Celiac disease is an autoimmune disease in which the consumption of gluten (a protein found in wheat, barley, and rye) triggers an intestinal immune response. The inside lining of the small intestine has tiny microscopic finger-like projections called villi through which nutrients are absorbed. In people with celiac, ingested gluten protein severely damages and destroys these delicate intestinal villi.
Celiac disease is not the same thing as a gluten allergy, intolerance, or sensitivity. However, many people who lack the autoimmune response and signs of intestinal damage, but still experience many of the same symptoms of celiac disease suffer from non-celiac gluten sensitivity.
Non-celiac gluten sensitivity, also known as gluten sensitivity, is not the same thing as celiac disease. Those with gluten sensitivity experience many of the symptoms of celiac disease, such as diarrhea, joint pain, fatigue, and abdominal pain, but lack any physical evidence of altered immunity or injury as a result of gluten. Non-celiac gluten sensitivity is diagnosed by the process of exclusion. Treatment includes the avoidance of gluten.
Although the majority of people with Celiac disease are symptomatic, some people may have no symptoms at all. Symptoms can vary slightly depending on age. In adults, symptoms include:
Certain complications are known to be more likely to occur in people with celiac disease. However, these can most often be prevented by staying on a strict gluten free diet. Some of these potential complications include:
The first step towards diagnosis is to take a full medical history and to do a physical exam. If celiac disease is suspected, a celiac panel (simply a blood draw), will be taken. This includes a variety of different tests that can point towards a diagnosis of celiac. If a celiac panel is positive, the diagnosis must be confirmed by biopsy during an endoscopy because this test is much more accurate than the celiac panel. This is done under sedation, at which time the physician examines and takes biopsies of the small intestine with a thin, lighted, flexible endoscope. It is very important to note that your diet must contain a sufficient amount of gluten before and during the time of either the celiac panel blood test or endoscopic biopsy to ensure accurate results. If you are on a gluten-free diet beforehand, there is a chance the test will show a false negative (you have celiac disease, but the test reads negative).
It is very important to follow a gluten free diet if you have a known diagnosis of celiac disease. Over time, complete adherence to a strict gluten free diet usually allows inflammation in the small intestine to lessen and the villi to heal. Accidental ingestion of gluten can cause a flare in symptoms, such as abdominal pain and diarrhea. Foods to avoid on a gluten free diet include:
It is important to read the ingredient labels on items bought in the grocery store to see if there is any source of gluten in the product. It is also important to ask servers when eating out if meals contain hidden sources of gluten, or if meals may be cooked in ways that contaminate food with gluten.
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