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On June 6, 2011, in Health conditions, MEDICAL FACTS, by Dr. Tuchinsky

What is celiac disease?

Celiac disease, also known as gluten-sensitive enteropathy or celiac sprue is a multisystem disorder that affects 1% of American population. Gluten is a protein in wheat, rye and barley. In susceptible individuals, their immune systems mistakes gluten antigen for a pathogen and initiates an inflammatory response, which damages intestinal wall mucosa. This in turn leads to the poor intestinal absorption of food and vitamin and nutrient deficiencies.

 Signs and symptoms of celiac disease.

Celiac disease can present itself within many other organs, causing a specific rash called (dermatitis herpetiformis) on elbows and buttocks, or affecting nerve endings, blood cells or reproductive organs. The prevalence of celiac disease in the US has been on the rise in the last few decades but it may also have to do with physicians becoming more aware of the disease and learning to identify it earlier.

However, most of the time celiac disease still goes unrecognized for many years and some people go through their lives without ever receiving the correct diagnosis (it can often be mistaken for Irritable Bowel Syndrome). It is more often found in people who have other autoimmune disorders, such as Type I diabetes or thyroid disease.

Most common presenting symptoms are gastrointestinal problems (diarrhea, heartburn, weight loss, and a lot of gas). However, it can also present with fatigue, miscarriages, rashes, joint pain, depression, headaches and a myriad of other problems. This “great mimicker” feature is what makes it so tricky to recognize celiac disease. The initial screening test is serum anti-tTG IgA antibody. If it is positive, then the diagnosis should be confirmed by small bowel biopsy done through endoscopy.

Treatment and prevention.

The only existing treatment is religious adherence to gluten free diet, which is very cumbersome and difficult to achieve, because most of the foods in our diet are rich in gluten. Not only dietary but also even some other non-edible items, such as lipstick of some medications may contain gluten. It requires significant amount of knowledge, planning and discipline. Patients are recommended to take supplements of fat-soluble vitamins (D, E, A and K), B12, B6 folic acid and iron. Long-term complications include intestinal cancer and liver disease. The longer a person goes undiagnosed and untreated, the greater the risk for long-term complications.

CLICK HERE for tips for staying gluten-free while dining out, from the Gluten Intolerance Group:


Image: Suat Eman /



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