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Overview

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in medicines, vitamins, and lip balms.

When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi, the tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats.

Celiac disease is both a disease of malabsorption, meaning nutrients are not absorbed properly, and an abnormal immune reaction to gluten. Celiac disease is genetic, meaning it runs in families. Sometimes the disease is triggered after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.

What are the symptoms of celiac disease?
Symptoms of celiac disease vary from person to person. Symptoms may occur in the digestive system or in other parts of the body. Digestive symptoms are more common in infants and young children and may include

  • Abdominal bloating and pain
  • Chronic diarrhea
  • Vomiting
  • Constipation
  • Pale, foul-smelling, or fatty stool
  • Weight loss

Irritability is another common symptom in children. Malabsorption of nutrients during the years when nutrition is critical to a child's normal growth and development can result in other problems, such as delayed growth and short stature, delayed puberty, and dental enamel defects of the permanent teeth.

Adults are less likely to have digestive symptoms and may instead have one or more of the following:

  • Unexplained iron-deficiency anemia
  • Fatigue
  • Bone or joint pain
  • Arthritis
  • Bone loss or osteoporosis
  • Depression or anxiety
  • Tingling numbness in the hands and feet
  • Seizures
  • Missed menstrual periods
  • Infertility or recurrent miscarriage
  • Canker sores inside the mouth
  • An itchy skin rash called dermatitis herpetiformis

People with celiac disease may have no symptoms but can still develop complications of the disease over time. Long-term complications include malnutrition, which can lead to anemia, osteoporosis, and miscarriage, among other problems, liver diseases, and cancers of the intestine.

Why are celiac disease symptoms so varied?
Researchers are studying the reasons celiac disease affects people differently. The length of time a person was breastfed, the age a person started eating gluten-containing foods, and the amount of gluten-containing foods one eats are three factors thought to play a role in when and how celiac disease appears. Symptoms also vary depending on a person's age and the degree of damage to the small intestine. Many adults have the disease for a decade or more before they are diagnosed. The longer a person goes undiagnosed and untreated, the greater the chance of developing long-term complications.

What other health problems do people with celiac disease have?
People with celiac disease tend to have other diseases in which the immune system attacks the body's healthy cells and tissues. The connection between celiac disease and these diseases may be genetic. They include

  • Type 1 diabetes
  • Autoimmune thyroid disease
  • Autoimmune liver disease
  • Rheumatoid arthritis
  • Addison's disease, a condition in which the glands that produce critical hormones are damaged
  • Sjögren's syndrome, a condition in which the glands that produce tears and saliva are destroyed