Digestive Health Clinic, LLC specializes in diseases of the digestive system, liver diagnostic and therapeutic endoscopy. Digestive Health Clinic is a state-of-the-art outpatient healthcare facility located in Boise, Idaho. We provide comprehensive care of diseases of the digestive system, including colon cancer screening and prevention.

Celiac Disease

Recently at DHC’s Lunch-N-Learn, our very own DNP, Nancy L’Heureux presented to us the gluten-sensitive disease known as celiac. Nancy explained the details of the disease, symptoms, diagnosis and treatment. Read on to find out the highlights of Nancy’s presentation.

Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is a serious, genetic autoimmune disorder activated by consuming a protein called gluten. Gluten is found in wheat, barley and rye and can also hide in foods such as candy, gum and ketchup. When a person with celiac eats gluten, the protein restricts the absorption of nutrients from food by damaging a part of the small intestine called villi. Damaged villi make it practically impossible for the body to absorb nutrients into the bloodstream, leading to malnourishment and a multitude of other problems as well as causing gastrointestinal upset. In some individuals the symptoms can be quite dreadful however, there are those who experience no symptoms at all and will go undiagnosed.

Some of the most common symptoms include:

• Abdominal pain
• Dermatitis Herpetiformis (skin rash)
• Anemia
• Diarrhea
• Fatigue
• Nausea
• Vitamin D Deficiency
• Iron Deficiency

Diagnosis of celiac disease can be tricky and often difficult as the symptoms can mimic those of other GI related diseases such as irritable bowel syndrome, Crohn’s disease, intestinal infections, and lactose intolerance. However, there are several tests performed in order to reveal a celiac disease diagnosis. Blood tests are usually the first step in the diagnosis process as they have a high rate of accuracy. Currently, the recommended blood tests include:

• Total IgA
• IgA-tTG
• IgA-EMA
• If IgA is deficient, it is recommended that the IgG/IgA-DGP also be ordered.

It is important to remain on a normal, gluten-containing diet prior to testing for celiac disease as a gluten-free diet can interfere with an accurate diagnosis. If the blood tests and symptoms indicate celiac disease, a provider will likely suggest an EGD in order to get a biopsy of the lining of the small intestine to confirm the diagnosis. If your blood tests come back negative there is still a small chance you could have celiac disease which is another good reason for an EGD. And if the intestinal biopsy results indicate that celiac disease is not present, but you and your provider still suspect gluten is the cause of your symptoms, you can explore the possibility of eliminating all gluten from your diet.

Although living with celiac disease may seem challenging, it is actually not that difficult to lead a gluten-free life. Thankfully, many mainstream grocery stores carry plenty of gluten-free items making it easier to follow such a restrictive diet. Nevertheless, it can be overwhelming at times and perhaps the easiest way to handle switching to a gluten-free diet is to first stick to the foods that are naturally gluten-free. If you are one of the lucky ones with celiac disease, just remember to ALWAYS read labels and that to be gluten-free means gluten-free, not gluten-sort-of.

Rebecca Jensen
Quality Improvement Specialist
Digestive Health Clinic, LLC