Celiac Disease

Overview

Celiac disease is an autoimmune condition where eating gluten — a protein found in wheat, barley, and rye — triggers your immune system to attack the lining of your small intestine. This damages the tiny finger-like projections (villi) that absorb nutrients, leading to malnutrition, anemia, and a wide range of symptoms. About 1% of people worldwide have it, but it is often undiagnosed for years. The only treatment is a strict, lifelong gluten-free diet — but with that, the intestine heals and symptoms resolve.

Symptoms

• Chronic diarrhea or unusual stool consistency
• Bloating and excessive gas
• Iron-deficiency anemia that doesn't respond to iron pills
• Unexplained weight loss or growth failure in children
• Mouth ulcers, skin rash (dermatitis herpetiformis), or brittle bones
• Brain fog, fatigue, or peripheral neuropathy
• Infertility or recurrent miscarriage in some women

Common causes

• Genetic predisposition (HLA-DQ2 or HLA-DQ8 genes)
• Triggered by gluten exposure in genetically susceptible people
• A first-degree family member with celiac increases risk 10-fold
• Type 1 diabetes, autoimmune thyroid disease, or Down syndrome
• May appear at any age — childhood through old age
• Often appears after a major life event (pregnancy, surgery, severe infection)

Living Gluten-Free

• Avoid all wheat, barley, rye, malt, and most oats (unless certified gluten-free)
• Read every food label — gluten hides in soy sauce, sausages, soups, sauces, and even some medications
• Use separate toaster, cutting boards, and utensils to avoid cross-contamination
• Replace pasta, bread, and flour with rice, corn, quinoa, potato, or certified GF products
• Get checked for vitamin D, B12, iron, calcium, and folate — deficiencies are common at diagnosis
• See a registered dietitian — a true GF diet has a steep learning curve
• Symptoms usually improve within weeks; the intestine fully heals over 6–24 months

When to see a doctor

Get tested before starting a gluten-free diet — testing while gluten-free can give false negatives. The two key tests are a tissue transglutaminase IgA blood test and an upper endoscopy with small-bowel biopsy. See a doctor for unexplained anemia, chronic diarrhea, or if a close family member has celiac disease.