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Celiac Disease


Major Spencer
Celiac disease is a chronic, or long-lasting, disease in which foods containing gluten cause inflammation of the small intestine. Dr. Malone, what can you tell us about celiac disease?

Dr. Malone
Well, Major Spencer, gluten describes a specific protein found in wheat, barley, rye, and related grains. In people with celiac disease, when food containing gluten reaches the small intestine, the immune system reacts against the gluten, causing the wall of the intestine to become inflamed.

Millions of finger-like projections, called villi, line the small intestine. Villi increase the surface area of the intestine so that more nutrients can be absorbed. The inflammation from celiac disease damages these villi, which decreases the ability of the intestine to absorb nutrients from food. The good news is that damage is reversible. When gluten is removed from the diet, inflammation is reduced and the villi begin to heal.

Many people who have celiac disease may not know they have it until symptoms are triggered. Those symptoms can include:

  • Abdominal pains
  • Bloating and gas
  • Diarrhea
  • Stools that float or smell very bad
  • Weight loss
  • Skin rash specific to celiac
  • Symptoms of nutritional deficiencies
  • Poor growth or weight loss in children, and
  • Anemia

Sometimes symptoms are more vague, including fatigue and feelings of un-wellness, other skin changes, and even constipation or weight gain. It's important to note that some people with celiac disease may have few or no symptoms, but damage to the lining of the intestine is still occurring.

If a provider suspects that a patient may have celiac disease, they may order blood tests to check for the presence of specific antibodies. Genetic tests may also be ordered to look for the genes that enable celiac disease.

However, endoscopy is the most accurate way to diagnose celiac disease. During an endoscopy, a thin, flexible tube with a tiny camera on the end, called an endoscope, is passed through the mouth into the stomach and small intestine. Special tools can be passed through the endoscope to take tissue samples from the wall of the small intestine, which is necessary to confirm diagnosis of celiac.

The treatment for celiac disease is avoiding all foods that contain gluten. When gluten is removed from the diet, the intestine will heal and return to normal.