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Celiac Disease

Celiac Disease is the only autoimmune disorder where those affected can take “disease” out of their diagnosis. Healing begins when Celiacs avoid gluten.

Celiac Disease is created by a cascade of events that result in damage to an individual's small intestine. For most people diagnosed with Celiac Disease, there’s a “genetic link”–the presence of HLA markers DQ2 or DQ8. These markers are present in 30% to 40% of the population. Celiac Disease doesn’t affect everyone who has this genetic vulnerability. Only about one person in 100 acquires celiac disease during their lifetime. About 1 in 22 of the first-degree relatives of people who have Celiac Disease develop Celiac Disease themselves. First-degree relatives are a person’s parents, siblings and children. 

For those diagnosed with Celiac Disease, there’s also an “environmental link.” Celiac Disease is sometimes called “gluten-sensitive enteropathy.” Enteropathy means a disease of the small intestine. In Celiac Disease, the environmental trigger causing enteropathy is gluten.

Celiac disease is “immune-mediated.” “Immune-mediated” conditions include autoimmune disorders (celiac disease is one of many), allergic diseases, and asthma. In Celiac Disease, a person’s immune system reacts to gluten, resulting in damage to the villi in the small intestine. Since villi are the finger-like projections that absorb nutrients from food into the body, undiagnosed and untreated Celiac Disease results in malabsorption, leading to malnutrition.

Once a person is diagnosed, the disease process can be halted and reversed by means of the gluten-free diet.

After a Celiac’s health is restored on a gluten-free diet, there are no clinical measures that show any difference between that Celiac and non-Celiacs.

However, the disease process reactivates if that Celiac returns to eating gluten.

Refractory Celiac Disease develops in a small portion of Celiacs. According to the Oslo definitions, refractory celiac disease refers to “persistent or recurrent malabsorptive symptoms and signs with villous atrophy despite a strict gluten free diet for more than 12 months.” In a study published in February 2013 that included 6 patients who met this definition, 5 showed recovery after 3 to 6 months on a Gluten Contamination Elimination Diet (GCED). The study also included 11 patients whose symptoms had not improved in the gluten-free diet; 9 of these also improved on the GCED. The abstract of this hopeful study can be found here. The full text is available here.

To summarize, Celiac Disease is:

• an autoimmune condition

• triggered by fractions of protein called gluten (see what is gluten)

• damaging to the villi in the small intestine (and since villi absorb nutrients into the body, undiagnosed and untreated celiac disease results in malabsorption, leading to malnutrition)

• treated with a Gluten Free Diet

• treated with a Gluten-Contamination Elimination Diet if necessary

• not perceived clinically once celiac health has been restored on a gluten-free diet

• reactivated to a disease process if a celiac returns to eating gluten