What is dermatitis herpetiformis and how is it related to celiac disease?

Dermatitis herpetiformis (DH), also known as Duhring’s Disease, is a form of celiac disease that results in itchy, blistering skin rashes. Patients with DH almost always have the same gluten-dependent intestinal damage as celiac disease patients and they must also follow a strict gluten-free diet.

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What is “leaky “gut”? How does it relate to celiac disease?

The intestines are always somewhat “leaky” because they are always absorbing nutrients. A leaky gut, while not a medical term, typically refers to increased intestinal permeability, which can be caused by inflammation of the gut due to celiac disease.

What are villi and what is villous atrophy? How fast does gluten destroy the villi? Is it permanent?

Villi are small, finger-like projections in the small intestines that help you absorb nutrients. Villous atrophy is the blunting or flattening of the villi can be caused by the damage done by the immune system in a person with celiac disease after ingesting gluten. Damage to the villi can begin as early as three hours after exposure to gluten. However, the villi are not permanently damaged as the intestines continuously renew themselves.

What are the chances that others in my family have celiac disease since I’ve been diagnosed with it?

The prevalence of celiac disease in 1st and 2nd degree relatives of someone already diagnosed with the disease is significantly higher than in the general population. It is estimated that among 1st degree relatives (children, parents, siblings), the prevalence rate is between 4% and 16% (1 in 25 and 1 in 6) while among 2nd degree relatives (aunts, uncles, grandparents), the rate is about 2.6% or 1 in 38.

I have the genes for celiac disease but I haven’t shown any symptoms yet. What should I do?

An estimated 1/3 of the population has at least one of the genes associated with celiac disease yet most never develop the disease, so there is a good chance you won’t develop it either. However, you should still get your blood screened every 2-3 years or immediately if symptoms appear. If you also have 1st or 2nd degree family members with celiac disease, it is even more imperative you keep getting screened as time passes.

I feel better on a gluten-free diet. Can I just assume I have celiac disease?

No. There are other possible causes for improvement on a gluten-free diet. Always refer to a medical professional when making a clinical diagnosis.

Should I be eating gluten before my blood test?

Yes. If you aren’t on a gluten-free diet yet, continue eating a normal diet including gluten. If you have been on a gluten-free diet for a few weeks or more, you should start a “gluten challenge” under the advisement and care of a medical professional. A gluten challenge is the reintroduction of gluten into the diet. For current blood tests, you will typically need to go on a gluten challenge for 3 or so months. If you experience symptoms immediately after reintroducing gluten, you and your doctor could consider a shorter gluten challenge (a week to two weeks) followed by an endoscopic biopsy. Ask your doctor for more information.

Can celiac disease be tested for genetically?

Genetic testing for celiac disease, like having a family history of celiac disease, can be used to determine who is at risk for developing the disease. However, most people who have the associated genes do not ever develop the disease.

How is celiac disease diagnosed?

Celiac disease is typically screened for by an antibody blood test, such as antibodies for tissue transglutaminase (tTG), and if positive, followed by an endoscopic biopsy to confirm.

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What are the major symptoms of celiac disease?

There are about 300 known symptoms which may occur due to celiac disease. However there are many individuals who have celiac disease with no symptoms (asymptomatic).

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