Celiac Disease


This image shows the damage that eating the protein gluten can cause in the small intestine of a person with celiac disease. Experts believe that nearly 1 in 100 people may have this autoimmune ailment which is triggered by exposure to the protein gluten in wheat and similar proteins in rye and barley. This man's small intestine enlarged in the background image is lined with finger-like healthy villi (inset) which absorb nutrients from food. But when those with celiac disease eat gluten it is seen as a foreign invader. The resulting autoimmune response damages villi cells (right inset). The villi are worn away and cannot absorb nutrients properly resulting in malnutrition and many other serious effects. Photo credit: wheat image comes from the National Cancer Institute.

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Celiac disease is often misunderstood and misdiagnosed. Yet, experts believe that nearly 1 in 100 people may have this autoimmune ailment, which is triggered by exposure to the protein gluten in wheat and similar proteins in rye and barley. People with celiac disease, or CD, have a genetic predisposition to the illness. Some researchers believe that CD sufferers also have an intestinal wall abnormality which allows gluten fragments to reach underlying cells, where they trigger an autoimmune reaction. Read more

Coeliac disease (/ˈsiːli.æk/; celiac disease in the United States and often celiac sprue) is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy onward. Symptoms include pain and discomfort in the digestive tract, chronic constipation and diarrhoea, failure to thrive (in children), anaemia and fatigue, but these may be absent, and symptoms in other organ systems have been described. Vitamin deficiencies are often noted in people with coeliac disease owing to the reduced ability of the small intestine to properly absorb nutrients from food.

Increasingly, diagnoses are being made in asymptomatic persons as a result of increased screening; the condition is thought to affect between 1 in 1,750 and 1 in 105 people in the United States, and 1 in 100 in the UK. Coeliac disease is caused by a reaction to gliadin, a prolamin (gluten protein) found in wheat, and similar proteins found in the crops of the tribe Triticeae (which includes other common grains such as barley and rye).

Upon exposure to gliadin, and specifically to three peptides found in prolamins, the enzyme tissue transglutaminase modifies the protein, and the immune system cross-reacts with the small-bowel tissue, causing an inflammatory reaction. That leads to a truncating of the villi lining the small intestine (called villous atrophy). This interferes with the absorption of nutrients because the intestinal villi are responsible for absorption. The only known effective treatment is a lifelong gluten-free diet. While the disease is caused by a reaction to wheat proteins, it is not the same as wheat allergy.

This condition has several other names, including cœliac disease (with œ ligature), c(o)eliac sprue, nontropical sprue, endemic sprue, and gluten enteropathy. The term coeliac derived from the Greek κοιλιακός (koiliakós, "abdominal") and was introduced in the 19th century in a translation of what is generally regarded as an ancient Greek description of the disease by Aretaeus of Cappadocia.


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