What is Celiac Disease?
Celiac disease is a type of autoimmune disorder that causes the body to attack parts of the intestinal tract – finger-like projections known as villi, that absorb nutrients. In the presence of gluten – a protein found in wheat, rye, and barley products – a person with celiac disease will experience chronic inflammation of the intestines, and their villi will shorten and eventually flatten out. Chronic diarrhea, abdominal pain, and abdominal swelling are all notable symptoms of classic celiac disease.
What Happens If Celiac Disease Goes Undiagnosed?
If a person with celiac remains undiagnosed and continues to consume gluten, they will often develop more serious secondary problems such as anemia, malnutrition, infertility, migraines, joint pain, and more. Unfortunately, according to the National Institutes of Health (NIH), it is more common to for a person with undiagnosed celiac disease to experience a range of secondary health problems without any gastrointestinal symptoms than it is to have the classic symptoms.
Gluten sensitivity is a very real issue for some individuals, and it has received a lot of attention lately with the craze around celiac disease and gluten free diets. However, true gluten intolerance (celiac disease) only affects around 1 percent of the population. That being said, just as with lactose, varying levels of gluten sensitivity do affect a significant portion of the population. This condition is currently referred to as “non-celiac gluten sensitivity” (NCGS), and is not yet an established condition in the medical community. Approximately 5 percent of the population has NCGS.
DNA test for gluten sensitivity
The answer lies in your DNA! There are two genes associated with gluten sensitivity: HLA-DQA1 and HLA-DQB1. The NIH estimates that somewhere between 30 and 40 percent of the US population carries one or both genes, but only 3 percent of carriers will actually develop celiac disease. To make things even more interesting: you can be a carrier for celiac disease or NCGS and not know it until an external event causes the gene to ‘turn on’. This is known as a trigger, and can be anything from being born (which can be traumatic), menopause, influenza, or even antibiotic use for a common infection (or the infection itself). There are also countless environmental triggers known to trigger celiac disease such as exposure to certain chemicals
So, in a nutshell, there are three factors needed for you to experience celiac or NCGS: be a carrier for the gene, experience some sort of trigger to turn the gene on, and have a diet that contains gluten.
What Are The Risk Factors for Celiac Disease?
While celiac disease is rare, there are a few circumstances that would put you at an increased risk for the condition:
- A family member with celiac or NCGS
- Rheumatoid arthritis
- Type 1 diabetes
- Down syndrome or Turner syndrome
- Addison’s disease
- Disorder of the thyroid gland
How Can I Find Out If I Have Celiac Disease or NCGS?
DNA and Gluten Sensitivity
There are a variety of genetic tests available, and nowadays they are fairly accurate. According to the NIH, it takes – on average – 6 to 10 years after the onset of symptoms to be diagnosed with celiac disease. This is partially because most cases of adult-onset celiac present with non-classic symptoms, but also because the tests for celiac markers are not foolproof. To further complicate the test results: many people are going gluten-free as a ‘cure-all’ to see if they start feeling better. When they do, the inflammatory markers associated with gluten sensitivity decrease or disappear. So, when an in-office gluten sensitivity test is performed after removing gluten from the diet it will come back with a false-negative.
The only foolproof way of finding out if you have celiac disease is by getting a genetic test to see if you have one or both of the genetic markers. If your results show that you carry one or both of the genes, it means just that: you are a carrier. To test for NCGS or celiac, you will need to be tested once more for the inflammatory markers (usually a biopsy) while refraining from a gluten-free diet for accurate results.