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Director of Mayo Clinic Executive Health Program, Michael A. Covalciuc, M.D., M.P.H, discusses the digestive condition, Celiac disease. 


DIGESTIVE SYMPTOMS ARE COMMON. Most are transitory or respond to simple changes in diet or lifestyle. However, for some people, digestive symptoms can be chronic, severe and cause significant impairment to their quality of life. One such condition is Celiac disease (also known as Celiac Sprue, Nontropical Sprue or Gluten-Sensitive Enteropathy). Celiac disease is an immune reaction to the protein gluten, which is found in foods containing grains like wheat, barley and rye (e.g. bread, pasta and pizza crust). When gluten is ingested, the immune reaction causes damage to the lining of the small intestine.

The cause(s) are unknown. There is a hereditary risk of five to 15 percent if an immediate family member is affected. In studies of identical twins, 70 to 85 percent of the time, the second twin is affected if one twin has Celiac disease. Sometimes the disease develops after some form of trauma like infection, surgery or pregnancy. People with type 1 diabetes (insulin-dependent) or certain thyroid diseases are more commonly impacted.

Typical symptoms include bloating, abdominal pain and diarrhea. However, these symptoms can mimic other gastrointestinal diseases, and infrequently some people may not have any gastrointestinal symptoms. Other features/complications include anemia (from malabsorption of nutrients and vitamins leading to malnutrition), joint pains, muscle cramps, skin rash, mouth sores, osteoporosis (loss of calcium and vitamin D), nerve damage, general weakness and fatigue and weight loss. Due to damage to the small intestines, some people will develop lactose intolerance. Untreated people have a long-term increased risk of some cancers including intestinal lymphoma.

Diagnosis, in addition to the medical history and physical exam, involves testing the blood for specific antibodies present at high levels. These antibodies can identify people more likely to have the disease. In addition, a biopsy of the small intestine (done by a scope inserted through the mouth) is used to confirm the diagnosis. Treatment involves a gluten-free diet.

If you have persistent digestive symptoms, discuss them with your doctor. Keeping a diary of foods eaten and symptoms can be very helpful. Only your doctor can make the proper diagnosis.

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To Learn More: For more than a century, Mayo Clinic has given patients peace of mind knowing they received care from the world’s leading experts. Since opening in Arizona in 1987, Mayo Clinic continues its tradition of a team of specialists listening to thoroughly understand and find the answers to patients’ health issues and concerns. Mayo Clinic’s Executive Health Program combines Mayo’s diagnostic expertise with the latest in preventive medicine for an individualized, thorough and expedited healthcare evaluation.

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