Regional Gastrointestinal Consultants

Celiac Disease

Celiac Disease

Celiac Disease


Other names for Celiac Disease are Gluten Enteropathy, Celiac Sprue, Gluten Intolerance. In people with celiac disease (pronounced ‘seel-ee-ak’ and spelt celiac in some countries) the immune system reacts abnormally to gluten (a protein found in wheat, rye, barley and oats), causing small bowel damage. The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened. This is referred to as villous atrophy. Villous atrophy reduces the surface area of the bowel available for nutrient absorption, which can lead to various gastrointestinal and malabsorptive symptoms. Symptoms can also be caused by inflammation in other parts of the body.

Celiac disease can occur at any age and is more common than is often recognized. It may also be associated with diabetes mellitus and autoimmune disorders. If one person in a family has celiac disease, it is more common in other family members.


Symptoms of celiac disease vary considerably. Some people experience severe symptoms while others are asymptomatic (they have no obvious symptoms at all).

Symptoms can include one or more of the following:

  • gastrointestinal symptoms e.g. diarrhea, constipation, nausea, vomiting, flatulence, cramping, bloating, abdominal pain, steatorrhea
  • fatigue, weakness and lethargy
  • iron deficiency anemia and/or other vitamin and mineral deficiencies
  • failure to thrive or delayed puberty in children
  • weight loss (although some people may gain weight)
  • bone and joint pains
  • recurrent mouth ulcers and/or swelling of mouth or tongue
  • altered mental alertness and irritability
  • skin rashes such as dermatitis herpetiformis
  • easy bruising of the skin

People who experience any of the following should also be screened for celiac disease:

  • early onset osteoporosis
  • unexplained infertility
  • family history of celiac disease
  • liver disease
  • autoimmune disease e.g. type 1 diabetes, autoimmune thyroid condition


The diagnosis is made by a high index of suspicion, and by screening close relatives for celiac disease. Blood tests can be very useful in suggesting the diagnosis (serum folate, gliadin antibodies and endomysial transglutaminase antibodies). However, the diagnosis is made by taking tissue samples (biopsies) of the lining (mucosa) of the small intestine for examination by a pathologist. If the lining is found to be ‘flat’ (i.e.: there is loss of the normal highly specialized surface) and if this returns to normal once gluten has been removed from the diet, the diagnosis is confirmed.

A strict, lifelong gluten free diet is currently the only recognized medical treatment for coeliac disease. By removing the cause of the disease, a gluten free diet allows the small bowel lining to heal and symptoms to resolve. As long as the gluten free diet is strictly adhered to, problems arising from coeliac disease should not return. Relapse occurs if gluten is reintroduced into the diet.

A gluten-free diet is the treatment for coeliac disease (see Diet Information). Patients need to stay on the gluten-free diet for life. It is also important that any nutritional deficiencies be detected and treated. A dietitian should be consulted for advice.


We recommend that people experiencing gastrointestinal symptoms do not attempt self-treatment. With many medications being available over the counter, and numerous do-it-yourself online unqualified remedy recommendation, it is natural to consider treating yourself but we highly recommend against this.

If you are experiencing gastrointestinal symptoms you may have a more significant issue than you would expect from the sometimes muted or infrequent symptom you may be experiencing. It is important to keep in mind that is you are having gastrointestinal symptoms or concerns it is best see a doctor to have those symptoms diagnosed and any conditions treated. Also, it is worth noting, that if health conditions do exist, the earlier they are diagnosed and treated, the greater the probability will be to successfully eliminate or manage a present condition, in fact successful outcomes will increase significantly with early detection.

If you have gastrointestinal concerns or are experiencing any gastrointestinal symptoms, please contact us promptly to schedule a consultation with a physician.


The information on this website is to provide general information. In no way, does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a best in class physician regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today at (215) 321-4700 to schedule a consultation.