Celiac Disease

Digestive disease specialists at UT Southwestern have expertise in diagnosing and managing celiac disease, a serious immune reaction to eating gluten. Our goal is to provide immediate relief of symptoms and support patients with the resources needed to sustain long-term health and well-being.

Expert, Compassionate Care for Celiac Disease

Celiac disease is an autoimmune condition in which gluten, a protein found in cereal grains, causes damage to the small intestine.

When people with celiac disease eat gluten, their bodies produce an immune response that attacks the small intestine and prevents the absorption of some nutrients in food. This can lead to diarrhea, anemia, or other symptoms and cause life-threatening complications.

While there’s no cure for celiac disease, most people can manage their symptoms by completely avoiding gluten.

UT Southwestern gastroenterologists work collaboratively with pathologists, dietitians, and nurses to diagnose and treat celiac disease. Our faculty is advancing digestive disease research to determine the treatments that are most effective.

Causes and Risk Factors of Celiac Disease

The exact cause of celiac disease is unknown, but there is a genetic link: The risk of developing celiac disease is increased by variants of certain genes that provide instructions for making proteins with important immune system functions.

The disease tends to run in families. People who have a first-degree relative (parent, sibling, or child) with celiac disease have a roughly one in 10 risk of developing the disease themselves.

Celiac disease is also more common in people with:

• Type 1 diabetes
• Addison’s disease (adrenal insufficiency)
• Turner syndrome, a chromosomal disorder that affects females
• Autoimmune thyroid disease, a condition in which the immune system attacks the thyroid
• Microscopic colitis, an inflammation of the large intestines

Celiac disease affects people of all ages and ethnicities, though it’s more common in Caucasians and females.

Symptoms of Celiac Disease

Most people with celiac disease have at least one symptom, but some people don’t show any signs of the disease.

Symptoms related to digestion are more common in children. These include:

• Abdominal pain
• Chronic diarrhea
• Constipation
• Fatigue
• Fatty or pale stools that float and might smell foul
• Upset stomach
• Vomiting
• Weight loss

In addition to some of the above symptoms, older children and teens may experience stunted growth and delayed puberty. Dental enamel defects can also be a symptom in children with celiac disease.

Most adults who have celiac disease have additional symptoms such as:

• Anemia, a lack of healthy red blood cells
• Anxiety
• Depression
• Dermatitis herpetiformis, a chronic itchy skin rash
• Headaches
• Joint pain
• Mouth ulcers
• Numbness and tingling in the hands and feet
• Softening of the bones (osteomalacia) or loss of bone density (osteoporosis)

Diagnosing Celiac Disease

Celiac disease shares symptoms of other conditions such as lactose intolerance and irritable bowel syndrome. It’s important to see an experienced gastroenterologist for a comprehensive assessment and accurate diagnosis.

UT Southwestern gastroenterologists conduct a thorough evaluation, which includes a:

• Physical exam
• Discussion of personal and family medical history
• Discussion of symptoms and risk factors

We might also look for dental enamel defects, which are a common sign of celiac disease, particularly in children.

To confirm a diagnosis, we may use:

• Blood tests: We look for high levels of certain antibody proteins, which are a sign of an immune reaction to gluten.
• Intestinal biopsy: Doctors remove a small tissue sample from the small intestine during an upper GI endoscopy, a procedure that uses a thin, flexible tube with a camera to examine the lining of the upper gastrointestinal tract.
• Genetic testing: We’ll look for certain gene variants that are linked to celiac disease.
• Skin biopsy: For suspected dermatitis herpetiformis, we may take a small skin sample to examine under a microscope.

If patients suspect they have celiac disease, it's important they receive a diagnosis before they stop eating gluten. Removing gluten from their diet could make the results of blood tests appear normal.

Treatment for Celiac Disease

If left untreated, celiac disease can cause serious problems at any age.

In children, the ability to absorb nutrients plays a key role in healthy development. Without it, a child can experience problems such as delayed puberty, mood changes, or weight loss.

Over the long term, untreated celiac disease can lead to conditions such as:

• Heart disease
• Type 1 diabetes
• Multiple sclerosis (MS)
• Infertility and miscarriage
• Gastrointestinal cancer

While there is no cure for celiac disease, it can be managed by strictly avoiding gluten.

UT Southwestern dietitians work with patients to create a gluten-free eating plan. We help patients avoid all gluten, which can be present in non-food items such as vitamin supplements, toothpaste, and medications. Even small amounts of gluten can cause intestinal damage.