Hopkins 24/7

Back to ABC News

This Thursday at 10/9c

This content requires javascript and flash player version 8.

Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

Close Article Browser

Celiac Disease

What is it?

Celiac disease (also referred to as celiac sprue and gluten-sensitive enteropathy) is a digestive disorder caused by an intolerance to a protein (gliadin) found in gluten—the component of wheat that makes flour smooth and elastic. A related compound is found in other grains, such as barley, rye, bulgur, and matzo meal. In people with this disorder, ingestion of gluten produces an immune reaction that damages the lining of the small intestine, resulting in symptoms such as diarrhea, flatulence, bloating, and vitamin deficiency owing to nutrient malabsorption.

Celiac disease can occur at any age, but usually first appears during infancy or early childhood. However, the symptoms are often mild or absent, and so many cases go undiagnosed until adulthood. In some instances, people first experience symptoms following an infection, an injury, pregnancy, surgery, or severe psychological stress. It is unclear, however, why or how these factors influence celiac disease.

Through complete removal of gluten from the diet, patients can expect to recover from the disorder itself. However, celiac disease is often associated with other autoimmune disorders, such as certain thyroid diseases, scleroderma, Sjögren's syndrome, systemic lupus erythematosus, and type 1 diabetes. In addition, those with the disorder are at increased risk for non-Hodgkin's lymphoma.

What Causes It?

  • The exact cause of celiac disease is unknown, but it appears to have a hereditary component.
  • It is more common in people of European decent than in others.

Prevention

  • Celiac disease is not preventable, but sufferers can reduce the chance of a recurrence of the disease by following a gluten-free diet.

Diagnosis

  • A patient history and physical exam are the first steps toward getting diagnosed with celiac disease.
  • Blood tests can uncover vitamin and mineral deficiencies; blood serum is analyzed to detect antibodies that are highly suggestive of celiac disease.
  • Stool samples may be analyzed for signs of steatorrhea (abnormally high levels of fat in the stool due to malabsorption).
  • The gold standard for diagnosing celiac disease is a biopsy of the lining of the small intestine, which is taken during an endoscopic exam.

How to Treat It

  • Patients are instructed to eliminate all sources of gluten from the diet. Most patients are referred to a registered dietitian to learn both acceptable and unacceptable foods for this lifelong diet.
  • A gluten-free diet excludes most grains and other ingredients that contain gluten, such as soy sauce, modified food starch, and vegetable protein. Hidden sources of gluten, such as postage stamps, are also excluded.
  • Safe foods include rice, soybean, potato and corn flours, a moderate amount of oats, plain meats, fruits, vegetables, and most dairy products.
  • Many people with the disorder also experience lactose intolerance, so dairy foods may have to be avoided.

When to Call a Doctor

  • Contact a doctor if you have chronic gastrointestinal discomfort or other symptoms that signal celiac disease.