Celiac Disease (Celiac Sprue)

Celiac disease, also called celiac sprue, is a reaction by your body's immune system that occurs in your small intestine when you eat gluten, a protein in wheat, rye and barley.

Your small intestine's lining reacts by becoming inflamed and damaged. When that happens, your body doesn't properly absorb nutrients from the food you eat.

Doctors don't know exactly what causes celiac disease, and there is no cure. Often, celiac disease is undiagnosed. It can be triggered for the first time by a virus, emotional stress, pregnancy, childbirth or surgery.

You can often manage your symptoms by eating a gluten-free diet.

You Are at Risk for Celiac Disease (Celiac Sprue) if You Have:

  • A family member with celiac disease or a related condition
  • Type 1 diabetes
  • An autoimmune thyroid condition
  • Sjogren's syndrome
  • Down syndrome
  • Turner syndrome
  • Addison's disease
  • Intestinal cancer
  • Dermatitis herpetiformis (an itchy, blistering rash)
  • Ulcerative colitis
  • Rheumatoid arthritis
  • Lupus
  • Epilepsy

Anyone can get celiac disease. People in the above groups are at a higher than average risk for developing the condition.

Symptoms

Symptoms of celiac disease vary. The most common symptoms are diarrhea and weight loss, but that can be misleading. Only one-third of people with celiac disease have diarrhea. Only about half lose weight. Some people have constipation or are obese. Often, children with celiac disease are overweight.

When symptoms do happen, they can include:

  • Weight loss
  • Diarrhea
  • Bloating
  • Malnutrition
  • Anemia
  • Damage to tooth enamel
  • Headache
  • Tiredness
  • Low bone density
  • Joint pain
  • Acid reflux or heartburn
  • Dermatitis herpetiformis (an itchy, blistering rash)
  • Problems with your spleen
  • Numbness or tingling in your feet or hands
  • Problems with your balance

Symptoms in children can include:

  • Diarrhea
  • Constipation
  • Stomach pain after eating
  • Delayed puberty
  • Short height
  • Lack of muscle coordination
  • Headaches
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Learning disabilities
  • Swollen abdomen (infants)
  • Pain (infants)
  • Failure to thrive (infants)

Diagnosis

If you think you might have celiac disease, talk to your doctor about testing before you try a gluten-free diet. If you first eliminate gluten from your diet, your test results may be skewed and your disease won't be properly diagnosed.

You may have these tests to determine if you have celiac disease:

  • Blood tests to check for an immune reaction to gluten
  • Endoscopy to get a biopsy (tissue sample) from your small intestine
  • Capsule endoscopy to get pictures of your digestive tract for your doctor to review

It is important to get a proper diagnosis for celiac disease and, if you have it, to eliminate gluten from your diet. If you have celiac disease and do not change your diet, you can develop malnutrition, anemia, weight loss, calcium loss and low bone density. Children can have delayed development and growth.

Women who have malnutrition from untreated celiac disease can have fertility problems and higher risk of miscarriage.

You also have a higher risk of developing some types of cancer if you have celiac disease and do not adopt a gluten-free diet.

Treatment

The only treatment for celiac disease is to control your symptoms by avoiding gluten.

The inflammation in your small intestine decreases when you eliminate gluten from your diet. You may start to feel better within a few days or a few weeks. It takes a few months for your intestine to heal.

It's important to avoid gluten as much as possible if you have celiac disease. If you eat even a little bit, your intestine can become inflamed. If you eat gluten after you've eliminated it from your diet, you may have stomach pain and diarrhea.

Your doctor may recommend you meet with a dietitian to learn more about eating a gluten-free diet.

Foods and drinks with gluten include:

  • Wheat
  • Rye
  • Barley
  • Malt
  • Semolina
  • Durum
  • Farina
  • Bulgur
  • Spelt
  • Triticale
  • Graham flour

Foods that are generally safe to eat include:

  • Fruit
  • Vegetables
  • Potatoes
  • Wine and distilled cider and spirits
  • Most dairy products
  • Fresh meat and poultry
  • Fresh fish
  • Rice
  • Corn and cornmeal
  • Corn tortillas
  • Quinoa
  • Tapioca
  • Buckwheat

Your doctor may prescribe vitamins and supplements to make up for nutrients you lose with celiac disease.

Some people need medication to treat inflammation and damage in the small intestine.

You can develop a skin condition called dermatitis herpetiformis with celiac disease. It causes a rash with itching and blistering, and is treated with a topical medication (cream or ointment).

Our gastroenterology specialists are experienced in treating every colorectal condition, including celiac disease.

Find an Aurora Health Care GI Specialist