Celiac disease occurs when a protein called gluten, found in wheat, barley and rye generates an immune reaction in the small intestine of susceptible people. Food normally doesn't provoke a response by the body's immune system - the body's defense against microbes and other threats to health - but in a person with Celiac disease, the ingestion of gluten triggers a reaction from the immune system that causes the lining of the small intestine to become inflamed and swollen. This results in the ‘villi’, the tiny hair like projections in the small intestine, to shrink and eventually disappear. In a healthy body, the villi absorb vitamins, minerals and other nutrients from food. With shrunken or no villi, a person with Celiac loses the ability to digest and absorb nutrients; resulting in malabsorption. Malabsorption can deprive the brain, nervous system, bones, liver and other organs of nourishment and cause vitamin deficiencies that may lead to other illnesses.
Although celiac disease is inherited, it can affect anyone. It can develop at any age. Symptoms in infants only appear after foods containing gluten are introduced. The condition should be strongly suspected in pale, irritable infants who fail to thrive and who have a potbelly with flat buttocks and malodorous, bulky stools.
Pregnancy, severe stress, physical trauma, or a viral infection can trigger celiac disease in susceptible people for reasons that aren't well understood. Celiac disease also is more common among people with type1 diabetes and thyroid disease.
Some speculate that celiac disease has been around since humankind first switched from a foraging diet of meat and nuts to a cultivated diet that included high-protein grasses like wheat.
There is no "typical" celiac case. The disease has a broad range of symptoms but no common symptom. Some people with Celiac have gastrointestinal symptoms while others can have a host of other symptoms like anemia, skin disorders, osteoporosis, neurological conditions, and many others.
Celiac disease can be diagnosed on the basis of blood tests, and confirmed with an endoscopy. It is important that people not go on a gluten-free diet before seeking a medical evaluation. Doing so may change the results of blood tests and biopsies so that they appear to be normal.
Once thought to be a rare disease, it is now known that celiac is quite common, affecting approximately 3 million people in the U.S. (diagnosed) and several times that number undiagnosed. Celiac disease is incurable, but treatable by adhering to a 100% gluten-free diet.
Today there are hundreds of food products labeled gluten-free in a variety of categories. In most regards, this is great news for those of us living gluten-free lifestyles but it can also be a two edged sword. The wave of popularity for the gluten-free diet has motivated many food manufacturers to label their products ‘gluten-free’ to attract more customers, not because they set out to produce gluten-free food products. For that reason, we recommend that people with celiac disease do their homework before purchasing even labeled gluten-free products. In the ‘old days’ we used to contact food manufacturers to find out if a product contained gluten and what their procedures for testing for gluten were. We believe that it is still the safest way to ensure a processed food item is truly gluten-free.