Celiac Disease 101: Information From your Plano GI Doctor

If you experience abdominal pain, bloating, or diarrhea after eating bread, pasta, or other wheat products, you may suffer from a disease process celiac disease. As a gastroenterologist in Plano, I often help patients identify and manage this tricky autoimmune disorder. In this article, I’ll walk through celiac disease basics - from symptoms and diagnosis to treatment with a gluten-free diet and lifestyle adjustments.

What is Celiac Disease?

Celiac disease is an autoimmune condition where the small intestine is damaged by exposure to gluten, a protein found in wheat, barley, and rye. When people with celiac eat gluten, their immune system attacks and destroys the small intestine’s villi – the finger-like projections that absorb nutrients from food. This can lead to a whole host of gastrointestinal and malabsorption issues.

Common Symptoms

Celiac symptoms can vary widely, which makes diagnosis tricky sometimes. Here are some of the most common signs my patients report:

• Diarrhea, constipation, bloating

• Abdominal pain, gas, cramps

• Fatigue and weakness

• Unexplained weight loss or poor growth in kids

• Itchy skin rash or dermatitis herpetiformis

• Mouth sores or dental enamel issues

Celiac can also lead to osteoporosis, iron deficiency anemia, joint pain, headaches, and other systemic issues over time. Kids may show signs of delayed puberty or behavior changes too.

Getting Tested

If celiac is suspected, I’ll typically start with blood tests looking for certain antibodies. Common ones include:

• Tissue transglutaminase (tTG)

• Deamidated gliadin peptide (DGP)

• Endomysial antibody (EMA) (although noy used as much anymore due to lower testing sensitivity)

If these are elevated, I’ll recommend an upper endoscopy to biopsy the small intestine lining. Finding damaged villi confirms celiac disease. I may also test for nutritional deficiencies like low iron, vitamin D, or calcium.

Some patients are “gluten sensitive” and improve on a gluten-free diet but don’t have the antibody response or intestinal changes of celiac. This can make diagnoses tricky in some cases! As a Plano GI doc, getting to the bottom of vague symptoms is my specialty.

Treatment = A Strict Gluten-Free Diet

The only treatment for celiac is removing gluten 100% from the diet. For most, this also means avoiding barley, rye, spelt, and other related grains. I advise working with a skilled dietitian to ensure no trace gluten enters the diet and to balance nutrition.

Completely avoiding gluten allows the small intestine to heal and stops further damage. Most patients report improved symptoms within weeks to months on the diet, though some take longer. Kids often show improved growth and development too.

I recommend follow up blood tests and repeated endoscopies periodically to ensure the small intestine is healing properly on the gluten-free diet. Strict adherence is key. Even small hidden sources of gluten can trigger symptoms and set back healing. (You may have heard of this referred to as "cross-contamination")

Living Gluten-Free - Advice From Your GI Plano

Adjusting to a gluten-free life takes work at first. Reading labels carefully, finding substitutes for favorite baked goods, ensuring safe restaurant meals, and avoiding cross-contamination in the kitchen are so important. But it does get easier! Celiac support groups and gluten-free bloggers can provide helpful tips. Most large supermarkets will have areas dedicated to gluten-free foods.

A naturally gluten-free diet focused on lean proteins, fruits, vegetables, gluten-free grains (like rice and quinoa), beans, nuts and healthy fats is very nutritious! More specialty products are being introduced constantly too.

Though celiac requires diligence, with the right dietary changes, monitoring, and follow through, most patients find their symptoms and health improve greatly! There are more resources than ever to live well gluten-free.

Let me know if you need guidance navigating celiac – I’m here to help! Proper management lets patients get back to enjoying food and thriving.

References:

1. Leffler DA, Green PH, Fasano A. Extraintestinal manifestations of coeliac disease. Nat Rev Gastroenterol Hepatol. 2015;12(10):561-571.

2. Husby S, Koletzko S, Korponay-Szabó I, et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. J Pediatr Gastroenterol Nutr. 2020;70(1):141-156.

3. Pinto-Sánchez MI, Verdu EF, Liu E, et al. Gluten introduction to infant feeding and risk of celiac disease: systematic review and meta-analysis. J Pediatr. 2016;168:132-143.

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DISCLAIMER: Please note that this blog is intended for Informational Use only and is not intended to replace personal evaluation and treatment by a medical provider. The information provided on this website is not intended as a substitute for medical advice or treatment. Please consult your doctor for any information related to your personal care.