Celiac disease occurs when the immune system reacts abnormally to gluten, causing inflammation and injury to the lining of the small intestine. Over time, this damage flattens the villi—tiny projections that absorb nutrients—leading to malabsorption, nutrient deficiencies, and a wide range of digestive and non-digestive symptoms.
The condition is genetic and lifelong, but symptoms often improve and the intestine can heal when gluten is strictly removed from the diet. A strict gluten-free diet is currently the only proven treatment.
Celiac disease can cause classic digestive symptoms like diarrhea and bloating, but many people present with fatigue, anemia, bone loss, or other subtle signs. Some individuals have few or no symptoms despite intestinal damage.
Call the office if you have persistent diarrhea, bloating, weight loss, anemia, or other symptoms suggestive of celiac disease, especially with a family history or other autoimmune conditions. Also call if you have diagnosed celiac disease but symptoms or labs are not improving on a gluten-free diet.
Seek emergency care for signs of severe dehydration (such as dizziness, confusion, or feeling faint), severe abdominal pain, or black/bloody stools. Although many celiac symptoms are chronic rather than emergency-type, these signs may indicate a different or more serious problem that needs immediate evaluation.
Evaluation involves blood tests for specific celiac antibodies and, if positive or strongly suspected, upper endoscopy with small-bowel biopsies to confirm the diagnosis. Testing is usually done while the patient is still eating gluten regularly.
The cornerstone of treatment is a lifelong strict gluten-free diet, often with guidance from a dietitian. Management also includes correcting nutrient deficiencies, monitoring symptom and antibody response, and screening for complications.
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