celiac
Explore the truth about celiac disease information. (For Spectrum Health Beat)

Does your abdomen frequently send distress signals that seem to puzzle doctors? Or does the cause of your malaise and exhaustion remain a mystery?

Don’t wave the white flag just yet. Instead, consider talking with your health care provider about celiac disease.

Celiac disease is caused by exposure to dietary gluten, a protein found in cereal grains such as wheat, barley and rye.

Also known as celiac sprue, it tends to run in families, particularly those of European descent. It’s also more common in women than in men.

For people with the disease, the gluten acts like a toxin, or poison, and can do some ghastly things to the gut: diarrhea, constipation, bloating and abdominal pain.

But that’s just part of the picture.

While about 50 percent suffer gastrointestinal symptoms, celiac disease sufferers also include people with more subtle digestive, as well as systemic, symptoms, said Ben Kieff, MD, a gastroenterologist with Spectrum Health Medical Group.

“In some patients, canker sores may be (the) sole presenting complaint,” Dr. Kieff said. “Because many symptoms may not necessarily be associated with something you eat, celiac disease is likely under diagnosed.”

Other less obvious symptoms include weight loss, fatigue, irritability, infertility in women, depression and anemia.

The only way to combat the disease is to avoid gluten.

Dr. Kieff encourages his patients with celiac disease to carefully read food labels and look for ingredients that may contain wheat, rye and barley. He also suggests visiting celiac.com for useful information about food and ingredients that are safe for patients.

Dr. Kieff sets the record straight on other frequent questions, myths and misunderstandings that surround celiac disease.

Test your knowledge with his ‘Fact or Fiction’ quiz:

1. Ancient grains are a healthy choice for those who have celiac disease.

Fact. Quinoa, millet, amaranth and buckwheat are centuries-old grains that are all gluten-free. Other good grain choices include rice, corn, sorghum and millet. Oats are tolerated by most patients with celiac disease but it’s important to look for certified gluten-free oats that are not milled with other potentially contaminated grains.

2. Celiac disease is only found in children.

Fiction. Though common in children, celiac can occur at any age in those with a genetic predisposition to the disease. Some people can tolerate gluten for decades then suddenly develop sensitivity to it.

3. Celiac disease is one of the most common digestive disorders in the U.S.

Fact. About 3.9 million adults and children in the United States have been diagnosed. It’s the most common inherited immune disorder and is more prevalent than Crohn’s disease, ulcerative colitis, cystic fibrosis and type 1 diabetes.

4. If you have celiac disease, a little bit of gluten isn’t really dangerous.

Fiction. Studies show even a small amount of gluten is as dangerous as eating an entire loaf of bread.

5. People with celiac disease are allergic to wheat.

Fiction. Celiac disease is an inherited immune disorder, like rheumatoid arthritis, not an allergy. If you have celiac disease and eat gluten, your immune system responds by attacking the small intestine and altering the absorption of nutrients into your body.

6. Most foods contain at least a small amount of gluten.

Fiction. Most fresh foods, including fruits, vegetables, dairy products and meat, are gluten-free.

7. If you have diabetes, you may be more prone to celiac disease.

Fact. People with diabetes and other autoimmune diseases may be more susceptible to celiac disease.

8. People of Dutch heritage may be more likely to develop celiac disease.

Fact. This genetic composition is fertile ground for celiac disease. Other Dutch connections: In the 1940s, doctors observed that Dutch children with celiac improved during World War II grain shortages and then worsened again after Swedish planes dropped relief supplies with bread. In the 1950s, it was Netherlands pediatrician Willem Dicke who discovered that wheat flour, and later gluten, was the dietary element toxic to celiac patients.

9. Gluten is present in many foods where you may not expect it.

Fact. Salad dressings, sausage, chewing gum, candy and beer all contain gluten. But many of these foods are also available in gluten-free versions.

10. Celiac disease is associated with nerve and bone problems.

Fact. Reduced bone density is common and can lead to some serious consequences. According to a research review published in The Journal of Clinical Endocrinology & Metabolism, celiac disease was associated with a 30 percent increased risk of any fracture and a 69 percent increased risk of hip fracture. Neurological issues such as ataxia, peripheral neuropathy (nerve damage) and seizures are also possible.