivity or intolerance may cause symptoms similar to those experienced by people with celiac disease, but it is not clear how the immune system might be involved, no antibodies are produced, and there is seemingly no damage to the gut lining.

Can you develop celiac disease over time?

Yes, celiac disease develops over time and symptoms can start at any age. It is most common among adults aged between 50 and 70.

Women are also three times more likely to develop the disease than men.

Can celiac disease develop later in life?

How is celiac disease diagnosed? Can you test for celiac disease?

Diagnostic testing for celiac disease usually includes blood testing for antibodies and, depending on the results of the blood test, a gut biopsy to assess any damage to the gut lining.

However, before undergoing any unnecessary invasive testing, a genetic test for celiac disease can be a helpful option for determining whether an individual is at risk of having or developing celiac disease in the future.

A Genetic Celiac Disease Test uses Human Leukocyte Antigen (HLA) typing to confirm or rule out the potential of developing celiac disease by analysing six DNA markers for the HLA-DQ2 and HLA-DQ8 genes.

If the test results show that an individual has one or both genes (HLA-DQ2 and/or HLA-DQ8), this indicates that they could be at risk of developing celiac disease in the future.

The test results will show either a negative result or that the person is at very low, low, moderate, or high risk of developing celiac disease, depending on which genes they have. This information can then be shared with the person’s physician, which can be useful when trying to secure a diagnosis more quickly.

However, it’s important to remember that having these genes does not guarantee that a person will develop celiac disease or indicate that they are currently suffering from it.

If the test results show that neither of these genes are present, this means that the individual is unlikely to develop celiac disease in the future.

How can celiac disease be treated?

Celiac disease can only be controlled by adhering to a lifelong gluten-free diet.

This means that any foods containing gluten should be avoided including (but not limited to) bread, pasta, cereals, cookies, and cakes.

If you have been diagnosed with celiac disease, it is especially important to check the labels on any food you buy, as many foods (particularly processed foods) include additives and flavorings that contain gluten.

Once a person with celiac disease removes gluten from their diet, they will typically start to see a significant improvement in their health.

Gluten can also be found in some non-food products including cosmetics and certain medications.