Celiac Disease and Gluten Sensitivity
Sometimes referred to as: celiac sprue, celiac disease, coeliac, gluten intolerance, gluten allergy
Interview between:
Jamila Schwartz, MD
Andrew Cunningham, MD
Celiac disease, also known as gluten intolerance, is inflammation of the small intestine caused by exposure to gliadin—a component of gluten, which is a protein found in wheat, barley, rye, and (to a lesser extent) oats. (Oats do not contain gluten by nature, but they can become contaminated in facilities that process the other grains.)
Cases Per Year (US)
1 in 133 people, or approximately 3 million Americans, currently have celiac disease.
General Frequency
Celiac disease is 2-3 times more common in women than in men.
Risk
Varies depending on sensitivity.
Symptoms
When does celiac disease show up for most people?
The average age of diagnosis in the US is about 40, though there is a peak around age six and another in the fourth and fifth decades. Celiac can show up in genetically predisposed children once the environmental trigger (exposure to gluten) has occurred, so historically it was considered more of a childhood disease.
Celiac also presents differently depending on age. In children, diagnosis may be pursued due to diarrhea, malnutrition, failure to gain weight, or delayed puberty. Adults more commonly find out during a workup for IBS, or possibly through investigation into reasons for anemia or low bone density. Age of diagnosis has shifted to include more older adults, and there is increased awareness that symptomatology can vary.
What are the most common celiac disease symptoms?
Recurrent or chronic diarrhea, abdominal pain, bloating, foul-smelling stools, and constipation are the most common gastrointestinal symptoms.
Do people always have GI issues with celiac disease?
No, they can also have what we call extraintestinal symptoms (symptoms beyond the intestines). Sometimes people present with a characteristic rash, joint pains, or even a routine blood test revealing elevated liver enzymes—all these symptoms are more common in adults.
Most people do have GI symptoms, but the spectrum of severity is relatively broad. Around 60-70% of those who have celiac are undiagnosed, likely because celiac can have these non-GI presentations—like fatigue or coordination and balance problems.
Causes
Diagnosis
Treatment
Gluten Sensitivity
Reducing Gluten
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Jamila Schwartz, MD and Andrew Cunningham, MD are both members of the Galileo Clinical Team. Connect with one of our physicians about Celiac Disease and Gluten Sensitivity or any of the many other conditions we treat.
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