Celiac disease, also called celiac sprue, is a chronic small bowel disease that has trouble digesting and absorption of food nutrients. The typical feature of celiac disease is that the patient cannot tolerate the gluten, which is a protein commonly found in wheat, rye, and barley made products, such as cookies, bread, pizza, pasta, noodles, and many other foods. There are about 3 million people in the United States are affected by celiac disease. Celiac disease itself rarely causes death, but it is a significant problem to affect the quality of life, disturb multiple organ systems, and increase complications and risks for cancers, such as lymphomas, adenocarcinomas, etc, in the gastrointestinal tract.

Causes and risk factors

Exact cause of celiac disease is not known. Common risk factors are:

• Family history of celiac disease. There is about 10% chanve of getting this condtion if your first degree relatives have celiac disease.
• Geographic area. The Western Europe and the United States have the high incidence of celiac disease.
• Gender. Females have a slightly higher chance to get celiac than males.
• Type 1 Diabetes.
• Thyroid problems.

Symptoms and signs

Common gastrointestinal symptoms are:

• Diarrhea
• Malnutrition
• Dyspepsia
• Low apetite
• Abdominal bloating or cramps
• Severe abdominal pain
• Flatulence

Other symptoms that involves other parts of the body

• Anemia.
• Weakness and fatigue.
• Weight loss.
• Growth retardation in children.
• Bleeding and bruising easily.
• Osteopenia, osteoporosis, and bone fracture.
• Neurologic symptoms, such as weakness, sensory loss, tingling or numbness in the hands or feet, seizures, etc.
• Psychological symptoms, such as depression, anxiety, change of personality, etc.
• Skin changes, such as dermatitis herpetiformis, which is an itchy skin rash.
• Abnormal periods and infertility.

Diagnosis and Treatment

Diagnosis of celiac disease is usually based on symptoms, risk factors, and clinical suspicion with one or more of the following tests:

• Blood works
• Stool studies
• X-ray
• CT scan
• Endoscopy

After celiac disease is confirmed, treatment will focus on gluten free diet and management of complications. A nutritionist or dietitian may help and guide you to choose gluten free foods and balance your nutrition.

References:

1. PubMed Health.
2. Wikipedia.
3. Mayo clinic online health information.
4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
5. The Little Black Book of Gastroenterology-by David W. Hay.
6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.

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