What You Need to Know About Celiac Disease

You've seen them on hundreds of products, in specialty aisles at your local grocery store, on restaurant menus—even on "South Park." And these two little words mean a lot for the dietary needs of millions: gluten-free.

The demand for gluten-free foods grew at an annual rate of 28 percent between 2004 and 2011. Many experts attribute the rise in demand to celebrity claims of weight loss and enhanced athletic performance. However, the truth is that very few people need to follow a strict gluten-free diet—except, of course, gluten-intolerant people and those with celiac disease.

When a person with celiac disease digests gluten, the body responds with an immune reaction, launching an attack on the body and damaging the small, fingerlike projections lining the small intestines.

Experts believe there are as many as 3 million Americans living with celiac disease. But of those 3 million, it is estimated that a staggering 97 percent are undiagnosed.

Celiac disease is a genetic autoimmune disorder characterized by reactions to gluten, a protein found in wheat, rye, barley and triticale. When a person with celiac disease digests gluten, the body responds with an immune reaction, launching an attack on the body and damaging the small, fingerlike projections lining the small intestines, known as villi. Villi help you absorb nutrients from digested foods and distribute them into the bloodstream, which then carries said nutrients to the necessary organs.

When gluten damages the villi, they can't properly absorb nutrients from digested food and therefore can't distribute them into the bloodstream, which can lead to malnutrition, anemia and a plethora of other nutrition-related problems.

Signs, symptoms and complications

The complications from celiac disease are seemingly endless, and in some cases, life-altering, including diarrhea, nausea and vomiting, depression or anxiety, debilitating fatigue, brain fog, bone or joint pain and infertility or recurrent miscarriages.

Not every person with celiac disease deals with such symptoms. Cases like these are considered "silent celiac." While it may seem like the better deal to skip the symptoms, people with silent celiac still suffer the same intestinal damage as their symptomatic peers.

Untreated celiac disease can have long-term health consequences. People with celiac disease have twice the risk of developing coronary artery disease compared to the general population, and a staggering four times greater risk of developing small bowel cancers. Untreated celiac disease also increases the risk of developing other autoimmune diseases, such as type 1 diabetes, multiple sclerosis, Sjögren's syndrome and several other autoimmune disorders. The older a person is at the time of diagnosis, the more likely they are to develop a secondary autoimmune disorder.

How do you get celiac disease?

Celiac disease is genetic. People with celiac disease have one or both of the celiac genes: HLA-DQA1 or HLA-DQB1. A person with one or both of these genes can live their entire life without developing celiac disease. If you suspect you have celiac or have a family member who does, talk to your doctor about running tests to investigate. Online genetic testing is available, but only a physician, preferably a specialist, will be able to assist you through the comprehensive diet and lifestyle changes you will have to make.

Whether a person with a genetic predisposition to celiac disease actually develops it depends on a combination of environmental triggers, as well as interactions with other genes still under study. Some cases of celiac manifest after stressful situations, such as pregnancy, trauma, emotional distress or a viral infection.

It's important for anyone with celiac disease to read their food labels carefully and be wary of food manufactured on lines shared with wheat-containing products.

Currently, the only treatment for celiac disease is lifelong adherence to a strictly gluten-free diet. Most people with celiac disease are incredibly sensitive to gluten—even a tiny crumb of bread or other gluten-containing food is enough to damage their villi and make them sick. For that reason, it's often not enough to simply avoid food with gluten-containing ingredients. Celiacs also have to be careful about cross-contamination, particularly when dining out in restaurants. People with celiac disease even have to be careful about using the same cookware, cutlery and appliances that gluten-eating people use.

It's important for anyone with celiac disease to read their food labels carefully and be wary of food manufactured on lines shared with wheat-containing products. When in doubt, only consume fresh fruits, vegetables, lean meats or packaged foods with a "Certified Gluten-Free" label.

Support for celiacs

Receiving a celiac disease diagnosis can be hard on a person's lifestyle. Feelings of loss, anger and even grief are common.

Celiac disease is life-changing, and it's okay to feel upset about that. Be vocal about your condition and advocate for yourself whenever possible. There are many things someone with celiac disease can do to seek support. Having celiac disease can feel lonely, so it's important to cultivate relationships with other people with the condition. Joining a Facebook group or a subreddit for those with the condition is a great way to connect with others and can make the learning process easier.

The Celiac Disease Foundation is a wonderful resource for newly diagnosed celiacs. They have everything people need to know about this often misunderstood autoimmune disorder, plus they offer support in the form of gluten-free meal plans, guides on how to read food labels and more.