Celiac disease is an autoimmune disease in which the small intestine is damaged by the consumption of even the tiniest amount of gluten. According to recent statistics, 1 in 100 people in the world have celiac disease. Unfortunately, a large percent of people (80% of Americans), although experiencing early signs of celiac, are still not diagnosed. In fact, it takes 6 to 10 years on average to get properly diagnosed. This means that people are left to self manage the painful symptoms of celiac disease and many are unnecessarily suffering for years. Like other autoimmune diseases, celiac disease can manifest through a variety of symptoms that are seemingly unrelated. Let’s have a look at the early signs of celiac disease.
Symptoms of Celiac Disease
What exactly are early signs of celiac and how can you identify them? Celiac disease is linked to over 300 symptoms, so unfortunately there’s no one clear definitive answer to this question. Symptoms of most autoimmune illnesses are individual, and can vary from person to person.
The most common symptoms of celiac disease include digestive issues such as chronic diarrhea, stomach cramps, bloating, gas and constipation. Although ingestion of gluten in celiac patients physically damages the small intestine, this disease is not limited to stomach issues. It is an autoimmune disease, meaning it can affect every organ in the body.
Symptoms of celiac disease may be psychological, such as brain fog, depression and anxiety. Some patients experience fatigue, iron deficiency anemia and rapid, unexplained weight loss and weight gain. Infertility is also linked to celiac disease, as well as joint pain, weak bones and tooth enamel loss.
As you can see, these symptoms may seem unrelated and can point to various other conditions and illnesses. This is one of the reasons this disease is widely misdiagnosed.
Celiac Disease Diagnosis
There are two steps to diagnosing celiac disease: endoscopy and blood tests.
The blood tests that can help diagnose celiac disease are:
- Serology test, which looks for antibodies (Tissue Transglutaminase IgA antibody and IgA antibody) that indicate a reaction to gluten, and
- Genetic test for human leukocyte antigens which can be used to rule out celiac disease.
The upper gastrointestinal endoscopy is the most accurate test for celiac disease. With this procedure, the doctor can examine your small intestine through a camera that’s attached to a long, thin tube that’s passed down your throat to your stomach. While inspecting the damage to the small intestine, the doctor will take a small tissue sample (biopsy) to do further testing and confirm your celiac disease diagnosis.
Celiac Disease Treatment
As for now, there is no cure for celiac disease. The only treatment known to ease the symptoms and manage this disease is following a strict gluten free diet. This includes avoiding foods that are made in the same facility as gluten containing foods and contain traces of gluten. The gluten free diet is far more complex than it seems – there’s so much more to it than just avoiding bread. Gluten can be found in products you’d least suspect, such as toothpaste, medicine, cosmetics, chewing gum, etc.
The only available therapy for celiac disease is the GFD which usually reduces clinical symptoms and morbidity and increases nutritional parameters including body weight and bone density. However, studies have reported low patient satisfaction, high costs, and continued symptoms and histologic signs of intestinal damage, indicating that the GFD is not always optimal. Nonetheless, the concept that the GFD is an ideal therapy has contributed to the lack of effective alternative and adjunct treatments.
For the GFD to be effective, all wheat (gluten), rye (secalin), and barley (hoerdin) products must be strictly avoided. As little as 50 mg of gluten, an amount present in a few crumbs of bread or a small piece of pasta, can increase enteropathy.In addition to obvious sources of gluten such as bread and pasta, many products are contaminated with gluten during harvesting, processing, and packaging.Due to the combination of contamination of gluten-free foods and accidental and intentional gluten exposures, it is not possible for most people to remain totally gluten free.Kelly, C. P., Bai, J. C., Liu, E., & Leffler, D. A. (2015). Advances in diagnosis and management of celiac disease. Gastroenterology, 148(6), 1175–1186.
Article available at https://doi.org/10.1053/j.gastro.2015.01.044
Additionally, there are people with celiac disease that experience symptoms despite being on a strict gluten free diet for 6 months to a year. This condition is called non-responsive celiac disease, and it shows that there’s a need for an effective cure. The gluten free diet is a tool to manage this disease, but not enough of a treatment for many people.
Why should you get tested for celiac disease?
Celiac disease is associated with other autoimmune illnesses such as Type 1 Diabetes Mellitus, Arthritis, Hashimoto’s thyroiditis, Multiple Sclerosis, Lupus, Addison’s Disease and more. The later you get diagnosed with celiac disease, the greater the chance of developing one or more of these serious conditions.
If you’re experiencing any of the early signs of celiac, have a first degree relative with celiac disease, or have one of the associated autoimmune conditions, you should consider getting tested. You may not even be aware of it and not feel any obvious symptoms, but your small intestine might be damaged from gluten consumption.
When do symptoms appear? Early signs of celiac may appear in children and adults at any age, as early as 6 months old. Just like any other disease, it’s best to get tested early on to avoid further risks and complications.