Symptoms of celiac disease vary between
individuals. In childhood, celiac disease manifests itself primarily
with digestive symptoms such as chronic diarrhea; vomiting;
constipation; abdominal bloating and pain; pale, foul-smelling stools;
and weight loss. Due to nutrient malabsorption, an infant or child may
have other problems such as failure to thrive, delayed growth, short
stature, delayed puberty, and defects in the enamel of the permanent
teeth. Irritability is also a common symptom in children.
If celiac disease develops in adulthood, it is less likely to cause digestive symptoms. More commonly, adults will develop symptoms such as fatigue, unexplained iron-deficiency anemia,
bone and joint problems, depression or anxiety, canker sores in the
mouth, infertility, or a skin rash known as dermatitis herpetiformis.
It is entirely possible for someone with celiac disease to have no symptoms
at all, but still develop complications of the disease such as
malnutrition, anemia, osteoporosis, liver disease, and intestinal
Celiac disease has long been under-diagnosed or misdiagnosed. As
noted in a 2009 study, the prevalence of undiagnosed celiac disease
seems to have increased dramatically in the United States during the
past 50 years.
As more is learned about the variety of symptoms that people experience
and as better blood tests are developed, more people are being
diagnosed. If blood tests and a person's symptoms are consistent with
celiac disease, an intestinal biopsy is performed to confirm the
"A gluten-free diet is the 'prescription' for someone
with celiac disease," Sandquist said. The diet will stop the
symptoms, help to heal damaged areas of the intestine, and prevent
further damage. A person with celiac disease must stay on the diet for
the rest of their lives.
Eating gluten-free means excluding wheat, rye, barley, and all foods
made with these grains. This includes most breads, pasta, cereals, and
many processed foods. Instead of using wheat flour, potato, rice, soy,
amaranth, quinoa, buckwheat, or bean flour must be substituted.
The inclusion of oats in a gluten-free diet has been an area of
question in recent years, but according to Sandquist they can be
included. "The source of oats needs to be gluten-free. It's recommended
to wait a year (after diagnosis of celiac disease) to introduce oats
because there may be a subset of people with celiac disease who still
may not be able to tolerate oats. In most cases, the gut is healed after
a year on the gluten-free diet," Sandquist said.
CELIAC AND GLUTEN SENSITIVITY
Recent research has acknowledged the possibility that celiac disease and gluten sensitivity or intolerance are two separate gluten-associated disorders.
Some experts believe that gluten sensitivity may result from any of a
variety of causes: human genetics, plant genetic modifications, the use
of gluten as a food additive, environmental toxins, hormonal
influences, intestinal infections, or autoimmune diseases. There
currently is no clear definition or diagnosis for gluten sensitivity so
diagnosing it may be delayed in people who exhibit symptoms. A
gluten-free diet or an elimination diet may help people to determine if
they are gluten sensitive.