Celiac disease is a condition in which the lining of the small intestine is damaged in response to ingestion of gluten and similar proteins, which are found in wheat, rye, oats, barley, and other grains.

The exact cause of celiac disease is unknown. The disorder may be caused by an abnormal immune response to proteins found in grains, particular gluten. The intestines contain projections called villi which normally absorb nutrients. Celiac disease causes the villi to become flattened and lose the ability to absorb nutrients.

- abdominal pain

- bloating

- diarrhea

- fatty, foul smelling stools

- fatigue

- weight loss

- anemia

Risk factors are genetic or familial tendency toward the disease. The disorder is most common in Caucasians of northern and southern European ancestry. Approximately 70% of reported cases occur in women.

The diagnosis of celiac disease is made with several tests. Blood tests are done to determine anemia and/or malnourishment. A blood study is also done to determine the body's immune response to the gliadin protein in gluten found in grains. The most definitive test is an upper G.I. endoscopy (use of instrument to visualize the upper G.I. tract) to take biopsies of the small intestine. These pieces of tissue are examined under a microscope and characteristic findings consistent with celiac disease are noted.

A life-long gluten-free diet is required. Foods that contain wheat, rye, oats, and barley must be eliminated from the diet. Food and drug labels should be read carefully to look for hidden sources of gluten. Eliminating gluten allows the intestine to heal and the villi to return to normal. A appointment with a registered dietician will be scheduled to determine dietary guidelines. Vitamin and mineral supplements may be needed to correct nutritional deficiencies.

Symptoms usually improve within several weeks of treatment with a gluten-free diet. The diet must be strictly followed continuously or the symptoms will return.

In most cases, a repeat biopsy of the small intestine is done after a period of adhering to a gluten-free, gliadin-free diet. Improvement of biopsy findings and/or improvement of symptoms are highly indicative of celiac disease.

Complications include malnourishment and vitamin deficiencies. Other complications include pancreatic disorders, damage to the nervous system, infertility, and miscarriage. People with celiac disease may have greater risk for lymphoma and intestinal cancers. However, strict compliance with diet lessens this risk.