Celiac disease is a digestive disorder caused by an abnormal reaction to gluten. In celiac disease, the immune response to gluten creates toxins that destroy the villi — tiny, finger-like protrusions inside your small intestine.

Celiac disease is more than gluten intolerance. People with non-celiac gluten sensitivity may have a mild sensitivity to gluten, while others have celiac disease, which is an autoimmune disorder.

Celiac disease is also known as:

  • sprue
  • nontropical sprue
  • gluten-sensitive enteropathy

Gluten is a protein found in foods made with wheat, barley, rye, and triticale. It’s also found in oats that have been processed in facilities that handle other grains. Gluten can even be found in some medications, vitamins, and lipsticks.

Gluten intolerance, which may also be called a gluten-related disorder, involves symptoms that arise after you consume foods containing gluten.

In celiac disease, the immune response to the presence of gluten creates toxins. These toxins destroy the villi, which are tiny finger-like protrusions inside your small intestine. When the villi become damaged, your body is unable to absorb nutrients from food. This can lead to malnutrition and other serious health complications, including permanent intestinal damage.

According to a 2018 research review, 1% of the world’s population has celiac disease. Researchers estimate that roughly 2 million people in the United States have this autoimmune disorder.

People with celiac disease need to eliminate all forms of gluten from their diet. This includes most bread products, baked goods, beer, and foods in which gluten may be used as a stabilizing ingredient.

Celiac disease symptoms usually involve your intestines and digestive system, but they can also affect other parts of your body. Children and adults tend to have a different set of symptoms.

Celiac disease symptoms in children

Children with celiac disease may feel tired and irritable. Additionally, they may not gain weight at the expected pace or may experience delayed puberty. Other common symptoms include:

Celiac disease symptoms in adults

Adults with celiac disease may experience digestive symptoms. But in most cases, symptoms will also affect other areas of your body. These symptoms may include:

  • iron deficiency anemia
  • joint pain and stiffness
  • constipation
  • diarrhea
  • weight loss
  • depression and anxiety
  • nausea and vomiting
  • headaches or migraine episodes
  • weak, brittle bones
  • fatigue
  • seizures
  • skin disorders
  • numbness and tingling in your hands and feet
  • tooth discoloration or loss of enamel
  • pale sores inside your mouth
  • irregular menstrual periods
  • infertility and miscarriage

Dermatitis herpetiformis (DH) is another common symptom of celiac disease. DH is an intensely itchy skin rash made up of bumps and blisters. It may develop on your elbows, buttocks, and knees. DH affects 10 to 15% of people with celiac disease. Those who experience DH usually don’t have digestive symptoms.

It’s important to note that symptoms can vary from person to person depending on various factors, meaning that celiac disease can be difficult to diagnose. Symptoms may vary depending on:

  • the length of time you were breastfed as an infant
  • the age at which you started eating gluten
  • the amount of gluten you eat
  • the severity of intestinal damage

Some people with celiac disease have no symptoms. But silent celiac disease can still result in long-term complications.

Schedule an appointment with a healthcare professional right away if you suspect that you or your child has celiac disease. When diagnosis and treatment are delayed, complications are more likely to occur.

If you need help finding a primary care doctor, then check out our FindCare tool here.

Celiac disease runs in families.

People who have other autoimmune diseases and certain genetic disorders are also more likely to have celiac disease. Conditions associated with celiac disease include:

Diagnosis begins with a physical examination and a medical history.

Healthcare professionals will also perform various tests to help confirm a diagnosis. People with celiac disease often have high levels of antiendomysium (EMA) and anti-tissue transglutaminase (tTG-lgA) antibodies. These can be detected with blood tests. Tests are most reliable when they’re performed while gluten is still in your diet.

Common blood tests include:

If you have DH, a skin biopsy can also help a doctor diagnose celiac disease. The doctor will remove tiny pieces of skin tissue for examination under a microscope. If the skin biopsy and blood test results indicate celiac disease, an internal biopsy may not be necessary.

If the blood test or skin biopsy results are inconclusive, a doctor can use an upper endoscopy to test for celiac disease.

During an upper endoscopy, a doctor will thread a thin tube called an endoscope through your mouth and down into your small intestine. A small camera attached to the endoscope allows the doctor to examine your intestine and check for damage to the villi. They can also perform an intestinal biopsy, which involves removing a tissue sample from your intestine for analysis.

The only way to treat celiac disease is to permanently remove gluten from your diet. This allows your intestinal villi to heal and begin absorbing nutrients properly.

A doctor or a registered dietitian can teach you how to avoid gluten and how to follow a nutritious gluten-free diet. They will also give you instructions on how to read food and product labels so you can identify any ingredients that contain gluten.

Symptoms can improve within days of removing gluten from your diet. However, you shouldn’t stop eating gluten until a diagnosis is made. Removing gluten too soon may interfere with test results and lead to an inaccurate diagnosis.

Alternative therapies for celiac disease

You can talk with a healthcare professional about taking a supplement, such as a multivitamin or an iron supplement. They may also recommend taking vitamin D, magnesium, or vitamin B6. But it’s essential to check the labels on supplements because some contain gluten.

Gluten-digesting enzymes are another supplement on the market that may be helpful for non-celiac gluten sensitivity. Claims that these enzymes help people with celiac digest gluten by breaking down the protein have not yet been verified.

Again, before starting an enzyme or any other supplement, you should schedule an appointment with a healthcare professional to discuss the potential benefits and risks.

Maintaining a gluten-free diet isn’t easy, but many companies are now making gluten-free products that you can find at various grocery stores and specialty food stores. The labels on these products will say “gluten-free.” In addition, more and more restaurants offer gluten-free bread products such as hamburger buns and pizza crust.

If you have celiac disease, it’s important to know which foods are safe. Here is a series of food guidelines that can help you determine what to eat and what to avoid.

Avoid the following ingredients:

  • wheat
  • spelt
  • rye
  • barley
  • triticale
  • bulgur
  • durum
  • farina
  • graham flour
  • semolina
  • malt

Avoid these products unless the label says “gluten-free”:

  • beer
  • bread
  • cakes and pies
  • candy
  • cereals
  • cookies
  • crackers
  • croutons
  • gravies
  • imitation meats or seafood
  • oats
  • pasta
  • processed lunch meats, sausages, and hot dogs
  • salad dressings
  • sauces (includes soy sauce)
  • self-basting poultry
  • soups

You can eat these gluten-free grains and starches:

  • buckwheat
  • corn
  • amaranth
  • arrowroot
  • cornmeal
  • flour made from rice, soy, corn, potatoes, or beans
  • pure corn tortillas
  • quinoa
  • rice
  • tapioca

Healthy gluten-free foods include:

  • fresh meats, fish, and poultry that haven’t been breaded, coated, or marinated
  • fruit
  • most dairy products
  • starchy vegetables like peas, potatoes, including sweet potatoes, and corn
  • rice, beans, and lentils
  • vegetables
  • wine, distilled liquors, ciders, and spirits

Your symptoms should improve within days to weeks of cutting all gluten out of your diet. In children, the intestine usually heals in 3 to 6 months. Intestinal healing may take several years in adults. Once your intestine completely heals, your body will be able to properly absorb nutrients.