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Small Bowel

Celiac Disease

Celiac disease is an autoimmune condition triggered by gluten in genetically susceptible individuals, causing damage to the small intestinal lining and a wide range of digestive and non-digestive symptoms.

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Symptoms

  • Chronic diarrhea, bloating, or abdominal discomfort
  • Unintentional weight loss and malnutrition
  • Iron-deficiency anemia not otherwise explained
  • Fatigue, brain fog, and osteoporosis
  • Skin: dermatitis herpetiformis

Possible causes

  • Autoimmune response to gluten in wheat, barley, and rye
  • Strong genetic component (HLA-DQ2/DQ8)
  • Family history significantly increases risk

How we diagnose

  • Serologic testing: tissue transglutaminase (tTG-IgA) with total IgA
  • Small-bowel biopsy via gastroscopy for confirmation
  • Do NOT start a gluten-free diet before testing — it obscures results

Treatment options

  • Strict, lifelong gluten-free diet with dietitian guidance
  • Replete deficiencies: iron, vitamin D, B12, folate
  • Bone-density evaluation at diagnosis
  • Regular follow-up with serology to confirm healing

Lifestyle & prevention

  • Read labels carefully; watch for cross-contamination
  • Screen first-degree relatives
  • Address associated conditions (thyroid, diabetes) when present