Celiac Disease Clinic

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What is celiac disease?

Celiac disease is a chronic digestive disorder that occurs in genetically susceptible individuals. This multisystem disorder is caused by the body's immune system reacting to proteins in wheat, rye and barley. The immune reaction damages the lining of the small intestine, causing reduced nutrient absorption. When the intestinal villi in the small intestine are damaged, the body cannot absorb critical vitamins, minerals and calories. This condition continues as long as these proteins are in the diet.

Dr. Shiela Crowe, director of the adult celiac disease clinic at UC San Diego Health System discusses the incidence of celiac disease and its treatment.

Are you at risk for celiac disease?

Celiac disease can occur at any time in a person’s life. Approximately one in 100 people in the United States have the disease, yet only a small percentage of individuals with celiac disease are diagnosed. Current estimates are that there are more than 2 million people nationwide with celiac disease who have not been diagnosed.

The main risk factor is having a family member with celiac disease. The disease can affect anyone, but it tends to be more common in those with existing autoimmune diseases (e.g., autoimmune liver disease, type 1 diabetes, rheumatoid arthritis and autoimmune thyroid disease).

Celiac disease symptoms

Symptoms of celiac disease can occur in the digestive system or in other parts of the body. From person to person, symptoms can vary a great deal, which can make a definitive diagnosis difficult.

 One person may have depression, irritability or fatigue, while another may have diarrhea, constipation, gas, bloating or abdominal pain. These symptoms can also sometimes first appear after an episode of gastroenteritis, severe emotional distress, abdominal surgery, pregnancy or childbirth.

Look for any of the following symptoms:

  • Bloating, gas or abdominal pain
  • Constipation or diarrhea
  • Significant unexplained weight loss
  • Chronic fatigue and weakness
  • Unexplained anemia
  • Premature onset of osteoporosis
  • Itchy skin rash with small blisters
  • Irritability or behavior change
  • Mouth ulcers
  • Tingling or numbness in hands or feet
  • Migraine headaches

Diagnosing celiac disease

While celiac disease primarily affects the gastrointestinal tract, it is now recognized that the condition can affect other organ systems without showing noticeable gastrointestinal symptoms. This makes diagnosing celiac disease challenging.

Several blood tests are available to test for celiac disease. The blood tests measure for certain antibodies, including IgA tissue transglutaminase antibody (also known as tTG antibody), IgA anti-endomysial antibody, anti-gliadin antibodies IgA and IgG (in younger children) and antibodies to deamidated gliadin.

If the tests results are positive, an upper endoscopy is performed to get a biopsy from the first part of the small intestine (duodenum). The biopsy is required to establish a definite diagnosis of celiac disease. Sometimes the symptoms are so pronounced that an endoscopy and biopsy is performed even if the celiac disease antibody test results are negative.

Prior to celiac disease diagnosis

DO NOT start a gluten-free diet before you are diagnosed. The damage to the small intestine that is caused by gluten in people with celiac disease is reversible, and eliminating gluten from the diet before the biopsy is performed can interfere with obtaining accurate test results.

Celiac disease is not the same as a wheat allergy or gluten sensitivity without intestinal damage. The hereditary nature of the disease and the risk of nutritional deficiencies, other autoimmune diseases and GI cancers make it important for a person to be properly diagnosed.

Read more about the differences between these conditions and diseases at the American Celiac Disease Alliance.

Celiac disease treatment

Currently, treatment for celiac disease involves following a lifelong gluten-free diet, similar to those with wheat allergies. This means strictly avoiding wheat, barley and rye, as well as certain foods, drinks and medications.

Maintaining a gluten-free diet can be challenging and life altering. At the Celiac Disease Clinics, our specialists provide tailored nutritional counseling to help you to find foods that are satisfying and healthy. We work closely to provide you with recipes, tips for dining out and useful information on staying gluten-free.

UC San Diego Health System Expertise

In addition to advanced diagnostic techniques and nutritional counseling, UC San Diego Health System provides opportunities for you to participate in clinical trials examining new treatment options for celiac disease. Read more about our research and clinical trials.

To meet the clinical needs of people with celiac disease, we run a pediatric celiac disease clinic, directed by Dr. Kimberly Newton, and an adult celiac disease clinic, directed by Dr. Sheila Crowe.

Wm. K. Warren Medical Research Center for Celiac Disease

Research shows that adults with celiac disease who are members of a celiac support system are more likely to stick to a gluten-free diet. The Wm. K. Warren Medical Research Center for Celiac Disease encourages the community to participate in local support group activities, including meetings for parents of children with celiac disease, teen events, mentorship programs and other special events.