Celiac Disease: Symptoms and Treatment
What is Celiac disease?
You have probably heard of Celiac disease or gluten intolerance in the health and wellness space. If not, then you definitely have seen an ad for a new gluten-free (GF) recipe to try or a product that just came to the market. Many people are “going GF'' because it's the latest diet trend, although they might not fully understand what gluten is or who should be avoiding it.
Gluten is a protein found naturally in wheat, barley, and rye, which triggers an immune response in people with Celiac disease when eaten. According to the Celiac Disease Foundation, Celiac disease is an autoimmune disease that leads to damage to the small intestine when ingesting gluten and occurs in those who are genetically predisposed. A gluten intolerance, or non-celiac gluten sensitivity is when someone experiences adverse effects from consuming gluten such as fatigue, gas, bloating, or nausea. These individuals do not trigger an immune response and do not have a genetic susceptibility. Symptoms of the two can be similar, although they are not the same.
Celiac disease is estimated to affect 1% of the population, however, experts believe there are many more people with this condition who are undiagnosed. It is important to be mindful and aware of celiac symptoms as they can progress at any age.
Celiac disease can cause an array of symptoms, with some more serious than others. Some common ones that affect the GI tract include:
- Bloating and gas
- Abdominal pain and distention
- Nausea and vomiting
- Weight loss
While many symptoms of Celiac disease manifest in the digestive system, there are other various atypical symptoms as well that affect other parts of the body such as:
- Joint pain
- Skin disorders
- Numbness or tingling in hands or feet
- Iron deficiency anemia
- Mouth/canker sores
- Loss of enamel
- Weakening of bones
- Depression and anxiety
What can cause Celiac?
Celiac disease is known as an autoimmune disorder causing an immune response from the consumption of gluten. Those who are susceptible, trigger an immune response that damages the villi located on the mucosal lining of the GI tract and impairs its ability to absorb nutrients. Over time, the villi will erode and can become flat, known as villi atrophy. Genetic susceptibility as well as environmental factors such as feeding patterns during the first of life and less exposure to different microbes can contribute to a Celiac diagnosis. Celiac disease can progress at any age when an individual starts to eat gluten. Those who have celiac run in their family, or who are already diagnosed with an autoimmune disease or other condition are at increased risk for developing Celiac disease.
If Celiac disease is left untreated or ignored, it can lead to serious health outcomes.
Malabsorption - Malabsorption is when we don’t get adequate nutrients, vitamins, and minerals due to not being able to absorb them properly from our food. When someone with celiac continues to consume gluten, they can damage the villi on the small intestine whose primary function is to uptake nutrients, thus leading to poor absorption.
Malnutrition - Malnutrition is a lack of proper nutrition where an individual is not meeting their necessary nutrient requirements. This can occur from not eating enough, not eating the right foods, or not being able to use the nutrients from the food we do eat.
Osteopenia/osteoporosis - Osteopenia is softening of the bones and osteoporosis occurs when bones become less dense and are more susceptible to fractures. Over time, malabsorption of Calcium and Vitamin D can cause our bones to become more weak and brittle and increase the risk of these conditions.
A simple blood test can be done to help diagnose Celiac disease. Those with the condition will have higher than normal Tissue Transglutaminase (tTG-IgA), and IgA antibodies. IgA Endomysial antibody (EMA) is another marker that can be tested, however, it is not common since it is very expensive to test compared to other options and is typically only used for patients who are more difficult to diagnose. Regardless, be sure gluten remains in your diet when you test. If you omit gluten for some time and then test, your body will not have produced antibodies for an accurate reading and can lead to a misdiagnosis.
Genetic testing is another option and best for those who have Celiac disease that runs in the family, especially first-generation. Those with the condition carry one or both of the HLA DQ2 or DQ8 genes. Although, a diagnosis cannot be made solely due to carrying one of these genes. Many people can carry either one of these genes and will not develop Celiac disease, although your risk increases.
An Intestinal biopsy can be done to diagnose Celiac disease or test whether you have a different gastrointestinal condition. This is known as the “gold standard”. A sample of your mucosal tissue is taken through an endoscopy. This is a procedure where a scope is inserted through your mouth down your GI tract and can give a clear view of your gut. This sample can show any changes in the cells that line the small intestine, show damage to the villi, inflammation, and more.
Currently, the only treatment is to follow a strict GF diet. This will allow the villi in the gut to heal and be able to properly absorb nutrients. Symptoms can improve in as little as weeks of following a GF diet.
Gluten is predominantly found in wheat, rye and barley which can be found in many food products. Some foods to look out for include breads, cereals, baked goods or desserts, pasta, crackers, packaged snacks, some beverages such as beer or malted beverages, condiments, and oats (unless labeled GF). It is important to read ingredient labels and look for keywords for gluten-containing foods or look for the “GF” label on any packaged item. Gluten-containing grains include:
- Wheat, rye, barely
- Brewer’s yeast
- Wheat starch
There are some grains that naturally do not contain gluten and are allowed on a GF diet. These include:
- Tapioca (cassava root)
If you have persistent symptoms and may suspect you are Celiac or have a gluten intolerance, be sure to consult with your doctor before beginning a GF diet. If you are instructed to omit gluten from your diet, by doing so, you can help heal the stomach mucosal lining, improve your symptoms, and decrease your risk of it progressing into a more serious condition. It’s best to work with a Registered Dietitian (RD) as navigating a new pattern of eating can be challenging. Working with an RD can help you guide this dietary change in a safe and effective way.
Working with a Foodsmart Registered Dietitian can make the transition to a gluten free lifestyle an easy process. Your dietitian can help guide you on food choices, product recommendations, recipes and meal plans, as well as methods to heal your digestive system and calm any gluten-related health implications. Book your appointment today and find yourself a step closer to digestive peace, better nutrition, and a healthier you!
Foodsmart offers one-on-one nutrition counseling with a registered dietitian, with nutrition programs such as our Celiac Nutrition Program. This program is designed to help you manage celiac disease treatment or gluten intolerance, and will be customized specifically to you.