Celiac Disease: Causes, Symptoms, Diagnosis, and Treatment
Celiac disease is a chronic digestive and immune disorder that damages the small intestine, triggered when the patient eats gluten — a protein found naturally in wheat, barley, and rye. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the NIH, an estimated 2 million Americans have celiac disease, roughly 1% of the population, but many cases remain undiagnosed.
Causes
The disease occurs when people carrying certain genes consume gluten. Specifically, the disease is linked to two groups of gene variants called DQ2 and DQ8. About 30% of the population carries DQ2 or DQ8, but only about 3% of those actually develop celiac disease — showing that genes are only part of the cause; scientists are still investigating other factors. When gluten is eaten, the patient's immune system reacts abnormally, mistakenly attacking the lining of the small intestine. Gastrointestinal infections in childhood and changes in the gut microbiome are also thought to contribute to increased risk.
Who is at higher risk
According to the NIH, the following groups have higher rates of the disease:
- People with a family history of celiac disease
- White Americans have higher rates than other racial/ethnic groups in the US
- Women are diagnosed more often than men
Symptoms
Symptoms vary widely and can include digestive issues (diarrhea, bloating, abdominal pain, weight loss) as well as non-digestive ones (fatigue, anemia, bone pain, skin rash known as dermatitis herpetiformis, mouth ulcers, and neurological symptoms such as tingling). Some people have few or no symptoms despite intestinal damage — which is why screening is important in at-risk groups.
Diagnosis and treatment
Diagnosis begins with blood tests for specific antibodies (tissue transglutaminase IgA, among others), followed by an endoscopic small intestine biopsy to confirm the characteristic damage. The only effective treatment is a strict, lifelong gluten-free diet, which allows the intestinal lining to heal. A registered dietitian can help ensure the diet is nutritionally adequate — especially for iron, calcium, B vitamins, and fiber. Regular follow-up is recommended to monitor healing and nutritional status. This article is for general educational purposes and is not a substitute for individualized medical advice.
Helpful products
- Gluten-free cookbook — practical support for building a varied, safe gluten-free diet.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - NIH
