Understanding Celiac Disease

What is Celiac Disease?

Celiac disease is an autoimmune disease, which occurs in 1 out of every 100 people worldwide, but only about 30% of the population is diagnosed appropriately.

When people with celiac disease eat foods that contain gluten such as wheat, rye, and barley products, their immune system attacks the gluten protein. This causes damage to the lining of the GI tract and disrupts the body’s ability to absorb important nutrients. Over time, impaired absorption can lead to malnutrition.

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Symptoms of celiac disease include:

  • Abdominal pain
  • Diarrhea
  • Nausea with or without vomiting
  • Bloating/gas
  • Weight loss
  • Fatty, loose, bulky, or foul-smelling stools
  • Constipation

Fatigue is another common symptom of celiac disease, and in some cases, this may be the only symptom. Extreme tiredness is experienced as a result of gut damage which inhibits the absorption of nutrients that are essential to energy metabolism such as iron, vitamin B12 and folic acid.

Symptoms may come and go and can vary widely. Not all symptoms are noted to be gastrointestinal. Symptoms that affect other parts of the body include:

  • Skin rash
  • Joint or bone pain
  • Mental health problems including anxiety and depression
  • Headache
  • Reproductive problems including infertility
  • Canker sores


Celiac disease can develop at any age, and even after someone has tested negative for the disease previously. Research suggests that celiac disease is only found in people who possess certain genes and eat gluten-containing foods that trigger the symptoms. Other research is being done to determine alternative factors that may lead to the disease. Some studies suggest that people with a high number of infections early in life or changes in the microbiome bacteria of the GI tract could have an increased risk of developing celiac disease.


An appointment with your family doctor should be made if you are concerned about the possibility of celiac disease. The physician will review your medical and family history. A physical exam will be performed to check for symptoms like weight loss, skin rashes, and joint pain. The following testing may be ordered if celiac disease is suspected:

  • Blood tests
  • Biopsy of the small intestine
  • Genetic testing


The treatment for celiac disease is following a gluten-free diet. This requires becoming familiar with gluten-containing food ingredients and derivatives. Gluten is found in many foods as well as some medications, vitamins, skin care products, cosmetics, toothpaste, and lipstick.

Avoiding gluten in all forms can help relieve symptoms in just a few days and begin healing damage to the small intestine.

Nutrition Recommendations and Support

A gluten-free diet is void of all foods that contain gluten. Gluten is a protein found in wheat, barley, rye and triticale (a cross between wheat and rye). Following a gluten-free diet requires careful attention. A registered dietitian can teach you the terms you need to know to detect the different sources of gluten listed on food labels. They can also support you by ensuring your gluten-free diet is adequate and well-balanced to promote overall good health as you live with celiac disease.

Sarah Hammaker, RDN

Sarah Hammaker, RDN is a clinical dietitian working primarily in long-term care and acute rehabilitation hospital settings in Pennsylvania. Outside of work, Sarah enjoys spending time with her husband and their four children. She loves running and being outdoors. Her hobbies include reading, planting and shopping.

If you have more questions about celiac disease, it’s always a great idea to speak with a registered dietitian. Registered dietitians are the only credentialed experts qualified to address your unique health questions. Click here to request a direct consultation with a dietitian today!

What is Celiac Disease? Available at https://celiac.org Accessed on May 5, 2022
Symptoms and Causes of Celiac Disease. Available at
https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/symptoms-causes Accessed on May 5, 2022.

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