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Who Gets Celiac Disease?

Heredity and other autoimmune diseases put you at risk for celiac disease. Find out how common celiac disease is and if you are at risk.

Medically reviewed by Niya Jones, MD, MPH

Celiac disease, also called celiac sprue, is one of the most widespread genetic disorders in the world — and yet the vast majority of people with celiac disease don't even know they have it.

According to the Celiac Disease Foundation, 97 percent of people with celiac disease remain undiagnosed. "Celiac disease is a genetic disorder that is common in people of European descent. It is less common in Asians and Africans," notes John Birk, MD, chief of gastroenterology at the University of Connecticut Health Center in Farmington.

In the United States, more than two million people have celiac disease. If your sibling, parent, or child has celiac disease, you have about a 5 percent risk of developing the condition yourself. Celiac disease becomes active if you're exposed to gluten, a protein found in wheat, barley, and rye. If you have celiac disease, gluten intake damages your intestinal lining and makes it hard to absorb nutrients from food.

Doctors once thought that celiac disease started in childhood, but now know that celiac disease can start at any age. The reason it starts later in some people is still unknown. Infection, pregnancy, surgery, and psychological trauma, however, are all factors that may trigger celiac disease symptoms.

Celiac Disease: The Role of Autoimmunity

Celiac disease is considered to be an autoimmune disease. This means that your immune system, which normally protects you from outside invaders like viruses or bacteria, becomes over-stimulated and attacks your body's own normal cells and tissues. Not surprisingly, other autoimmune diseases are more common in people with celiac disease.

"Someone who has unexplained anemia or abnormal liver blood tests, especially if they have autoimmune diseases like diabetes or thyroiditis, should be checked for celiac disease," advises Dr. Birk. Some of the most common autoimmune diseases associated with celiac disease include:

  • Type 1 diabetes, which typically occurs in childhood and requires treatment with insulin
  • Systemic lupus, a disorder that can cause arthritis and kidney damage
  • Sjogrens syndrome, a disease that leads to severe dryness of the mouth and eyes along with arthritis
  • Autoimmune thyroid disease, a condition in which an abnormal immune response leads to either an over- or under-active thyroid gland
  • Addison's disease, the underproduction of critical hormones made by special glands above the kidneys
  • Rheumatoid arthritis, a condition that causes severe joint swelling and pain
  • Autoimmune hepatitis, chronic inflammation of the liver
  • Dermatitis herpertiformis, blistering skin lesions, often found on the extremities, which affects 15 to 25 percent of people with celiac disease

Celiac Disease: Other Health Effects

Because celiac disease compromises the body's ability to process nutrients, the effects of the disease can be far-reaching. "People with celiac disease can also have osteoporosis from failure to absorb enough vitamin D and calcium. They can have lactose intolerance because of the inflammation of their intestines. Longstanding inflammation of the intestine can also lead to cancer of the intestine and lymphoma, which are both more common in celiac disease," notes Birk.

If you think you may be at risk for celiac disease, there are simple blood tests that can tell if your immune system is making antibodies, or specialized proteins, against your own cells and tissues. If these tests are positive, your doctor may then take a small biopsy from your intestine to make a definite diagnosis.

The good news about celiac disease is that a gluten-free diet will prevent further injury to your intestines. Existing damage usually heals within three to six months in children, longer in adults. Celiac disease can be difficult to recognize because its symptoms can vary widely from person to person. If you have unexplained symptoms, a family history of celiac disease, or if you have one of the associated conditions, see your gastroenterologist to check for celiac disease .

Last Updated: 09/26/2013

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