Celiac Disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food. The consumption of gluten also aggravates the small intestines creating chronic inflammation. Gluten is found primarily in wheat, barley, and rye. (Gluten may show up in unlikely places like salad dressings, Ketchup, BBQ sauces, etc.) At Granite Peaks Gastroenterology, we diagnose and treat Celiac Disease in our convenient Utah locations, and help those suffering with Celiac Disease understand and take control of their condition.
Do I have Celiac Disease?
“Most people who have Celiac have had symptoms for four years or more prior to being diagnosed- just this amount of time can result in quite a bit of damage to the small intestines,” says gastroenterologist David Schmidt, MD, who diagnoses several patients a month with Celiac Disease. Not a surprising number considering one in 141 Caucasians are diagnosed with it each year. (Celiac rarely affects people with Chinese, Japanese, or African ancestry.)
If left untreated, people can develop further complications such as anemia, vitamin deficiencies, osteoporosis, and cancer. Villi, minuscule finger-like projections, get worn down or blunted and become ineffective in absorbing nutrients. A lack of certain nutrients can have detrimental effects; for example, a lack of iron can result in anemia or a deficiency in vitamin D can lead to osteoporosis or even neurological dysfunction.
What are the symptoms of Celiac Disease?
The outward symptoms of someone with Celiac may include diarrhea, bloating, upset stomach, fatigue, headaches, and constipation among others. The disease can be asymptomatic as well. The symptoms can also overlap with or mimic other conditions such as being lactose intolerant or Irritable Bowel Syndrome. “There is a major distinction between being lactose intolerant and Celiac when considering the symptoms,” points our Dr. Schmidt. “When you’re exposed to glutens, it is actually doing damage to your body, long term. That is why it is so important to diagnose.” It is estimated that 83% of Americans who have Celiac Disease are undiagnosed or misdiagnosed with other conditions.
Testing for Celiac Disease
Testing for Celiac Disease can be done with blood tests or with an upper endoscopy. The blood test involves measuring antibodies and the immune response to gluten. These tests have a track record of being over 95% accurate. If tests results are positive, an upper endoscopy procedure will follow to secure a small biopsy of the villi in the small intestines to confirm the diagnosis and the extent of damage and severity of the disease. An accurate diagnosis is very important – as patients will be changing their eating habits for the rest of their lives.
It is possible that if one person in the family has Celiac Disease, then there will be other relatives that have it too. Other family members may also have another autoimmune disorder such as Rheumatoid Arthritis, Type 1 Diabetes, Lupus, or a thyroid condition. Genetically, up to 40% of Caucasians have one or both of the genes that are associated with Celiac Disease. Being a carrier, however, does not always mean you will have the disease.
“When I’m listening to my patients, I’m looking for red flags such as a family history of sensitive stomachs or food allergies or other autoimmune diseases,” says Dr. Schmidt. “This knowledge helps me sift through the symptoms that at first may seem like Irritable Bowel Syndrome, ulcers, Crohn’s Disease, or even a diseased gallbladder.” He looks for whether his patient has a first-degree relative (i.e., child, parent, or sibling) with Celiac or if there have been several diagnoses of Celiac in extended family members.
When diagnosed, Dr. Schmidt is quick to reassure his patients that living a gluten-free lifestyle is not near as tricky as it used to be. Now, grocery stores and restaurant menus abound with gluten-free options. Plus, plenty of naturally occurring gluten free foods offer healthy options, such as vegetables, fruits, and meats.
“You might have to say ‘No’ to a chicken nugget but you can say ‘Yes’ to a chicken breast,” Dr. Schmidt tells his patients. “I let them know it is a double-edged sword. The answer is not just a prescription for a pill – which I understand can be frustrating to some people. It is about making healthy gluten-free food choices on an on-going basis. You may be tempted to cheat, but be vigilant because there is a lot at stake.”
May Marschner, PA-C, tells her patients, “Once you commit to a gluten-free lifestyle, you will feel so much better. Your symptoms usually disappear quickly. You’ll wish you had come in years ago. Bagels may look tempting, but if you stick with eggs, bacon, and fruit, you’ll feel just as satisfied and your body won’t have to pay the price.”