Celiac disease is an autoimmune disorder in which the small intestine is hypersensitive to gluten – a protein commonly found in wheat, rye, and barley. Gluten is typically found in foods such as bread, pasta, pizza, pastries, and cereal. Consuming these foods causes damage to the lining of the intestine. This leads to difficulty absorbing nutrients from food. While there are only 40,000 known cases of celiac disease in the United States, it’s estimated that this digestive disorder affects more than two million Americans – including adults, adolescents, and children. People who have a first-degree relative with celiac disease have a 1 in 10 risk of developing it. Other high-risk groups include those who have Down syndrome, type 1 diabetes, autoimmune thyroid disease, and juvenile chronic arthritis.
Signs & Symptoms
Celiac disease can be difficult to diagnose because it affects people differently. Some develop celiac disease as children, while others later as adults. The ‘classic’ symptoms of celiac disease include:
- Abdominal Pain and Bloating
- Chronic Diarrhea
- Weight Loss or Failure to Thrive
- Pale, Foul-smelling, or Fatty Stool
Some of the less typical, non-gastrointestinal manifestations may include:
- Arthritis / Joint Pain
- Osteopenia / Osteoporosis
- Dental Enamel Defects
- Delayed Growth and Puberty
- Dermatitis Herpetiformis (itchy skin rash)
- Depression or Anxiety
- Irritability and Behavioral Issues
- Seizures or Migraines
- Iron Deficiency Anemia
- Missed Menstrual Periods
- Infertility or Recurrent Miscarriage
Young children tend to exhibit more classic signs of celiac disease along with growth problems, while older children and adults tend to have symptoms that are not entirely gastrointestinal in nature. Recent research has demonstrated that only a third of adult patients diagnosed with celiac disease experience diarrhea. In fact, the most common sign of celiac disease in adults is iron deficiency anemia that does not respond to iron therapy.
Detection & Treatment
If you are experiencing these symptoms or have additional risk factors, you should be evaluated for celiac disease by a gastroenterologist. It is advised to see a doctor first before cutting out gluten from the diet, which will help make diagnostic testing more accurate. Highly sensitive and specific tests can be useful screening tools. If celiac disease is suspected, an upper endoscopy with small intestinal biopsies is recommended to confirm the diagnosis. Once confirmed, living a lifelong gluten-free diet is the only known treatment available at this time. Guidance from your physician or a registered dietitian can be quite helpful in maintaining a balanced, nutritious diet.
Atlanta Gastroenterology Associates offers comprehensive nutrition counseling at many of our offices across Metro Atlanta. Our registered dietitians have helped many people suffering from celiac disease achieve and maintain a healthy and happy gluten-free lifestyle.
About Dr. Patel
Nirav R. Patel, MD is a board certified pediatric gastroenterologist with Atlanta Gastroenterology Associates and sees patients in Alpharetta, Marietta, and Sandy Springs. He evaluates and treats all types of digestive and liver diseases and has a special interest in inflammatory bowel disease, celiac disease, chronic constipation, gastroesophageal reflux disease, and eosinophilic esophagitis. A University of Georgia graduate, Dr. Patel completed his medical degree at St. George’s University School of Medicine in Grenada, West Indies, and fellowship in pediatric gastroenterology and nutrition at New York-Presbyterian Hospital/Weill-Cornell Medical Center in New York, N.Y. He is fluent in Gujarati.