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Celiac Disease

How Soon Can Celiac Disease Be Diagnosed?

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Celiac Disease, by definition, is a digestive condition triggered by the consumption of the protein gluten, which is found in bread, pasta, cookies, pizza crust, and many other foods containing wheat, barley, or rye. Once a person with celiac disease eats foods containing gluten, an immune reaction occurs in the small intestine, resulting in damage to the surface of the small intestine and an inability to absorb certain nutrients from food. Therefore, a person must be exposed to gluten before they can ever develop Celiac Disease.

Celiac Disease is often inherited; If someone in your immediate family has it, chances are 5 percent to 15 percent that you may as well. It can occur at any age, although problems don’t appear until gluten is introduced into the diet.  However, exposure to gluten may not trigger Celiac Disease. Often for unknown reasons, the disease emerges after some form of trauma: an infection, a physical injury, the stress of pregnancy, severe stress, or surgery.

Many people who experience some, all, or non of the symptoms of Celiac Disease do not necessarily have the disease, but rather are suffering from gluten intolerance. The key factor in having a diagnosis of Celiac Disease is specific damage to the small intestine.

Celiac Disease occurs when there is damage to the villi located in your small intestine.  Villi are tiny, hair-like projections resembling the deep pile of a plush carpet on a microscopic scale. Villi work to absorb vitamins, minerals, and other nutrients from the food you eat. In a person with Celiac Disease, gluten attack and destroy the villi.  Without villi, the inner surface of the small intestine becomes less like a plush carpet and more like a tile floor, and your body is unable to absorb the nutrients necessary for health and growth. Instead, nutrients such as fat, protein, vitamins, and minerals are eliminated from your stool. Eventually, decreased absorption of nutrients (malabsorption) can cause vitamin deficiencies that deprive your brain, peripheral nervous system, bones, liver, and other organs of vital nourishment, which can lead to other illnesses. The decreased nutrient absorption that occurs in celiac disease is especially serious in children, who need proper nutrition to develop and grow.

People with celiac disease carry higher than normal levels of certain antibodies (anti-gliadin, anti-endomysium, and anti-tissue transglutaminase).  In people with celiac disease, their immune systems may be recognizing gluten as a foreign substance and produce elevated levels of antibodies to get rid of it. A blood test can detect high levels of these antibodies and is used to initially detect people who are most likely to have the disease and who may need further testing. To confirm the diagnosis, your doctor may need to do an endoscopy to examine a small portion of intestinal tissue to check for damage to the villi.

The key to a diagnosis of Celiac Disease is exposure to gluten and damage to the small intestine.  Having a family member with the disease increases the risk of having the disease.  If you are concerned you may be at risk for the disease, even if you are not currently exhibiting symptoms you can ask your doctor for a blood test to determine if your anti-gliadin, anti-endomysium, and anti-tissue transglutaminase antibodies are elevated.

For more information on Celiac Disease, visit MayoClinic.com.

Facts & Statistics About Celiac Disease

Last Updated on by the Celiac-Disease.com Staff 4 Comments

Thanks to a heads-up from Zach of Gluten-Free Raleigh (via our contact form), it looks like he has taken the time to put together and post a great collection of Celiac statistics and/or facts about Celiac Disease.

As Zach mentions in his post, you can use this information to continue to promote Celiac awareness in your local area.

Celiac Disease Facts & Statistics

  • 1 out of every 133 Americans (about 3 million people) has Celiac Disease.
  • 97% of Americans estimated to have CD are not diagnosed.
  • CD has over 300 known symptoms although some people experience none.
  • Age of diagnosis is key: If you are diagnosed between ages 2-4, your chance of getting an additional autoimmune disorder is 10.5%. Over the age of 20, that rockets up to 34%.
  • 30% of the US population is estimated to have the genes necessary for CD.
  • 2.5 babies are born every minute in the USA with the genetic makeup to have CD.
  • There are 15 states in the US with populations less than the total number of Celiacs in the US.
  • CD affects more people in the US than Crohn’s Disease, Cystic Fibrosis, Multiple Sclerosis, and Parkinson’s disease combined.
  • People with CD dine out 80% less than they used to before diagnosis and believe less than 10% of eating establishments have a ‘very good’ or ‘good’ understanding of GF diets.
  • It takes an average of 11 years for patients to be properly diagnosed with CD even though a simple blood test exists.
  • The US Department of Agriculture projects that the GF industries revenues will reach $1.7 Billion by 2010.
  • GF foods are, on average, 242% more expensive than their non-GF counterparts.
  • The Food Allergen Labeling & Consumer Protection Act became law in 2006 allowing for easier reading of food labels for those with CD. What took so long?
  • 12% of people in the US who have Down Syndrome also have CD.
  • 6% of people in the US who have Type 1 Diabetes also have CD.
  • Among people who have a first-degree relative diagnosed with Celiac, as many as 1 in 22 people may have the disease.
  • There are currently 0 drugs available to treat CD.

What is Dermatitis Herpetiformis?

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Dermatitis Herpetiformis (DH), also commonly referred to as Celiac Skin, is a rare skin disease that is commonly found in people with Celiac Disease. Some quick research on the subject unveiled a few interesting things.

Here is what I’ve learned so far about DH:

What are the Causes of Dermatitis Herpetiformis?

The rash is caused when gluten in the diet combines with IgA, and together they enter the bloodstream and circulate. They eventually clog up the small blood vessels in the skin, which attracts white blood cells (neutrophils), and releases powerful chemicals called complements. This is how the rash is created. Iodine is required for the reaction, so people with DH should avoid using Iodized salt if possible.

What are the Symptoms of Dermatitis Herpetiformis?
The symptoms of Dermatitis Herpetiformis are intense burning, stinging, and itching around the elbows, knees, scalp, buttocks, and back. More locations can also be affected and the severity can vary depending on the person.

What Does Dermatitis Herpetiformis Look Like?
DH looks like small clusters of red, itchy bumps. There are tiny water blisters, but these are quickly scratched off. Before they form, the area usually has a burning feeling. They scab and heal over within 1-2 weeks, but new spots continue to appear.  DH is a lifelong condition, but remission may occur in 10 to 20 percent of patients.

What are the Tests for Dermatitis Herpetiformis?
Diagnosis of DH usually requires at least one skin biopsy, and sometimes a blood test (looking for anti-gliadin, anti-reticulin, and anti-endomysial antibodies).

How Do You Treat Dermatitis Herpetiformis?
Complete elimination of gluten will often cure DH, but improvement often takes months.  This means sufferers must follow a strict gluten-free diet.  Cutting down on wheat and gluten may reduce the amount of medication needed, but will not be curative.

In the meantime, there is a very effective treatment available to sufferers of DH.  Dapsone is a drug that will improve DH in only a few days. Because there can be side effects, the dose of Dapsone is usually started at a small amount, and then raised up over a few weeks until all symptoms are suppressed. Dapsone may have adverse effects, so weekly or bi-weekly blood tests will be needed for the first three months. There are a few alternative treatments if Dapsone cannot be used (sulfapyridine, tetracycline), however, these do not work as well.

Tell the USDA We Want Gluten-Free Lunches

Last Updated on by the Celiac-Disease.com Staff 5 Comments

Unless you have a child with Celiac Disease, you probably aren’t aware of the difficulty involved with helping a child to stay gluten-free while in school. This is especially true when lunch rolls around and all the other kids are enjoying their hot lunches.

Vanessa of Beyond Rice Cakes has been a vocal leader of sorts when it comes to this area and is leading a campaign urging people to tell the USDA to provide gluten-free options. This is a no-brainer for people who have children with Celiac Disease, but others may not think of it, so I wanted to draw everyone’s attention to Vanessa’s post.

According to Vanessa:

Currently the National School Lunch Program does not include any provisions for gluten-free food. The good news is that the U.S. Department of Agriculture is revising the Child Nutrition Act and wants to hear from you to help guide the revision process!

To give you a little background, the Child Nutrition Act includes legislation for the National School Lunch Program. This is the program that provides schools with federal assistance for school lunches. In 2009, the act will be reauthorized and, to help ensure the needs of all Americans are met, the USDA is accepting input on what needs to be changed to improve the program.

Please help improve the lives of children with celiac disease by sending your comments to the USDA. You can fax comments to 703-305-2879 or submit comments online.

The deadline for submission is October 15, 2008.

Vanessa goes on to provide some key points to remember as you submit your request to the USDA, so you’ll want to check out her post.

Remember, everyone with Celiac Disease needs to stick together and someone needs to speak up for the children who are going through school without gluten-free options.   Here is your chance!

Diagnosis of Celiac Disease Continues to Evolve

Last Updated on by the Celiac-Disease.com Staff Leave a Comment

Only a few years ago the symptoms of Celiac Disease were commonly believed to be malnutrition, diarrhea, bloating, and abdominal pain. In the last few years diagnosis of the disease has continued to evolve and both studies have shown that many people with Celiac Disease do not have the classic symptoms that doctors are trained to look for.

Recently Against the Grain Nutrition published a great post about The New Picture of Celiac Disease, which goes into detail about a recent study to support this:

Research conducted a few years ago found that the majority of adults with newly diagnosed celiac disease do not have the once-considered classic symptoms of diarrhea and malabsorption. A growing percentage have silent or atypical celiac disease, with either no symptoms, or symptoms such as bone disease, anemia, acid-reflux-type conditions, constipation, or neurologic symptoms.

A 2008 study recently found that most children diagnosed with celiac disease don’t have so-called “classic” gastrointestinal symptoms either.

The new study evaluated the presentation of celiac disease in children in a pediatric gastroenterology practice in southeastern Wisconsin during a 17-year period. During that time, 143 patients were diagnosed with celiac disease. Gastrointestinal symptoms predominated in children younger than 3 years, whereas in children older than 3 years, the majority presented with nongastrointestinal conditions associated with a high risk of developing celiac disease, including type 1 diabetes, thyroid disease, Down syndrome, iron-deficiency anemia, short stature, or mood disorders – or they were tested because they were a first-degree relative of a person with celiac disease.

The classic clinical view of pediatric celiac disease, which includes malnutrition, diarrhea, bloating, and abdominal pain, should be replaced with the more typical presentation of an asymptomatic school-aged child who belongs to a high-risk group. The authors of the study recommend screening people, and first-degree family members of people, with Down syndrome, Turner syndrome, type 1 diabetes, thyroiditis, Addison disease, short stature, iron-deficiency anemia, unexplained elevation of aminotransferase levels, and other autoimmune disorders.