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What is celiac disease?

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celiac disease and gluten free

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  • Celiac disease is a chronic autoimmune condition triggered by the consumption of gluten, a protein found in whole grains and their byproducts
  • Having a relative, whether of first- or second-degree, with celiac disease can increase your risk for this illness
  • Some patients may still experience persisting malabsorptive symptoms despite implementing a gluten-free diet. These cases are known as nonresponsive celiac disease

Celiac disease is a chronic autoimmune condition triggered by the consumption of gluten, a protein found in whole grains, including wheat, rye and barley, and their byproducts, such as cereal, bread, pasta, cookies, beer and other prepacked foods. It may also be present in nonconsumable products, such as lipstick, toothpastes and haircare items.1,2

When people with celiac disease ingest gluten-containing foods, their immune system attacks the small intestine. This response damages the small intestine’s lining called the villi, which can compromise the intestines’ functionality and inhibit your body’s ability to absorb nutrients.

Mayo Clinic notes that the intestinal damage caused by celiac disease “often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.” In children, this disease can also stunt growth and development.3

Is celiac disease genetic?

Having a relative, whether of first- or second-degree,4 with celiac disease can increase your risk for this illness. In fact, according to the Celiac Disease Foundation, “people with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease.”5 There are also illnesses and environmental factors that are known risk factors for celiac disease, including:6,7

Illnesses

  • Type 1 diabetes
  • Down syndrome or Turner syndrome
  • Microscopic colitis (either lymphocytic or collagenous colitis)
  • Autoimmune thyroid disease
  • Addison’s disease

Environmental factors

  • Infant feeding practices
  • Gastrointestinal infections
  • Unbalanced gut bacteria
  • Surgical procedures
  • Childbirth
  • Pregnancy
  • Certain viral infections
  • Severe emotional stress

What you need to know about nonresponsive celiac disease

While most individuals with celiac disease experience improvements in their symptoms within two weeks after adhering to a gluten-free diet, some may still experience persisting malabsorptive symptoms despite following the dietary recommendations. These cases are known as nonresponsive celiac disease, and experts believe that the main cause of it is inadvertent exposure to gluten. According to Mayo Clinic gastroenterologist Dr. Lucinda A. Harris:8

“Gluten can sneak in through sources you wouldn't expect, such as lipstick, lip gloss and medications. And many foods that people aren't aware of contain some type of gluten. My first recommendation for patients who don't seem to respond is to see a dietitian."

Some patients may also ingest gluten knowingly despite being diagnosed with celiac disease, because of the perception that gluten is everywhere, hence a gluten-free diet is hard to implement. Coexisting disorders may also be associated with nonresponsive celiac disease, including:9

  • Lactose and fructose sensitivity
  • Small intestinal bacterial overgrowth (SIBO)
  • Irritable bowel syndrome (IBS)
  • Exocrine pancreatic insufficiency
  • Microscopic colitis

If symptoms of celiac disease continue to occur even after the potential causes of treatment failure mentioned above have been ruled out, the possibility of the condition being a refractory celiac disease should be looked into.10

Also called refractory sprue, refractory celiac disease is a rare condition characterized by recurrent malabsorptive symptoms and persistent damage to the intestinal lining despite strictly implementing a gluten-free diet for six months to one year. It is more prevalent in women and those age 50 and above. Symptoms of refractory celiac disease are quite similar to untreated celiac disease, but they are more severe and disabling.11

MORE ABOUT CELIAC DISEASE

Celiac Disease: Introduction

What Is Celiac Disease?

Celiac Disease In Children

Celiac Disease Causes

Celiac Disease Types

Celiac Disease Symptoms

Celiac Disease Diagnosis

Celiac Disease Treatment

Celiac Disease Prevention

Celiac Disease Diet

Celiac Disease FAQ

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