September 13 is National Celiac Awareness Day, an opportunity to learn more about a condition that can be difficult to recognize. Bloating, abdominal pain, diarrhea, constipation, and fatigue are common symptoms with many possible causes. For some people, however, they may be signs of celiac disease.
Celiac disease is an autoimmune condition in which eating gluten triggers an immune response that damages the small intestine. Without treatment, celiac disease can interfere with the body’s ability to absorb important nutrients.
What Is Celiac Disease?
Celiac disease affects about 1% of people. It develops in people with certain genetic factors who eat gluten, a protein found in wheat, barley, and rye.
When someone with celiac disease eats gluten, their immune system responds in a way that damages the lining of the small intestine. Over time, this damage can interfere with the absorption of nutrients.
Celiac disease is not the same as choosing to avoid gluten or having a gluten sensitivity. Non-celiac gluten sensitivity can cause symptoms after eating gluten without the intestinal damage seen with celiac disease. A wheat allergy is also different and involves an allergic reaction to proteins in wheat.
Celiac Disease Doesn’t Always Cause Stomach Problems
Celiac disease does not look the same in everyone. Celiac disease can cause digestive symptoms such as bloating, abdominal pain, diarrhea, constipation, nausea, and gas. Symptoms can also occur outside the digestive system.
Some people may experience unexplained fatigue, iron-deficiency anemia, bone or joint problems, headaches, skin rashes, weight changes, or neurological symptoms. Others may have few or no noticeable symptoms at all.
Who Is More Likely to Develop Celiac Disease?
Celiac disease can affect both children and adults. Having a close family member with celiac disease increases your risk, although you can develop the condition without a family history.
Certain genetic and autoimmune conditions are also associated with a higher risk of celiac disease. Your healthcare provider can help determine whether testing is appropriate based on your symptoms and medical history.
Is It Celiac Disease, IBS or Something Else?
The symptoms of celiac disease can look a lot like those of other digestive conditions. Bloating, diarrhea, abdominal discomfort, changes in bowel habits, and fatigue can occur with celiac disease, irritable bowel syndrome (IBS), and other gastrointestinal disorders.
Because these symptoms have many possible causes, it is worth getting evaluated rather than assuming they are IBS or a food intolerance. Proper testing can help identify the cause.
How Is Celiac Disease Diagnosed?
Diagnosis typically begins with a discussion of your symptoms, medical history, and family history. Blood tests can look for antibodies associated with celiac disease. An upper GI endoscopy with a small-intestine biopsy may also be used to confirm the diagnosis.
If you suspect celiac disease, talk with your provider before starting a gluten-free diet. Removing gluten before testing can affect the results and make diagnosis more difficult. Genetic testing may also be useful in certain situations.
What Happens After a Celiac Disease Diagnosis?
A diagnosis means learning how to avoid gluten and prevent further damage to the small intestine. The primary treatment for celiac disease is a strict, lifelong gluten-free diet. This involves more than avoiding bread and pasta. Gluten can be found in unexpected foods and products, and cross-contact can also be a concern.
A gastroenterologist or registered dietitian can help you understand how to follow a gluten-free diet while getting the nutrients your body needs. Follow-up care may include monitoring symptoms, nutritional deficiencies, antibody levels, bone health and, when appropriate, healing of the small intestine.
Why Diagnosis Matters
Untreated celiac disease can lead to complications such as iron-deficiency anemia, malnutrition, bone loss, and neurological problems. Diagnosis and proper management can help prevent ongoing intestinal damage.
Talk with a gastroenterologist if you have persistent digestive symptoms, unexplained iron-deficiency anemia or nutritional deficiencies, a family history of celiac disease, unexplained weight changes, or symptoms that seem connected to gluten-containing foods.
National Celiac Awareness Day is a reminder that persistent digestive symptoms deserve attention, especially when there is no clear explanation for them. Don’t self-diagnose or eliminate gluten before talking with a healthcare provider.
Find an experienced GI Alliance provider near you to discuss your symptoms and whether testing for celiac disease may be appropriate.
