Celiac disease is an autoimmune disorder that damages the small intestine when gluten is ingested. Gluten is a protein found in wheat, barley, and rye. People with celiac disease have an abnormal immune response to gluten, which triggers an inflammatory reaction in the small intestine. This inflammation can damage the villi, which are small finger-like projections that line the small intestine. Villi are responsible for absorbing nutrients from food, so when they are damaged, people with celiac disease may not absorb enough nutrients from their diet.
Causes and mechanism of celiac disease development
The exact cause of celiac disease is not fully understood, but it is thought to be caused by a combination of genetic and environmental factors. The genetic risk factors for celiac disease include having certain human leukocyte antigen (HLA) genes. HLA genes are responsible for presenting antigens to the immune system. In people with celiac disease, the immune system mistakenly attacks the body's own tissues when gluten is ingested.
The environmental trigger for celiac disease is gluten. Gluten is a protein found in wheat, barley, and rye. When gluten is ingested, it is broken down into smaller peptides. These peptides can then bind to HLA-DQ2 or HLA-DQ8 molecules, which are present on the surface of immune cells. This binding triggers an immune response, which can lead to inflammation and damage to the small intestine.
Symptoms and course of the disease
The symptoms of celiac disease can vary from person to person and can range from mild to severe. Some common symptoms include:
- Diarrhea
- Weight loss
- Abdominal pain
- bloating
- Fatigue
- Anemia
- Indigestion
- Constipation
- Mouth sores
- Skin rash
- Depression
- Anxiety
The course of celiac disease can also vary from person to person. Some people may experience symptoms only when they eat gluten, while others may have symptoms even when they avoid gluten. In some cases, celiac disease can lead to complications such as osteoporosis, infertility, and neurological problems.
How is celiac disease diagnosed?
There is no single test that can definitively diagnose celiac disease. However, a combination of tests can be used to make a diagnosis. These tests may include:
- Blood tests: Blood tests can be used to measure levels of certain antibodies that are associated with celiac disease.
- Endoscopy with small bowel biopsy: An endoscopy is a procedure in which a doctor inserts a thin, flexible tube with a camera into the stomach and small intestine. During an endoscopy, the doctor can take a biopsy of the small intestine to look for damage caused by celiac disease.
- Genetic testing: Genetic testing can be used to determine if a person has the genetic risk factors for celiac disease.
Celiac disease prevention
There is no way to prevent celiac disease, but early diagnosis and treatment can help to prevent complications. If you have a family history of celiac disease, you may want to talk to your doctor about being tested for the disease.
Celiac disease - therapy and prognosis
The only effective treatment for celiac disease is a strict gluten-free diet. A gluten-free diet means avoiding all foods that contain wheat, barley, and rye. This can be challenging, but it is essential for people with celiac disease to follow a gluten-free diet in order to prevent symptoms and complications.
The prognosis for people with celiac disease who follow a gluten-free diet is generally good. With treatment, most people with celiac disease can live normal, healthy lives.
Here are some additional resources that you may find helpful:
- Celiac Disease Foundation: https://celiac.org/
- Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220
- National Institute of Diabetes and Digestive and Kidney Diseases: https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease