Celiac disease, also known as gluten intolerance, is a genetic disorder that affects at least 1 in 133  Americans. Symptoms of celiac disease can range from the classic features, such as diarrhea, weight loss, and malnutrition, to latent  symptoms such as isolated nutrient deficiencies but no gastrointestinal symptoms. The disease mostly affects people of European (especially Northern European) descent, but recent studies show that it also affects Hispanic, Black and Asian populations as well. Those affected suffer damage to the villi (shortening and villous flattening) in the lamina propria and crypt regions of their intestines when they eat specific food-grain antigens (toxic amino acid sequences) that are found in wheat, rye, and barley. Oats  have traditionally been considered to be toxic to celiacs, but recent scientific studies have shown otherwise. This research is ongoing, however, and it may be too early to draw solid conclusions.

Because of the broad range of symptoms celiac disease presents, it can be difficult to diagnose. The symptoms can range from mild weakness, bone pain, and aphthous stomatitis to chronic diarrhea, abdominal bloating, and progressive weight loss. If a person with the disorder continues to eat gluten, studies have shown that he or she will increase their chances of gastrointestinal cancer by a factor of 40 to 100 times that of the normal population. Further, gastrointestinal carcinoma or lymphoma  develops in up to 15 percent of patients with untreated or refractory celiac disease. It is therefore imperative that the disease is quickly and properly diagnosed so it can be treated as soon as possib

Symptoms and Diagnosis of Celiac Disease

There are many ways that celiac disease can present itself, and this wide spectrum of symptoms often causes doctors to misdiagnose the condition. For some, the condition rears its head in infancy, often when the child begins eating solids like cereal. For others, diagnosis doesn't come until adulthood, sometimes as a result of surgery,pregnancy or severe stress.
Some of the most common symptoms of celiac disease include chronic diarrhea, abdominal pains, weight loss despite a hearty diet, foul-smelling bowel movements and excessive gas. However, there are some non-gastrointestinal hints as well, including muscle cramps, joint pain, fatigue, irritability and depression. One big clue can be the presence of a skin rash known as dermatitis herpetiformis, which causes blistering and itching, usually on the elbows, knees and rear end.
The severity of these symptoms can vary from person to person, and indeed, some people are completely asymptomatic. It's easy to write off occasional fatigue and diarrhea, but regardless of whether the symptoms interfere with daily life, they're doing severe damage to the intestinal lining. As malnutrition sets in, sufferers are at risk for anemia, infertility, osteoporosis and cancer. Infants may demonstrate a failure to thrive that is easily detectable to doctors, but adults with the condition may continue to stumble through life not knowing why they feel so bad. Studies suggest that for every one person who has received a diagnosis of celiac disease, about 30 people walk around unaware of their condition [source: Mayo Clinic].
Yet, even those who suffer from the symptoms of celiac disease may have to wait years for a correct diagnosis from their doctor. The symptoms mimic many other conditions, such as cystic fibrosis, irritable bowel syndrome and Crohn's disease. In many cases, it's up to the patient to suggest the condition to a doctor. It's particularly important, given the genetic nature of the disease, for close relatives of someone who has received a diagnosis to seek testing.
To test for celiac disease, doctors will usually perform a blood test to check for the presence of certain antibodies; these antibodies attack the enzymes the body produces to deal with the consumption of gluten. Doctors may follow up the blood test with a biopsy to check for damage to the small intestine.
Once a diagnosis of celiac disease has been established, what are the patient's options?