Celiac Disease
Celiac Disease is an allergy to gliadin, a protein component of gluten, which is found in wheat and other grains. It was originally thought to be a relatively rare disease, primarily of childhood, and in adults presenting with severe diarrhea, weight loss and malnutrition. We now know it to be far more common than previously thought, and is present in 1.3 and 3 million Americans. The symptoms also are not necessarily as obvious as once thought. Although diarrhea is still the most common symptom, patients may present with iron deficiency anemia, abdominal pain, unexplained weight loss or abnormal liver function tests. Celiac disease can be diagnosed with a screening blood test, but biopsy of the small intestine (a simple out-patient procedure) is recommended to confirm the diagnosis. A trial of a Gluten-free diet is not recommended before a firm diagnosis is made, as that diet is very restrictive and expensive, and the response may be subjective. Only when the diagnosis is sure should patients be placed on this difficult diet.
