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Hi there!  This is Myron Brand, MD, a practicing gastroenterologist and clinical professor of Medicine at Yale University School of Medicine.  I want to bring you up to date on the etiology of Celiac disease, the potential consequences of this disease not being diagnosed and appropriately treated.   Missing the diagnosis of Celiac Disease or not treating the disease when known is no laughing matter!

Celiac disease is an immune related inflammatory disease of the small intestine caused by the dietary protein gluten.   It is a hereditary disease, so if you are diagnosed.  family members and  relatives should be tested.  Gluten is found in wheat, barley, rye and possibly oats. Exposure to gluten in susceptible individuals has the potential to set off a cascade of events not just in the gastrointestinal tract but throughout the body.

The effects of gluten in any susceptible individual are variable.  Some will have the disease classically with diarrhea, weight loss,  abdominal bloating, growth retardation, fatigue, and multiple vitamin deficiencies, while others will have minimal or no gastrointestinal  symptoms but present with symptoms of other organ systems such as anemias,  loss of dental  enamel, liver dysfunction, arthritis, osteoporosis,  or central nervous system dysfunction.  I have found that these atypical presentations have increased in frequency over the past few decades. In fact, celiac disease is present in as many as 1 in 100 persons in the United States and may present in early childhood or more typically between the ages of 10 and 40 years.

Once diagnosed with celiac disease sticking to a gluten free diet is Mandatory… this is not negotiable! Failure to stick to a gluten free diet could potentially lead to serious health issues including cancers of the gastrointestinal tract.   It is not an easy diet to maintain, as gluten containing products are all around us.  I often refer my celiac patients to a dietician or nutritionist to enlist their help in teaching the patient about what foods to avoid.  The Internet is helpful here. Positive dietary information is present there.  Fortunately, as more patients have been diagnosed and the public made more aware of this disease, the food industry has responded by improving on food labeling and producing more gluten free products.

Be vigilant and proactive about your health.  If you are not feeling well ask your physician.  “Could I have celiac disease?”  The testing is as easy as a blood screen.  Once diagnosed, take the disease seriously. The potential for adverse health consequences are real….. like I said,  celiac disease is no laughing matter!

Myron Brand, MD

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