For an estimated 3 million Americans, pizza-and-movie nights have to skip the pizza and there are no pretzels at the ball game. That’s how many people have celiac sprue, a condition in which an immune reaction to wheat gluten causes inflammation in the small intestine. This does more than cause pain and discomfort; over time, this inflammation can cause damage to the intestine that interferes with the ability to properly absorb nutrients.
The cause of celiac is not well understood, though research suggests that some people have a genetic predisposition to the disease, and it is correlated with certain genetic mutations. Often people first exhibit signs of the illness after surgery, pregnancy and childbirth, or a viral infection, or in times; it can also be triggered by emotional stress. People with colitis, type 1 diabetes, or other autoimmune diseases are at heightened risk for celiac, and scientists believe there is a link.
Celiac not only leads to diarrhea, nausea, cramping and weight loss, but the condition can also affect the skeletal, nervous, and even reproductive systems. People with celiac may experience anemia, fatigue, pain in the bones and joints, depression or anxiety, problems with fertility, a type of rash called dermatitis herpetiformis, and discolored teeth as well as digestive problems. It’s not only food that sufferers have to be wary of. Many products, including medications and cosmetics, can contain wheat, barley, rye, or other sources of gluten.
There is currently no cure. People with celiac must maintain a strict lifelong gluten-free diet, avoiding barley, bulgur, durum, farina, Graham flour, malt, rye, semolina, spelt, triticale, and wheat at all times. Every time a person with celiac consumes foods made with these ingredients, it does some damage to the small intestine. However, research is being conducted on an enzyme supplement that might allow sufferers to digest gluten, the way lactase is available for people with lactose intolerance. Patients who are having issues with nutrient absorption may need supplements to help make up the deficit, most commonly calcium, iron, and B vitamins as well as other nutrients. Corticosteroids such as prednisone, or other anti-inflammatory drugs, may be given to control inflammation.