By Brooke Douglas, Registered Dietician

Chances are very good that you know several people who have it – but just don’t know it yet.  If you have been diagnosed with celiac disease or you suspect you may have it, it is important for you to understand the condition in detail. 

Celiac disease is the most common genetic disease of mankind, occurring in about 1% of the population, yet most people who have it don’t know it.  And, people who go undiagnosed are at risk for developing a myriad of other conditions. 

Celiac disease is a genetic disorder in which gluten intolerance leads to damage to the lining of the small intestine.  In other words, people with celiac disease have sensitivity to gluten – a protein found in wheat, rye, oats (uncontaminated oats are ‘ok’) and barley (as well as malt, which is made from barley). 

In people with celiac disease, gluten damages the villi in the small intestine.  Villi are the small hair-like projections that are responsible for absorbing nutrients from digested food.  Eventually, the villi may become partially or even completely flattened, and unable to do their job.  When this happens, the body is deprived of basic nutrients, and the person may become malnourished and dehydrated.  There is good news, however.  The damage is completely reversible if gluten is removed from the diet. 

People often ask what causes celiac disease.  The truth is nothing causes it, although something may trigger it.  People with celiac disease have a “genetic predisposition” for developing it.  That is, they carry a gene or genes that may result in celiac disease under some circumstances, but not others. 

Celiac disease is multi-genetic.  This means that it’s more complex than being simply a dominant trait passed on by one parent, or a recessive trait passed on by both parents.  There are several genes involved, each of which may have different strengths of expression. 

The important thing to note is that if you have celiac disease, it’s because the disorder runs in one or both sides of the family.  Often after a child is diagnosed, parents will realize that, interestingly, Grandma had lymphoma (cancer), or Grandpa never did eat bread because he said it made him feel bad, or Dad feels lousy after drinking a beer, or someone in the family was told at some point that he or she had a wheat “allergy.”  It is likely that many of the family members have had celiac disease, but were never diagnosed. 

Genetics don’t tell the whole story, though.  We know this because identical twins, genetically the same in every way, do not always both get celiac disease.  In fact, in “only” 70-75% of identical twin sets do both twins have celiac disease; in the other 25-30%, only one of the twins has it.  The non-genetic factors are not yet known, but certain viruses and stress triggers are suspected. 

What are the Symptoms of Celiac Disease?

The symptoms of celiac disease result from the inability of the small intestine to absorb nutrients from food as it is digested.  These symptoms may appear as soon as you begin to eat gluten – usually just after a first birthday – or they may not show up until later in life.  Interestingly, the two most common age ranges for exhibiting celiac symptoms are the toddler years (ages 1-4) and the 50’s. Celiac disease is difficult to diagnose because the symptoms are so varied.  Some people exhibit “classic” symptoms such as diarrhea, malabsorption, gas and bloating.  Others may experience fatigue, anemia, irritability, vomiting, short stature or difficulty concentrating. 

It is extremely important to note that some people with celiac disease show absolutely no symptoms whatsoever.  These cases are called “asymptomatic” or “silent” celiac, but the damage is still being done.  It is also important to realize that just because you may not show these “classic” symptoms does not mean that you do not have celiac disease.  Celiac disease is a diagnosis based on the abnormality in the intestines, not the symptoms. 

How Is Celiac Disease Treated?

This is the beauty of celiac disease.  After diagnosis, a strict gluten-free diet will be prescribed.  Then you can expect to improve immediately!  Depending upon the severity of symptoms before diagnosis, you will be remarkably happier, more content and energetic, and have a much better appetite.  The bloated belly will slowly disappear, diarrhea should subside within a couple of weeks, and gas, cramping, and general not-feeling-well/discomfort will be a thing of the past. For kids, if growth was previously affected, it will increase quickly!  After a few weeks on the gluten-free diet, most people find that their energy levels increase substantially and they begin to “feel better” overall.  Within a matter of months you will see dramatic improvement!       

Ask your Sound Family Medicine physician if you are an appropriate patient to benefit from Medical Nutrition Therapy with Brooke.  Most insurance companies will cover nutrition consultations. Also, check your employee benefits plan at work.  Some plans cover up to $500 for counseling by a Registered Dietitian per year.

Brooke Douglas, RD, CD at www.NutritionAuthority.com