Information From Your Health Care Provider

CELIAC DISEASE

(Gluten Enteropathy; Non-Tropical Sprue)

Basic information

description

Celiac disease is a digestive disorder that damages the intestines and prevents the body from getting nutrients from food. It occurs when foods that contain gluten, a protein found in grains (wheat, rye, and barley), cause an immune reaction in the body. Symptoms may begin at any age in a child or an adult. Symptoms often start during infancy or early childhood after the child begins eating food with gluten. In adults, symptoms may develop gradually over months or even years.

FREQUENT SIGNS & SYMPTOMS

Symptoms vary from person to person and from one episode to another.
Weight loss or slowed weight gain in an infant following the introduction of cereal to the diet.
Poor appetite. Weight loss in older children or adults.
Loose, pale, bulky, bad-smelling stools; frequent gas.
Swollen abdomen; stomach pain. Muscle cramps.
Mouth ulcers.
Anemia or vitamin deficiency, with fatigue, pale skin, skin rash, or bone pain.
Mildly bowed legs in children.
Vague tiredness and weakness. Swollen legs.
Irritability, depression, or anxiety.
Adults tend to have fewer of the digestive symptoms and more of other, general types of symptoms.

causes

The exact cause is unknown. It is an autoimmune disorder because the body's own immune system causes the damage to the lining of the small intestine. A person inherits the tendency to get celiac disease.

risk increases with

Family history of celiac disease. A person's risk is about 10% if a first-degree relative has celiac disease.
The disease may be triggered, or becomes active, after surgery, with pregnancy or childbirth, a viral infection, or severe emotional stress.

PREVENTIVE MEASURES

Cannot be prevented at present.
Continuing to breast-feed at the time cereal is first given to an infant appears to reduce the risk.

expected outcomes

With a strict, gluten-free diet, most persons with celiac disease can expect a normal life. Improvement of symptoms begins in 2 to 3 weeks.

possible complications

If untreated, malnutrition and anemia can occur.
Celiac disease patients are more likely to have other autoimmune disorders, diabetes, dermatitis herpetiformis, certain cancers, and other medical problems.

diagnosis & treatment

general measures

Your health care provider may do a physical exam and ask questions about your symptoms and diet. Medical tests may include blood, urine, and stool studies. A biopsy may be done (small sample of tissue is taken from the small intestine for viewing under a microscope). Sometimes, diagnosis is based on a person going on a gluten-free diet to see if the symptoms stop.
The only treatment is a gluten-free diet.
To learn more: Celiac Sprue Association, PO Box 31700, Omaha, NE 68131; (877) 272-4272; website: www.csaceliacs.org or Celiac Disease Foundation, 13251 Ventura Blvd., Studio City, CA 91604; (818) 990-2354 (not toll free); website: www.celiac.org.

medications

Iron and folic acid for anemia may be prescribed.
Calcium and multiple-vitamin supplements for deficiencies may be recommended.
Cortisone drugs to reduce the body's inflammatory response may be prescribed.

activity

No limits.

diet

Gluten-free diet. Gluten is found in wheat, rye, barley, and possibly oats. It is difficult to exclude gluten from the diet completely. Be patient while becoming familiar with the diet. A dietitian can help you with a diet plan.

notify our office if

You or your child has symptoms of celiac disease.
Symptoms don't decrease after 3 weeks of eating a gluten-free diet.
Symptoms recur after they have been absent.
The child fails to regain lost weight or grow and develop as expected.