CELIAC DISEASE

General Information

DEFINITION--An allergic condition in the small intestine, triggered by gluten (a protein found in most grains), which prevents the intestine from absorbing nutrients. Most forms are inherited. Celiac disease is not contagious or cancerous.

BODY PARTS INVOLVED--Digestive system.

SEX OR AGE MOST AFFECTED--Usually begins during infancy or early childhood (2 weeks to 1 year). Symptoms appear when the child first begins eating food with gluten. In adults, symptoms may develop gradually over months or even years and can appear as late as age 60. It affects twice as many women as men.

SIGNS & SYMPTOMS

• Weight loss or slowed weight gain in an infant following the introduction of cereal to the diet.
• Poor appetite.
• Loose, pale, bulky, bad-smelling stools; frequent gas.
• Swollen abdomen; abdominal pain.
• General undernourished appearance.
• Mouth ulcers.
• Anemia or vitamin deficiency, with fatigue, paleness, skin rash, or bone pain.
• Mildly bowed legs in children.
• Vague tiredness, breathlessness.
• Swollen legs.
• Strange sensations in the hands and feet such as burning, prickling, tickling or tingling.

CAUSES--An inherited defect most often found in people of northwestern European ancestry.

RISK INCREASES WITH

• Family history of celiac disease.
• Pregnancy.
• Other allergies.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of stool and blood.
• Firm diagnosis is made by a biopsy, in which a small sample of tissue is taken from the small intestine. Three biopsies may be done, one when you are eating foods containing gluten, another when you are on a gluten-free diet, and a third when you again eat foods containing gluten.

APPROPRIATE HEALTH CARE

• Home care.
• Doctor's treatment.

POSSIBLE COMPLICATIONS--In rare cases, gluten withdrawal does not bring immediate improvement.

PROBABLE OUTCOME--With a strict, gluten-free diet, most persons with celiac disease can expect a normal life. Improvement begins in 2 to 3 weeks.

How To Treat

GENERAL MEASURES--

• Pay careful attention to the dietary instructions provided by your doctor or dietitian.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Iron and folic acid for anemia.
• Calcium and multiple-vitamin supplements for deficiencies.
• Oral cortisone drugs to reduce the body's inflammatory response during a severe attack.

ACTIVITY--No restrictions.

DIET--Gluten-free diet (see Gluten-Restricted diet in Appendix). It is difficult to exclude gluten from the diet completely, so be patient while becoming familiar with the diet, which a dietician can help you plan.

Call Your Doctor If

• You or your child have symptoms of celiac disease.
• Symptoms don't decrease within 3 weeks after beginning a gluten-free diet.
• The child fails to regain lost weight or grow and develop as expected.
• Fever develops.