celiac disease

Celiac Disease: Symptoms, Causes, and Treatment

Celiac disease manifests differently from one person to another. Some may have no symptoms while some display signs of nutrient deficiencies. And others can experience severe digestive problems.

In this article, we’ll explore celiac disease symptoms, causes, diagnosis, and treatment.

celiac disease - diagram of celiac disease

Celiac Disease Symptoms

Children will first show symptoms when you add cereals with wheat to their diet. Symptoms in children include:

  • Failure to thrive
  • Lethargic appearance
  • Look apathetic
  • Pale skin
  • Distended abdomen
  • Muscle loss

Their stools look bulky and have a lighter color. They will be soft and have an unusual, offensive smell. Later in life, they may have delayed puberty, ADHD, learning disabilities, and seizures.

Adults manifest celiac disease with a lack of appetite, weakness, fatigue, and diarrhea. The stool is pale, bulky, greasy, and foul-smelling. Some may experience weight loss and signs of nutrient deficiencies like anemia. They may also develop bone diseases like osteopenia and osteoporosis due to Vitamin D and calcium deficiencies.

There is an increased risk for infertility as well. Some women experience irregular menstrual cycles too.
Those with celiac disease may also develop lesions in the mouth. These lesions include:

  • Glossitis – inflammation of the tongue
  • Angular stomatitis – inflammation erosions and fissuring at angles of the mouth
  • Aphthous uclers – uclers in the mouth

Other symptoms include joint pain, numbness and tingling, and diminished function of the spleen.

Dermatitis herpetiformis, an itchy skin rash, develops in 10% of cases. The rash tends to affect more young adults. It appears on both sides of the body, symmetrically, on the elbows, knees, shoulders, scalp, or buttocks. As the name implies, the rash resembles herpes with red, itchy blisters and clustered hive-like swellings.

Some people may only develop this rash and show no other symptoms of celiac disease. However, those who develop this rash are likely to have other autoimmune conditions. Possible conditions include thyroid diseases, diabetes, pernicious anemia, and small bowel lymphoma.

celiac disease - dna strand

Celiac Disease Causes

Celiac disease is a hereditary disorder caused by sensitivity to gliadin, a protein in wheat. Factors of developing celiac disease include:

  • Genetics
  • Diet with gluten
  • Changes in gut flora
  • Viral infections
  • Stress

When a person with the condition consumes gluten, the immune system overracts causing damage to the villi of the small intestines. These villi play essential roles in absorbing nutrients from food. When damaged by celiac disease, malabsorption and malnutrition occur.

People with family members with this condition, other autoimmune diseases, or Down or Turner syndromes have a higher chance of developing celiac disease.

celiac disease - microscopes in lab

Diagnosis

Doctors suspect celiac disease after a clinical evaluation and lab studies. These tests confirm malabsorption. Serologic markers and small bowel biopsy are further needed to confirm the diagnosis. Doctors recommend another biopsy three to six months after starting a gluten-free diet.

By this time, symptoms should improve as well as the small bowel tissue. The anti-tissue transglutaminase antibody and anti-endomysial antibody titers levels should decrease too.
If these improvements do not show, doctors may suspect lymphoma. It is also possible that the disease became refractory too.

Someone with an iron deficiency and no signs of gastrointestinal bleed should test for celiac disease if supplements do not help.

grains and bread

Treating Celiac Disease

Treatment consists of a gluten-free diet and taking supplements to correct deficiencies.

The diet should be 100% gluten-free. Even a small amount can trigger inflammation and symptom relapses. It is important to avoid grains with gluten like wheat, rye, and barley. Do not consume processed foods either as many contain gluten. For example, ice cream, sauces, dressings, hot dogs, and soups have gluten.

Oats are often contaminated with wheat because they’re processed in the same facilities. Although gluten-free oats are available, some studies suggest avenin, a protein in oats, is similar to gluten. So, cross-reactivity may occur.

Many need supplements to correct nutrient deficiencies. This is due to the condition interfering with the absorption of a majority of nutrients in the small bowel.

Supplements include iron, calcium, folate, multivitamins, and multi-minerals. Severe cases of malnutrition require IV supplementation with nutrients.

Corticosteroids can be useful in cases of refractory disease that do not respond to gluten-free diets and supplements.

For skin rashes from celiac disease, use dapsone. It can cause hemolytic anemia, though. You can use sulfapyridine, an alternative drug, instead.

Celiac disease can be successfully managed to improve symptoms and avoid complications. Talk to your doctor about how to manage your condition for more information.