Celiac disease, also known as celiac sprue and gluten-sensitive enteropathy, is a genetic, auto-immune disorder. Gluten, a protein found in wheat, spelt, kamut, rye, barley, and oats, is toxic to individuals who have celiac disease. When they ingest foods that contain gluten, their immune systems respond inappropriately by attacking the lining of their intestinal tract. The tiny little hairs called villi that line the intestine and are responsible for nutrient absorption, shorten and atrophy. The body tries to increase the production of the cells that line the intestinal wall, but it cannot keep up with cell loss. As a result the intestine cannot maintain its absorptive function and eventually, if gone untreated, malabsorption and malnutrition can occur.

If the disease goes unchecked, secondary effects can arise, which further exacerbate malabsorption. These effects are not often talked about but are important to be aware of: due to the damage to the intestinal lining, the production of certain intestinal hormones is reduced, which can lead to a decrease in the secretion of pancreatic enzymes and expulsion of bile from the gallbladder (both of which aid in digestion). In addition, the damage to the gi tract causes significant inflammation, which can cause other food sensitivities until gluten is removed from the diet and the inflammation is dealt with.

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CELIAC FACTS

• In the U.S., on average, 1 in 133 people has celiac disease, whether they know it or not. This amounts to about 2.2 million Americans.

• The number in African, Hispanic, and Asian communities is lower: 1 in 236 people have CD.

• CD is not uncommon in Western European countries, with Italy having one of the highest rates of diagnosis. It is not known whether there is a greater genetic predisposition in that culture or if they have a higher rate of diagnosis simply because they are more aware of the disease and test more frequently for it.

• A landmark study shows that 60% of children and 41% of adults who have CD are completely asymptomatic.