What is Celiac Disease & Gluten Intolerance?
With the popularity of gluten-free diets and products, you may be wondering what is Celiac disease and gluten intolerance? Celiac disease affects approximately 1% of the American population. This number does not sound significant until you realize that translates to 3 million Americans! Celiac disease involves an autoimmune response to gluten, a protein found primarily in wheat, barley, and rye that makes dough elastic and gives bread its chewy texture. Typically, the autoimmune response affects the small intestine. More broadly, the term “wheat intolerance syndrome” encompasses Celiac disease, non-Celiac gluten sensitivity (gluten intolerance), and wheat allergies, each of which affects the body differently.
What is Celiac Disease?
Celiac disease is an autoimmune disorder wherein the immune system attacks the body as it would foreign invaders like bacteria and viruses. In the case of Celiac, gluten prompts an immune system attack on the small intestine, causing inflammation and a host of intestinal and multi-system problems. These can include:
- Abdominal pain
- Bone or joint pain
- Headaches or general fatigue
- Mouth ulcers
- Weight loss
Celiac disease is a genetic disorder and appears only in those with certain genes called HLA-DQ2 or DQ8. Even still, just a small percentage of people with those genes will develop Celiac. When left untreated, Celiac can lead to anemia, chronic fatigue, loss of bone density, impaired spleen, neurologic disorders, malnutrition, skin rashes, infertility, and cancer. There is a blood test to check for the disease, but it is not 100% accurate. If your test comes back negative but there is still a strong suspicion of Celiac, your gastroenterologist may perform an endoscopy to check for signs of inflammation and take biopsies.
If you are diagnosed with Celiac disease, the only treatment is to remove all forms of gluten from your diet completely and permanently. In addition to obvious sources like bread, pasta, cereal, beer, and baked goods, gluten can be found in surprising places, like toothpastes, medications, and some candies. It is recommended that patients with Celiac seek the assistance of a nutritionist to develop a gluten-free diet and address any nutritional deficiencies they may be experiencing as a result of the disease.
What is Gluten Intolerance?
Some patients have symptoms of Celiac disease – abdominal pain, bloating, gas, diarrhea, foggy brain, fatigue – but the results of their blood tests and endoscopies are negative for Celiac. If symptoms improve when gluten is eliminated from the diet and return when gluten is reintroduced, they are diagnosed with a condition called non-Celiac gluten sensitivity (NCGS).
This can be a controversial diagnosis because there are no tests for NCGS and it is not well defined. It does not appear to prompt an autoimmune reaction as with Celiac, nor do the symptoms match the traditional immunoglobulin response of a food allergy. If Celiac, wheat allergies, and other possible causes of symptoms are ruled out, and improvement is seen when following a gluten-free diet, then it is likely gluten intolerance or sensitivity. As with Celiac, adhering to a gluten-free diet is the only known treatment for NCGS at this time.
Understanding Celiac Disease and Gluten Intolerance
If you would like more information on what is Celiac disease and gluten intolerance, or if you are experiencing symptoms of gluten sensitivity, schedule an appointment with Dr. Malhotra, MD, FAARM, ABAARM today. As a Board Certified physician in Family Medicine as well as Board Certified with the American Board of Anti-aging and Regenerative Medicine, Dr. Malhotra can get to the root of your symptoms and develop a comprehensive treatment plan to restore you to your optimal health.