Celiac disease is an inflammation of the small intestine which occurs when someone with the disease eats gluten — a component of certain grains, such as wheat, rye, and barley. Considered at one time to be fairly rare in this country, research conducted at NewYork-Presbyterian and elsewhere indicates that celiac disease is fairly common in the United States. As many as one in 133 Americans has celiac disease, but about 97 percent remain undiagnosed. More than two million Americans are thought to have celiac disease.
At the Center for Advanced Digestive Care (CADC) of NewYork-Presbyterian/Weill Cornell Medical Center, patients can be evaluated for celiac disease, and those who are diagnosed can receive nutritional counseling from a dietitian to help them learn how to avoid gluten-containing foods. We also monitor patients for vitamin and mineral deficiencies.
What Is Celiac Disease?
Celiac disease, also known as "gluten-sensitive enteropathy," causes inflammation in the small intestine and damage to the villi, the small fingerlike structures inside the intestine that are responsible for absorbing nutrients. When the villi of the small intestine cannot absorb nutrients from food effectively, malnutrition can result and can affect many of the body's organs and tissues, including the skin, bones, teeth, nervous system, and reproductive organs.
Some people with celiac disease have no symptoms. Others may experience abdominal bloating, abdominal pain or cramping, diarrhea, and/or unexplained weight loss. Some people feel irritable or depressed.
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Diagnosis of Celiac Disease
The symptoms of celiac disease are often similar to those of other digestive diseases, making it difficult to diagnose and explaining why some patients go undiagnosed for years. However, new diagnostic methods are facilitating a faster and more accurate diagnosis of celiac disease.
If celiac disease is suspected, a physician at the CADC will order a blood test for certain antibodies, including:
- Anti-gliadin antibodies
- Anti-endomysial antibodies
- Anti-tissue transglutaminase antibodies
- Total immunoglobulin A levels
The physician will also want to determine whether a patient has any nutritional deficiencies, such as low levels of iron, folate (a B vitamin), vitamin B-12, calcium, and vitamin D, as well as copper and zinc levels.
Patients being assessed for celiac disease may also have an endoscopic examination of the small intestine, where a biopsy (tissue sample) will be taken to look for changes characteristic of the disease. This procedure is considered the gold standard for diagnosing celiac disease.
Celiac Disease Treatment
There is no cure for celiac disease, but it can be effectively treated by eliminating gluten from the diet for life. With strict adherence to a gluten-free diet, it is possible to stop and even reverse damage to the intestine.
There are many foods containing flour of particular grains and vegetables that people with celiac disease can safely eat, including potatoes, corn, rice, beans, and soy. Newly diagnosed patients benefit from speaking with a nutritionist knowledgeable about celiac disease, who can help them plan a proper diet.