Severe Celiac Disease

Celiac Disease

Ambulatory Care,Gastrointestinal

Written by the doctors and editors at UpToDate
What is celiac disease? — Celiac disease is a condition that impairs your body's ability to break down certain foods. People who have the disease get sick if they eat bread, pasta, pizza, and cereal. These foods and others contain a protein called "gluten." Gluten damages the intestines of people with celiac disease (figure 1). As a result, their bodies can't absorb nutrients from food. The disease affects children and adults.
What are the symptoms of celiac disease? — Some people with celiac disease have no symptoms. When symptoms do occur, they can include:
Pain in the belly
Diarrhea
Bowel movements that are oily and float
Weight loss
Feeling bloated, or too full all the time
Low appetite
Bad gas
Itchy skin rashes
Invisible symptoms, such as weak bones or low iron levels
Slow growth in children
Should I see a doctor or nurse? — If you think you have celiac disease, see a doctor before cutting out gluten from your diet. It's the only way to make sure you get the right kind of help.
Should I take my child to the doctor? — Your child should see the doctor if he or she:
Has diarrhea that lasts for weeks
Has constipation that won't go away
Has brown or yellow teeth with pits or grooves in them
Is too small or light for his or her age
Is close to becoming a teenager but does not seem to be going through the changes that teenagers go through (doctors call this "delayed puberty")
Has other family members with the disease
Is there a test for celiac disease? — Doctors use more than one test to diagnose celiac disease:
Blood test – A blood test looks for proteins that some people make after eating gluten. People who have celiac disease have lots of these proteins, called antibodies. You should ideally be on a gluten-containing diet for several weeks before getting the blood test. If you are on a gluten-free diet, your doctor might do other blood tests to see if you are genetically likely to have celiac disease.
Biopsy – To do a biopsy, the doctor will put a thin tube with a tiny camera down your throat. When the tube is in your small intestine, he or she will take a small sample of tissue. That way he or she can look at the tissue under a microscope and see if eating gluten has damaged the intestine.
How is celiac disease treated? — The best treatment is to stop eating gluten completely. This might be hard to do at first. You will need to avoid rye, wheat, barley, and maybe oats. These ingredients appear in many common foods, including:
Bread, pasta, pastries, and cereal
Many sauces, spreads, and condiments
Beers, ales, lagers, and malt vinegars
You should also avoid milk, cheese, and other dairy foods at first. These foods can be hard to break down. You will want to wait to eat these foods until after your intestines have a chance to heal.
Foods that do not contain gluten (and are fine to eat) include:
Rice, corn, potatoes, buckwheat, and soybeans
Fruits and vegetables
Flours, pasta, and other products made from these ingredients that have a label on them that says "gluten free"
Wine and distilled alcoholic drinks, such as rum, tequila, vodka, and whiskey
Your doctor might also prescribe vitamins to make up for nutrients that you have not been getting from food.
What will my life be like? — People usually feel a lot better within 2 weeks of starting a gluten-free diet. Still, most people need to make huge changes in their lives to avoid gluten.
A health expert can help you learn how to change your eating habits and still be healthy. You will also need to learn how to read and understand labels on foods.
You will probably need to avoid gluten for the rest of your life. Your doctor will most likely suggest getting a blood test at least once a year. This is to see how your body is responding to a gluten-free diet.
The hardest part about the disease is learning to eat in a whole new way. The good news is, there are plenty of foods made just for people with celiac disease. The new diet just takes a little getting used to.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15378 Version 8.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

Adult Celiac Disease,Celiac Sprue,Coeliac Disease,Gluten Enteropathy,Gluten Intolerance,Gluten Intolerance/Sensitivity,Gluten Sensitivity,Gluten-Induced Enteropathy,Gluten-Sensitive Enteropathy,Nontropical Sprue

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