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Celiac Disease

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by Wood D

(Celiac Sprue; Nontropical Sprue; Gluten-Sensitive Enteropathy)



Symptoms vary and may start in childhood or adulthood. Children often have different symptoms than adults. Symptoms may not develop if a large section of the intestine is undamaged. Malnutrition may produce the first signs of the condition, which are often the most serious.
Signs and symptoms may include:

In Children

In Adults

  • Bloating
  • Gas
  • Diarrhea
  • Foul-smelling, light-colored, oily stool
  • Weight loss
  • Hearty or a poor appetite
  • Fatigue
  • Abdominal pain
  • Bone pain
  • Behavior changes
  • Muscle cramps and joint pain
  • Seizures
  • Dizziness
  • Skin rash
  • Dental problems
  • Missed menstrual periods
  • Infertility
  • A change in limb sensation


A life-long, gluten-free diet is the only treatment for celiac disease. It is very effective. Symptoms usually go away within days of starting the diet. However, healing of the villi may take months or years. Additional intake of gluten can damage the intestine, even if you have no symptoms. Delayed growth and tooth discoloration may be permanent. Nutritional supplements, given through a vein, may be needed if the intestinal damage does not heal. Since gluten is added to many foods, the diet can be complicated and often frustrating. Some patients find support groups helpful.

Dietary Changes

You must avoid all foods containing:
  • Wheat
  • Rye
  • Barley
This includes most bread, pasta, cereal, and processed foods. Special gluten-free breads and pastas are available. They are made with potato, rice, soy, or bean flour. A dietitian can assist you with meal planning.
Gluten is found in some unexpected foods and beverages. Carefully read all labels. Other foods with gluten include:
  • Flavored coffee
  • Beer
  • Tuna in vegetable broth
  • Packaged rice mixes
  • Some frozen potatoes
  • Creamed vegetables
  • Commercially prepared vegetables, salads, and salad dressings
  • Pudding
  • Some ice cream
  • Many other products
Ordering at restaurants can be especially challenging, since many foods on the menu may contain gluten.

Screening and Supplements

Patients with celiac disease should be tested to make sure they are getting enough nutrients. Bone density testing may also be needed. If you lack vitamins or minerals, the doctor may advise taking supplements. However, once the disease is under control with a gluten-free diet, this is often not necessary.


Celiac Disease Foundation

Celiac Sprue Association



Canadian Celiac Association

Health Canada



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2/13/2014 DynaMed's Systematic Literature Surveillance Pelkowski T, Viera A. Celiac Disease: Diagnosis and Management. Am Fam Physician. 2014 Jan 15.


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