Celiac disease
What is Celiac disease?
Celiac disease is an autoimmune condition where eating gluten triggers your immune system to attack your small intestine. Gluten is a protein found in wheat, barley, and rye. When people with celiac disease eat gluten, their body produces antibodies that damage the lining of the small intestine. This damage makes it hard for your body to absorb nutrients from food.
Over time, this damage can lead to malnutrition, bone loss, infertility, and other serious health problems. About 1 in 100 people worldwide has celiac disease. Many people live with it for years without knowing because symptoms can be mild or confusing. The only treatment is strictly avoiding gluten for life.
Celiac disease is different from gluten sensitivity or wheat allergy. It involves a specific immune response and genetic predisposition. Certain genes, particularly variants of HLA DQB1, increase your risk. If you have a family member with celiac disease, your risk is higher than the general population.
Symptoms
- Diarrhea or constipation that lasts for weeks
- Abdominal pain, bloating, and gas
- Fatigue and weakness
- Unexplained weight loss
- Nausea and vomiting
- Skin rash called dermatitis herpetiformis
- Iron deficiency anemia
- Bone or joint pain
- Headaches or brain fog
- Tingling or numbness in hands and feet
Some people with celiac disease have no digestive symptoms at all. They may only experience fatigue, anemia, or other signs of malnutrition. Children may have growth delays or dental enamel problems. Because symptoms vary so much, celiac disease is often misdiagnosed or missed for years.
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Causes and risk factors
Celiac disease happens when your immune system mistakes gluten for a threat and attacks your small intestine. The condition has a strong genetic component. People who carry certain variants of the HLA DQB1 gene have a much higher risk. Nearly all people with celiac disease carry either HLA-DQ2 or HLA-DQ8 gene variants. However, having these genes does not guarantee you will develop the condition.
Environmental triggers also play a role. Some research suggests that viral infections, surgery, pregnancy, or severe stress may activate celiac disease in people who are genetically predisposed. Infant feeding practices and the timing of gluten introduction may influence risk. Having other autoimmune conditions like type 1 diabetes or thyroid disease also increases your likelihood of developing celiac disease.
How it's diagnosed
Diagnosis starts with blood tests that look for specific antibodies your body makes in response to gluten. The most common test measures tissue transglutaminase antibody IgA, or tTG-IgA. Doctors may also check total IgA levels to ensure your immune system produces enough of this antibody for accurate results. Some tests look at HLA DQB1 genes to assess genetic risk.
If blood tests suggest celiac disease, your doctor will usually recommend an upper endoscopy with a biopsy. This procedure takes small samples of your small intestine to check for damage. It is important to keep eating gluten before testing, or results may be inaccurate. Talk to a doctor about specialized testing for celiac disease. Rite Aid offers some general health markers, but celiac-specific antibody testing requires specialized labs.
Treatment options
- Follow a strict gluten-free diet for life, avoiding wheat, barley, rye, and contaminated oats
- Work with a registered dietitian who specializes in celiac disease
- Read food labels carefully and watch for hidden sources of gluten
- Take vitamin and mineral supplements if you have deficiencies, especially iron, calcium, vitamin D, and B vitamins
- Monitor your intestinal healing with follow-up blood tests and possibly repeat endoscopy
- Join a celiac disease support group for practical tips and emotional support
- Be cautious when eating out and communicate clearly with restaurant staff about cross-contamination
- Consider genetic testing for family members, as they have higher risk
Frequently asked questions
Gluten is found in wheat, barley, rye, and most oats due to cross-contamination. This includes bread, pasta, cereals, baked goods, beer, and many processed foods. Always read labels carefully, as gluten hides in sauces, soups, and even some medications. Look for certified gluten-free products to ensure safety.
Yes, celiac disease can appear at any age, from infancy to older adulthood. Some people are diagnosed as children, while others develop symptoms later in life after years of eating gluten without problems. A triggering event like infection, pregnancy, or stress may activate the condition in genetically susceptible people. If you have symptoms, getting tested is important regardless of your age.
No, celiac disease is an autoimmune disorder that causes measurable intestinal damage and specific antibody responses. Gluten intolerance or sensitivity causes symptoms when eating gluten but does not trigger the same immune response or intestinal damage. Celiac disease requires strict lifelong gluten avoidance and has serious health consequences if untreated, while gluten sensitivity is generally less severe.
Tissue transglutaminase IgA antibody tests are about 95% accurate when you are actively eating gluten. However, you must be consuming gluten regularly for several weeks before testing, or results may be falsely negative. Total IgA levels should also be checked, as some people have IgA deficiency that can affect test accuracy. A positive blood test is usually confirmed with an intestinal biopsy.
Untreated celiac disease can lead to serious complications over time. These include malnutrition, osteoporosis, infertility, neurological problems, and increased risk of certain cancers. You may develop other autoimmune diseases or experience chronic pain and fatigue. The good news is that following a gluten-free diet allows your intestine to heal and prevents most complications.
Many people notice symptom improvement within a few weeks of removing gluten from their diet. However, complete intestinal healing can take months to years, especially in adults. Younger people tend to heal faster than older adults. Stick with the diet even if you feel better quickly, as healing continues beneath the surface.
Genetic testing for HLA DQB1 variants can help rule out celiac disease if you test negative for the genes. Nearly everyone with celiac disease carries HLA-DQ2 or HLA-DQ8 genes. However, many people have these genes and never develop the condition. Genetic testing is most useful when other test results are unclear or for screening family members.
No, if you have celiac disease, you must avoid gluten for life. Even small amounts can trigger intestinal damage and increase your risk of complications. There is currently no cure or medication that allows people with celiac disease to safely eat gluten. Researchers are studying potential treatments, but strict avoidance remains the only proven therapy.
Yes, first-degree relatives of people with celiac disease have about a 10% chance of having it themselves. Parents, siblings, and children should be tested even without symptoms. Testing typically includes blood work for celiac antibodies. Genetic testing can also identify family members who carry high-risk gene variants and may benefit from periodic monitoring.
Common deficiencies include iron, calcium, vitamin D, vitamin B12, folate, and zinc. Damage to your small intestine prevents proper absorption of these nutrients from food. Your doctor should test your levels and recommend appropriate supplements. Once you follow a gluten-free diet and your intestine heals, nutrient absorption usually improves significantly.