Celiac Disease: The Gut and the Immune System
An immune response to gluten that damages the small intestine, with symptoms ranging from bloating to joint pain, and links to other autoimmune diseases.
Many of my arthritis patients ask about the relationship between the gut and the immune system. According to the Celiac Disease Foundation, about 1 in every 100 people is affected by celiac disease.
Celiac disease (CD) is an immune response to eating gluten, a protein found in wheat, barley, and rye. The prolonged immune reaction creates inflammation and damage to the lining of the small intestine, targeting small finger-like projections called villi, and results in malabsorption of critical nutrients.
Symptoms may include bloating, weight loss, constipation or diarrhea, flatulence, stomach pain, fatigue, nausea, vomiting, joint pain, skin rash, and bone pain.
Untreated CD can coexist with other autoimmune diseases, such as dermatitis herpetiformis, type 1 diabetes, multiple sclerosis, Sjögren's syndrome, rheumatoid arthritis, lupus, Hashimoto's thyroiditis, autoimmune hepatitis, and inflammatory bowel disease. Other complications may include anemia, osteoporosis, infertility, heart disease, intestinal cancers, and growth abnormalities.
A strict gluten-free diet is essential for most individuals. Removing gluten helps prevent the immune system from attacking the small intestine and allows the villi to recover from inflammation.
Please see your primary care physician and a gastroenterologist for a diagnostic workup, which may include an endoscopy, capsule endoscopy camera, and blood tests including genetic testing. Learn which foods don't contain gluten, and remember that gluten can be hidden in many foods, medicines, and preservatives. Many restaurants now offer gluten-free menu items, and the Celiac Disease Foundation has an abundance of resources.
Dr. Maggie Cadet, MD