Celiac Disease

Am Fam Physician. 2014;89(2):online

See related article on celiac disease.

What is celiac disease?

Celiac (SEE-lee-ack) disease is swelling in the gut that is caused by eating gluten. Gluten is a protein in foods made with wheat, rye, or barley. The swelling stops your body from getting the nutrients it needs. This disease can occur at any age. About one in 100 people has it.

What are the symptoms?

Some people with celiac disease have diarrhea, weight loss, bloating, nausea, or vomiting. The disease also can cause problems in other parts of the body, such as an itchy rash, bone weakness, or low red blood cell count.

How is it diagnosed?

The first step is usually a blood test. If the results are not normal, or if you are at high risk of having the disease (for example, if you have a relative with celiac disease), you may need more tests. Your doctor may do a test where a small camera is put down your throat to look into your stomach. The doctor will take a small piece of tissue for testing, which is called a biopsy. This will show if you have celiac disease.

How is it treated?

There is no cure for celiac disease, but a gluten-free diet will help you feel better. Not eating gluten will help over time. While you are healing, your doctor may have you take vitamins and minerals. You may need to see a nutritionist to learn the best ways to avoid gluten in your diet. Finally, your doctor may suggest you talk with other people who have celiac disease. The gluten-free diet needs to be followed for a lifetime. Note that feeling better after eating a gluten-free diet does not mean you have celiac disease.

Which foods have gluten in them?

Because gluten is in wheat, barley, and rye, you should avoid foods with these ingredients, such as bread, pasta, cereal, sauces, cake, and cookies. Some grains do not have gluten and can be eaten. These include corn, rice, or soy. Meat, fish, poultry, potatoes, fruits, and vegetables do not have gluten. Oats are okay to eat, and may be an important addition to the gluten-free diet.