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Cross Section of Small Intestine  
small intestine villi

Inner circle demonstrates little protrusions affected by Celiac disease.

Copyright © Nucleus Medical Media, Inc.

Definition  

Celiac disease is an autoimmune disease of the digestive tract. In celiac disease, eating food with gluten damages little bulges in the small intestine. These bulges, called villi, absorb nutrients from foods. The condition affects the absorption of all nutrients. Untreated patients often become malnourished.

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Causes  

Doctors do not fully understand what causes celiac disease. Eating gluten seems to be involved. There is most likely a genetic factor. Patients with specific genes develop the disease after exposure to gluten. There is some evidence that earlier exposure in infancy can cause a more severe disease than later exposure.

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Risk Factors  

Risk factors that increase your chance of having celiac disease include:

  • Family members with celiac disease
  • History of another autoimmune disease, such as:
  • Dermatitis herpetiformis—A skin condition associated with celiac disease
  • Rheumatoid arthritis
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Symptoms  

Symptoms vary and may start in childhood or adulthood. Children often have different symptoms than adults. Symptoms may not develop if a large section of the intestine is undamaged. Malnutrition may produce the first signs of the condition, which are often the most serious.

Signs and symptoms may include:

In Children  

  • Abdominal pain
  • Nausea, lack of appetite
  • Vomiting, in later stages of disease
  • Diarrhea
  • Bulky stools with a strong odor
  • Irritability
  • Short stature
  • Delayed puberty
  • Pale skin
  • Seizures
  • Cracked sores in the corners of the mouth
  • Shallow sores inside the mouth

In Adults  

  • Bloating
  • Gas
  • Diarrhea
  • Foul-smelling, light-colored, oily stool
  • Weight loss
  • Hearty or a poor appetite
  • Fatigue
  • Abdominal pain
  • Bone pain
  • Behavior changes
  • Muscle cramps and joint pain
  • Seizures
  • Dizziness
  • Skin rash
  • Dental problems
  • Missed menstrual periods
  • Infertility
  • A change in limb sensation
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Diagnosis  

The doctor will ask about your symptoms and medical history. A physical exam will be done. Blood tests may be done to look for malnutrition or anemia. Celiac disease may be suspected based on symptoms and related conditions. However, the symptoms are common to several other conditions. Other tests will help to confirm celiac disease including:

  • Bowel biopsy—a sample of tissue removed for testing to look for cell level changes.
  • Endoscopy—to allow your doctor to examine your intestines.
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Treatment  

A life-long, gluten-free diet is the only treatment for celiac disease. It is very effective. Symptoms usually go away within days of starting the diet. However, healing of the villi may take months or years. Additional intake of gluten can damage the intestine, even if you have no symptoms. Delayed growth and tooth discoloration may be permanent. Nutritional supplements, given through a vein, may be needed if the intest