Celiac disease is a digestive disorder that damages the small intestine and interferes with the absorption of nutrients from food. Celiac disease is the prototype of an immune mediated response dominated by the activation of the adaptive immune system and in particular of CD4+ HLA class II restricted T cells. Patients with celiac's disease have an intolerance to the protein in gluten which damages their intestinal lining and makes it difficult to absorb nutrients. Celiac disease affects about one out of eight children with type 1 diabetes. Treatment of celiac disease is based on the avoidance of gluten -containing food. It appears that most celiac disease patients can tolerate up to 50 mg of gluten a day.
   Originally considered a rare malabsorption syndrome of childhood, celiac disease is now recognized as a common condition that may be diagnosed at any age and that affects many organ systems. About 1.5 million to 2 million Americans have celiac disease, but just 40,000 to 60,000 have been diagnosed by a physician.

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Celiac disease is an autoimmune disorder
Celiac disease is a unique autoimmune disorder, since the cause is known. This condition was previously called celiac sprue, based on the Dutch word sprue, which was used to describe a disease similar to tropical sprue that is characterized by diarrhea, emaciation, aphthous stomatitis, and malabsorption.

Celiac disease and gluten
Celiac disease is caused by gluten in genetically predisposed persons. Gluten is the major storage protein of wheat and similar grains.

Future Celiac Disease Potential Treatment
Celiac disease is a disorder of the small intestine caused by an inappropriate immune response to wheat gluten and similar proteins of barley and rye. At present, the only available treatment is a strict gluten-exclusion diet, that means avoiding breads, cereals and other products containing whole wheat or wheat flours, including grains such as bulgur, barley, spelt, kamut and semolina. There are several attractive targets for new treatments. Oral enzyme supplementation is designed to accelerate gastrointestinal degradation of proline-rich gluten, especially its proteolytically stable antigenic peptides. Complementary strategies aiming to interfere with activation of gluten-reactive T cells include the inhibition of intestinal tissue transglutaminase activity to prevent selective deamidation of gluten peptides, and blocking the binding of gluten peptides to the HLA-DQ2 or HLA-DQ8 molecules. Other possible treatments include cytokine therapy, and selective adhesion molecule inhibitors that interfere with inflammatory reactions, some of which are already showing promise in the clinic for other gastrointestinal diseases.
 
Celiac Disease symptoms
The major modes of presentation of patients with celiac disease are the classic diarrhea-predominant form and silent celiac disease. Those with silent celiac disease lack diarrhea, although they may present with manifestations of celiac disease that include an irritable bowel syndrome, anemia, osteoporosis, neurologic diseases, or malignancy. Many additional celiac disease symptoms are possible, see a list submitted by a reader bottom of page.

Celiac Disease and Osteoporosis
Some people develop osteoporosis, the mineral loss disease that leads to brittle bones, because their bodies cannot tolerate wheat flour. Gluten intolerance, called celiac disease, can be treated, so the damage done by osteoporosis can be reversed in such patients. As many as three to four percent of patients who have osteoporosis have the bone disease as a consequence of having celiac disease, which makes them unable to absorb normal amounts of calcium and Vitamin-D

Causes of Celiac Disease
While there is a genetic predisposition for celiac disease, many people don't develop symptoms until later in life. Chemotherapy for certain forms of cancer can sometimes induce celiac disease. Another possibility is repeated infection with a virus.
   Repeated rotavirus infections may increase the risk of celiac disease in genetically susceptible children. Intestinal infections have long been thought to contribute to the development of celiac disease, a common digestive disorder triggered by eating wheat products and other foods containing the protein gluten. Few studies, however, have looked at the role of specific infectious agents in the development of the disease. As participants in a study of the natural history and environmental triggers of diabetes and celiac disease, 1,931 children from the Denver metropolitan area who are genetically susceptible to celiac disease were monitored from infancy for rotavirus infection and the development of celiac disease autoimmunity -- an erroneous immune reaction against "self" proteins. Each "study" child was matched to two "control" children. Dr. Marian Rewers from the University of Colorado School of Medicine in Aurora and colleagues report that 54 study children developed celiac disease autoimmunity at a median of 4.4 years of age. Thirty-six of these children had an intestinal biopsy, of which 27 (75 percent) were positive for celiac disease. According to the team, frequent rotavirus infections predicted a higher risk of celiac disease autoimmunity. The rate ratio for celiac autoimmunity was 1.94 for one rotavirus infection and 3.76 for two or more rotavirus infections compared with zero rotavirus infections. The current study "provides the first indication that a high frequency of rotavirus infections may increase the risk of celiac disease autoimmunity in childhood in genetically predisposed individuals." American Journal of Gastroenterology, October 2006.

Celiac Disease and Breast Feeding
Mothers who breast-feed their children may help to protect them from developing celiac disease, which is characterized by intolerance to a protein found in wheat, rye and barley. In a review of 15 studies, the longer children are breast fed the less likely they are to suffer from the illness.

Celiac Disease Research Update
Clinical features and diagnosis of celiac disease.
Gastroenterology. 2005 Apr;128(4 Pt 2):S19-24.
Celiac disease is a chronic enteropathy caused by intolerance to gluten. The true prevalence of this condition is much greater than previously recognized, with increasing numbers of silent cases being diagnosed. Population-based studies, using serologic screening, have indicated that the prevalence of celiac disease in Caucasian populations is .5%-1%. The pattern of incidence is changing, with a greater proportion of cases diagnosed later in adulthood. The pathologic lesion is characterized by a flattened small intestinal mucosa with a lymphocytic infiltrate, crypt hyperplasia, and villous atrophy. Absorptive function may be impaired and patients can experience gastrointestinal symptoms and malabsorption leading to development of anemia, osteoporosis, or other complications. Untreated celiac disease is associated with significant morbidity and increased mortality, largely owing to the development of enteropathy-associated intestinal lymphoma. The pathologic changes and symptoms resolve when gluten is excluded from the diet for a sustained period.

Women with celiac disease, a digestive disorder caused by sensitivity to gluten, have fertility and pregnancy experiences similar to women without celiac disease.

Gluten-free diet may alleviate depressive and behavioural symptoms in adolescents with coeliac disease: a prospective follow-up case-series study.
BMC Psychiatry. 2005 Mar 17;5(1):14.
Celiac disease in adolescents has been associated with an increased prevalence of depressive and disruptive behavioural disorders, particularly in the phase before diet treatment. We studied the possible effects of a gluten-free diet on psychiatric symptoms, on hormonal status (prolactin, thyroidal function) and on large neutral amino acid serum concentrations in adolescents with celiac disease commencing a gluten-free diet. CONCLUSION: Although our results of the amino acid analysis and prolactin levels in adolescents are only preliminary, they give support to previous findings on patients with celiac disease, suggesting that serotonergic dysfunction due to impaired availability of tryptophan may play a role in vulnerability to depressive and behavioural disorders also among adolescents with untreated celiac disease.

Ancient grains
Dr. Oyvind Molberg of the University of Oslo in Norway believes that the aberrant immune response seen in celiac disease is driven by T-cell recognition of small pieces of protein -- called peptides -- derived from gluten. Using intestinal T-cells taken from people with celiac disease, the researchers had previously found that particular bits of the gluten protein --known as 33mer fragments -- are targeted by T-cells, and seem to be the main source of the inflammatory response in celiac disease. The goal of the new study, published in the journal Gastroenterology, was to find out whether those same T-cells would go after the gluten found in ancient strains of wheat. The researchers tested the cells' ability to recognize the gluten from a number of wheat strains, which carried different variants of the genes that code for gluten. Most of tested wheat strains are currently cultivated in the historic "Fertile Crescent" area of the Middle East. The researchers found that wheats of certain genetic makeups -- including a grain known as einkorn, and certain pasta wheats -- did not appear to contain the troublesome 33mer fragment or protein bits similar to it. Some of the ancient wheat strains may be turned into "high-quality" bread. The main obstacle is that the structure of the plants keeps them from being harvested as easily as widely used bread and pasta wheats. That problem could be overcome through breeding. Gastroenterology, February 2005.

Celica Disease email from a person with this condition
As you know Celiac Disease is one of the most undiagnosed/misdiagnosed diseases in the U.S. I had to move to Germany to find out I had it! And only after two Doctor visits.  Pretty amazing since I suffered for years and years (I was 42 at diagnosis) and no U.S. Doctor was aware of it and the many symptoms which are manifested. May I add the following for people who have one or more of the following symptoms: (I'll * the ones I had)

Headaches
Chronic sinus and/or respiratory infections
Anemia
Constipation* /diarrhea
Joint pain
Bloating
Weight gain* /weight loss
Excessive gas
Abdominal pain
Infertility
Miscarriage
Neurological conditions
Osteoporosis
Chronic fatigue
Weakness
Muscle cramps
Indigestion
Steatorrhea (common with undiagnosed CD)
Eczema
Fuzzy-minded after gluten ingestion
Burning sensations in the throat
Pot belly with or without painful bloating
Concentration* or behavioral problems
Failure to thrive in infants
Dental enamel defects
Skin Rashes and Acne
Spastic colon
Thyroid problems

(It's clear to see that gluten intolerance affects the entire body.) Many patients have been diagnosed with the following problems which have disappeared once the correct diagnosis of Celiac Disease was given:

Diabetes
Fibromyalgia
Lupus
Arthritis
Anemia
Liver problems
Lupus
Thyroid Disease
Dermatitis Herpetiformus
Chron's Disease
Spastic Colon
Irritable Bowel Syndrome
Osteoporosis

Celiac Patients are at greater risk for:
Anemia
Addison's Disease
Chronic active hepatitis
Alopecia Areata
Graves Disease
Diabetes
Myasthenia gravis
Lymphomas – non Hodgkins lymphoma (t cell and b cell)
Lupus
Sjogren's Syndrome
Scleroderma
Chron's Disease
Thyroid Disease
Fibromyalgia

The reason I was diagnosed so quickly (compared to the average 10 years for U.S. citizens) is because European Doctors are trained in nutrition and preventive medicine much more thoroughly.  Rather than the 'pill' approach (Nexium, Zelnorm – their ad cries out Celiac Disease, Tums, Rolaids, etc. etc.) Rather than giving me constant antibiotics which I'd been given over the past 10 years, my Doctors here truly wanted to find out the underlying reason for My chronic rhinitis, sinusitis and bronchitis amongst the many other symptoms. Getting off of gluten was the best diet I ever went on. I eat gluten-free cookies, crackers etc.  regularly but the weight fell off (30 pounds in 4 months) after going gluten-free!

Q. I was just reading your list of symptoms of celiac disease. In it you mentioned skin rashes. Would this include petechiae too? In other words, could petechiae be a likely symptom of celiac disease?
   A. I am not an expert in celiac disease but I have not come across petechiae as being related to this condition.

Q. I purchased IP6 supplement, but I have celiac sprue. Does IP6 interact in those with celiac disease?
   A. We have not seen any studies regarding the interaction of IP-6 in those who have celiac sprue.

Q. Is inulin a safe supplement to use for those with celiac disease?
   A. To the best of our knowledge, inulin can be used by those with celiac disease. Confirm with your doctor before using inulin to see if it is appropriate for your particular condition.