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I’m worried that I may have celiac disease. I can’t eat wheat products without feeling sick afterwards. What exactly is it and how does it differ from being gluten intolerant?

— Sandy, Dietrich

Answered by Dr. Judith Csanky, St. Luke’s Clinic, Gastroenterology:

Celiac disease is a condition that damages the lining of the small intestine and prevents it from absorbing parts of food that are important for staying healthy. The damage is due to an immune system-related reaction to eating gluten, which is found in wheat, barley and rye. The disease can affect any part of your body, not just your intestinal tract.

You can have celiac disease and not have intestinal issues. Symptoms can include unexplained seizures, bone fractures and anemia. Women who have had one or two miscarriages or who have had difficulty getting pregnant may have the disease. Depression or personality disorders can also be indicators of celiac disease. One is not normally tested if you don’t have any family history or autoimmune disease.

The most common issues in celiac disease are bowel changes, diarrhea or constipation. Ten percent of people who have irritable bowel syndrome have celiac disease. Autoimmune diseases like Hashimoto, colitis, dry-eye or lupus can also be an indicator of the disease. With celiac disease, a person may experience many symptoms or nothing at all.

It is very important to distinguish between having gluten intolerance and celiac disease. Gluten intolerance is like lactose intolerance and can make you miserable, but is not life-threatening. With gluten intolerance, you may feel bloated or have heartburn or indigestion. Celiac disease is an immune-related disease and without treatment, can be dangerous. A person’s own immune system attacks certain parts of the small intestine, causing decreased absorption of nutrients the body needs. Celiac disease increases your risk of getting cancer threefold.

Treatment for celiac disease is a radical change in diet, including absolutely no wheat in food and no gluten in other products that may be used in daily life. For some, anything which can be absorbed by the body, including shampoos, makeup, detergent, etc., needs to be totally gluten free. With this strict diet change, the symptoms of the disease can go away. There is one kind of celiac disease — refractory celiac disease — that can’t be cured by diet alone. Medication can be prescribed to aid treatment.

If you suspect you may have celiac disease, see your primary care provider and get blood work done to determine if you need to see a specialist.

Disclaimer: The content of this article is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Do not stop or delay seeking treatment because of something you read in this article. Further, the views or opinions expressed in this article are for informational purposes only and do not necessarily represent those of St. Luke’s. Reliance on any information provided by St. Luke’s, St. Luke’s employees or others supplying information for the column at the invitation of St. Luke’s is solely at your own risk.


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