Coeliac disease–more commonly spelled celiac disease and also called gluten-sensitive enteropathy, celiac sprue and nontropical sprue–is an incurable yet treatable genetic disorder characterized by an abnormal immune-system reaction to ingesting the protein gluten. According to the National Institutes of Health, coeliac disease is found worldwide, and more than 2 million Americans have it.
Although coeliac disease often has no recognizable symptoms, which often causes it to go undetected for years, its impact is lifelong and profound. The condition targets the small intestine, which the immune system attacks every time the person ingests gluten, a protein found naturally in barley, rye and wheat, and as an added product in items like lip balm and some medicines.
The resulting damage leads to a decrease in the number of villi, small protrusions along the small intestine’s lining that are responsible for the absorption of food nutrients through the small intestine’s walls and subsequent passage to the bloodstream. Once that process is hampered, the person with coeliac disease becomes malnourished, regardless of the quantity or types of food eaten.
Symptoms of the disease differ. Adults usually have fewer digestive problems and other signs that include anemia, anxiety or depression, arthritis, bone or joint pain, fatigue, an inability to conceive or carry a baby to term, missed periods in women, oral canker sores, osteoporosis, seizures, the skin rash dermatitis herpetiformis and tingling in the extremities.
Young children and infants are more likely to have irritability, in addition to digestive problems, such as bloating and pain in the abdominal area, constipation, diarrhea, uncommonly smelly or pale stool, vomiting and weight loss.
Determining when coeliac disease is present is difficult because the condition’s symptoms are similar to other conditions that produce malabsorption, or the improper absorption of nutrients. Since sufferers tend to have abnormally high levels of specific autoantibodies–namely, anti-endomysium, anti-gliadin, and anti-tissue transglutaminase–testing the blood for the presence of such proteins can help determine if a person has or is likely to develop coeliac disease.
Another diagnostic approach is following a diet free of gluten, only under close medical supervision, to see if subsequent blood tests are normal. If coeliac disease is suspected, a biopsy of the small intestine normally follows for confirmation.
There is only way to treat coeliac disease: maintain a gluten-free diet for life. Removing the protein from the foods eaten will reduce the inflammation targeting the small intestine, and the person will often feel healthier in as little as several weeks.
People with coeliac disease frequently have no recognizable symptoms or erroneously attribute present symptoms to other medical conditions. Whether a person has symptoms, coeliac disease will cause progressive and lifelong complications, such as the hallmark malnutrition, which in turn can lead to secondary health conditions, including anemia, intestinal cancer, liver disease and osteoporosis. The longer it takes to diagnose coeliac disease, the more severe the related complications tend to be.