Celiac Disease

Lynn Mohr, R.Ph. - Seville Location

Q: What is celiac disease?

A: Celiac disease (CD) is an autoimmune disease that affects over 3 million Americans, many of whom are undiagnosed. CD is a disorder of the digestive system where there is a chronic reaction to certain proteins called gluten. This reaction causes the immune system to respond, which damages the villi in the small intestine. Villi are small finger like protrusions in the small intestine that absorb nutrients from food into the bloodstream. Damage to the villi prevents the absorption of essential nutrients that leads to nutrition related problems such as malnutrition, weight loss, osteoporosis, lactose intolerance, and deficiencies in iron, folate and other B vitamins.


Q: What is gluten?

A: Gluten is a protein found in wheat, barley, rye and oats.


Q: What are the symptoms of celiac disease?

A: Symptoms vary from person to person and may occur in the digestive track or present in other parts of the body. People with celiac disease may experience one or more symptoms or none. Digestive symptoms may include abdominal pain and bloating, chronic diarrhea, vomiting, chronic constipation, excessive gas, or fatty stools that float rather than sink.

Other symptoms may include unexplained iron deficiency anemia, any problem associated with vitamin deficiency, fatigue, bone or joint pain, arthritis, bone loss or osteoporosis, depression or anxiety, tingling in fingers and toes, or dermatitis herpetiformis (a disease in which severe rash forms often on the head, elbows, knees, and buttocks).

CD sufferers may also experience a strong lack of concentration referred to as "Celiac fog." This is due to lack of B vitamins. In addition to the digestive and neurological symptoms, patients may also suffer from depression.


Q: How is Celiac disease diagnosed?

A: Diagnosis can be challenging because symptoms may be similar to those of other diseases. A lab test looking for higher than normal levels of transgluctaminase or anti-endomysium in the blood can determine a diagnosis. Another method of diagnosis is a biopsy of the small intestine. Some people with no digestive symptoms have dermatitis herpetiformis. A skin biopsy and blood test can provide a diagnosis with no intestinal biopsy needed.


Q: How is Celiac disease treated?

A: The only successful treatment for celiac disease is a gluten-free diet. With strict adherence to a gluten-free diet, symptoms usually improve in 2-3 weeks. After 3 months, symptoms should be gone, but it takes 2-6 months for the villi to return to normal. Medicines are used to treat complications of the disease. Steroids are sometimes prescribed by a doctor to treat swelling in the intestine.


Q: Explain a gluten-free diet?

A: A gluten-free diet means eating no wheat, rye, and barley or any products made with these grains, such as pasta, bread, cereal. Eating a tiny amount of gluten can cause symptoms of diarrhea and weight loss. Avoidance of milk and milk products while the intestine heals may be recommended. This is a new approach to eating and many find working with a dietician helpful. Support groups can be very helpful since the gluten-free diet can be challenging for CD sufferers of any age. There are many gluten-free products on the market and available at some Ritzman Pharmacy locations. These products offer convenience as well as variety to the diet. A gluten-free diet will eliminate the symptoms of CD and prevent long-term complications.


Q: Are there supplements I should take?

A: Your doctor may recommend calcium and iron supplements. Other supplements that may be helpful are digestive enzymes and probiotics. The Ritzman 4 pillars - consisting of a multivitamin, calcium, antioxidant, and essential fatty acids in convenient packets ready for daily use - are a great choice for a CD sufferer on a gluten-free diet.