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Celiac Disease (Gluten Intolerance)

The inability to digest and absorb proteins called gluten found in wheat, rye, and barley. Celiac disease causes damage to the lining of the small intestine and prevents absorption of nutrients. Also called celiac sprue, gluten intolerance, and nontropical sprue.

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(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases)

About Celiac Disease

Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley.

Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins, and lip balms.

When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi—the tiny, fingerlike protrusions lining the small intestine.

Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats.

Celiac disease is both a disease of malabsorption—meaning nutrients are not absorbed properly—and an abnormal immune reaction to gluten. Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.

Celiac disease is genetic, meaning it runs in families. Sometimes the disease is triggered—or becomes active for the first time—after surgery, pregnancy, childbirth, viral infection, or severe emotional stress...Read more about Celiac Disease NIH - National Institute of Diabetes and Digestive and Kidney Diseases

What works? Research summarized

Evidence reviews

Celiac disease

Bibliographic details: Rostom A, Dube C, Cranney A, Saloojee N, Sy R, Garritty C, Sampson M, Zhang L, Yazdi F, Mamaladze V, Pan I, McNeil J, Moher D, Mack D, Patel D.  Celiac disease. Rockville, MD, USA: Agency for Healthcare Research and Quality. Evidence Report/Technology Assessment; 104. 200415346868

Diagnostic characteristics of given video capsule endoscopy in diagnosis of celiac disease: a meta-analysis

This review assessed diagnostic performance of video capsule endoscopy for uncomplicated coeliac disease and found that it was not adequate to justify routine use as an alternative to small bowel biopsies. The authors suggested that video capsule endoscopy may be helpful where biopsy cannot be done and more studies are needed. These conclusions are appropriate to the limited data available.

Introduction of oats in the diet of individuals with celiac disease: a systematic review

The authors concluded that moderate amounts of pure oats added to a gluten-free diet are well tolerated by most people with coeliac disease or dermatitis herpetiformis. In view of the weakness of the evidence base, this conclusion may be overstated. The authors’ recommendation that oats should be introduced with caution seems appropriate.

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Summaries for consumers

Celiac plexus block (CPB) in patients with unresectable pancreatic cancer‐related pain

Abdominal pain is a major symptom in patients with inoperable pancreatic cancer and is often difficult to treat. Celiac plexus block (CPB) is a safe and effective method for reducing this pain. It involves the chemical destruction of the nerve fibres that convey pain from the abdomen to the brain. We searched for studies comparing CPB with standard analgesic therapy in patients with inoperable pancreatic cancer. We were interested in the primary outcome of pain, measured on a visual analogue scale (VAS). We also looked at the amount of opioid (morphine‐like drugs) patients took (opioid consumption) and adverse effects of the treatment. Six studies (358 participants) comparing CPB with standard therapy (painkillers) met our inclusion criteria. At four weeks pain scores were significantly lower in the CPB group. Opioid consumption was also significantly lower than in the control group. The main adverse effects were diarrhoea or constipation (this symptom was significantly more likely in the control group, where opioid consumption was higher). Endoscopic ultrasonography (EUS)‐guided CPB is becoming popular as a minimally invasive technique that has fewer risks, but we were not able to find any RCTs assessing this method (current medical literature on this subject is limited to studies without control groups). Although the data on EUS‐guided CPB and pain control are promising, we await rigorously designed RCTs that may validate these findings. We conclude that, although statistical evidence is minimal for the superiority of pain relief over analgesic therapy, the fact that CPB causes fewer adverse effects than opioids is important for patients.

Irritable bowel syndrome: Overview

Abdominal pain, constipation and diarrhea are all typical symptoms of irritable bowel syndrome (IBS). Other names for this disorder include nervous stomach or irritable colon. Although IBS is not dangerous, the symptoms can be very painful and bothersome.

Causes and diagnosis of lactose intolerance

Some people have digestive problems after drinking milk or eating dairy products. They may only tolerate very small amounts of lactose because their bowel cannot digest it well.Lactose is the main carbohydrate in cow's milk and other animals' milk. It is also in human breast milk. It is not present in vegetable products that are sometimes also called "milk", for example soy milk. Lactose consists of two sugars: glucose and galactose. An enzyme in our small intestine called lactase quickly breaks down the lactose into its two parts. An enzyme is a protein that creates chemical reactions in our bodies. Only after the two sugars have been separated can they be absorbed and turned into energy by our bowel for our bodies to use.

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More about Celiac Disease

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Also called: Coeliac Disease, Non-tropical sprue, Sprue, Celiac sprue, Gluten-sensitive enteropathy

Other terms to know:
Gluten

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