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Celiac disease, an inflammatory reaction to a protein called gliadin that is found in gluten in wheat, barley, and rye, causes severe digestive distress and nutritional deficiencies that are hard to miss. The full-blown symptoms of celiac disease, which inspire drastic changes in diet, are only diagnosed in about 1 in 3000 people.
What Is Celiac Disease?
Celiac disease, also known as gluten-sensitive enteropathy or tropical sprue, is a condition of chronic inflammation in the lower digestive tract caused by an autoimmune reaction to gluten. In celiac disease, the immune system generates antigens in the presence of certain proteins from wheat, barley, and rye, and these antigens activate T cells that attack the lining of the intestines as if they were an infection.
The most common symptom of celiac disease is diarrhea, by which the body expels the irritant chemicals from grain, along with all the other digested food in the gut. Celiac disease also triggers mild to severe abdominal cramping, boborygmus (growing stomach), and severe flatulence. It interferes with the body's ability to absorb fat, which has to be expelled as greasy, smelly, floating stool. Nutrients that have to be absorbed with fat, such as vitamins A, D, E, and K, and minerals become harder to absorb, so there may be severe nutritional deficiencies that cause skin problems and brittle bones.
What Is Silent Celiac Disease?
If you have the full-blown symptoms of celiac disease, there is no doubt you know you have them. Doctors do not have any difficulty diagnosing celiac disease that causes severe, disabling symptoms. When celiac disease is "silent" or "atypical," however, the diagnosis--and the diet that prevents future symptoms--may be overlooked.
Silent celiac disease can be recognized by saliva test for antigens to gliadin, the gluten protein in wheat, barley, and rye, but may not cause any noteworthy symptoms.
Atypical celiac disease may result in nutritional deficiencies that cause infertility, iron-deficiency anemia, or osteoporosis, without the diarrhea, cramping, tummy rumbles, and flatulence of the full-fledged disease.
People who have full-fledged celiac disease are usually very thin, even emaciated. People who have silent or atypical celiac disease, however, are often overweight, due to the accumulation of inflammatory substances and inflammatory white blood cells in belly fat. The sheer mass of white blood cells may account for up to 1/3 of abdominal "fat."
Only about 1 person in 3000 is diagnosed with celiac disease. As many as 1 person in 100 may have silent or atypical celiac disease, however, with vague symptoms that don't quite add up to a condition that doctors ordinarily treat. Fortunately, it is not difficult to find out whether you have a mild form of celiac disease that can cause nutritional deficiencies and, paradoxically, overweight.