Understanding Celiac Disease
October 1, 2011
Celiac disease is often misunderstood and misdiagnosed. Yet, experts believe that nearly one in 100 people may have this autoimmune ailment, which is triggered by exposure to the protein gluten in wheat and similar proteins in rye and barley. People with celiac disease, or CD, have a genetic predisposition to the illness. Some researchers believe that CD sufferers also have an intestinal wall abnormality which allows gluten fragments to reach underlying cells, where they trigger an autoimmune reaction. As in any autoimmune disease, the body senses an invader, and launches an attack to drive it out. In CD, these attacks destroy cells in the small intestine's absorptive villi, finger-like projections that absorb nutrients from food. Eventually, CD sufferers' villi are totally flattened and cannot absorb nutrients. This dramatic chain of events is not the same as gluten intolerance, which causes other symptoms but does not involve an all-out autoimmune response. Children with CD often have digestive symptoms, such as abdominal pain, weight loss and diarrhea. Those diagnosed as adults commonly have fatigue and "head fog," and are more likely to have anemia, arthritis, depression, bone loss, infertility, joint pain, seizures, even hand or foot numbness. What an array of symptoms! No wonder diagnosing CD is tricky business.
If you have symptoms that match up with the signs of CD, tell your doctor. A simple blood test can check for an enzyme called tissue transglutaminase, which is released from damaged cells in the intestine. If that test is positive, doctors will study an intestinal tissue sample to confirm the structural symptoms. Those diagnosed with CD must stop eating wheat, barley and rye forever, without exception. While that prescription is clear, it is not easy to follow. Our food supply relies heavily on these grains, and cross-contamination of foods that are supposed to be "safe" can wreak havoc. So can other misinformation about the disease.