Celiac disease is a genetic malady, and the disease is triggered by a protein in wheat called gluten. Gluten is found in wheat, rye and barley, and sufferers have an immune system response to the presence of gluten in their intestinal tract. The immune response creates antibodies that mistakenly attack the lining of the small intestine.
Until recently, celiac disease has been considered a children's disorder marked only by gastrointestinal (GI) problems.
But more and more adults, including those without GI problems, are being diagnosed with this autoimmune disorder, which is trigged by eating wheat, rye and barley.
An understanding of the links between celiac disease, also known as celiac sprue, and associated conditions, such as osteoporosis, is helping doctors identify more people with celiac disease.
"Basically, there is an immune response to the gluten proteins, which eventually leads to inflammation and damage to the villi in the small intestine," explains Armin Adaedini, PhD, an assistant professor of neuroscience at Weill Cornell Medical College of Cornell University.
It may occur when someone has a gastrointestinal infection; GI infections have been found to increase risk of the development of celiac disease in children.
In adults and children, the villi damage caused by celiac disease can lead to symptoms such as abdominal pain, diarrhea, pale, foul-smelling stool, weight loss and weakness.
One reason the celiac disease diagnosis is challenging, however, is that the vague GI symptoms can also be caused by a number of other intestinal conditions, including irritable bowel syndrome, gastric ulcers and Crohn's disease.
If the test is positive---or if the test is negative but your symptoms strongly suggest celiac disease---you should undergo an intestinal biopsy, in which a piece of the intestine is removed and studied under the microscope to look for signs of celiac disease-related damage.
But a diagnosis of celiac disease is not final until someone responds well to a gluten-free diet, which reverses villi damage; the diet is currently the only way to treat celiac disease, though some people may go on steroids to reduce inflammation if diet by itself does not improve symptoms.