What is celiac disease?iStock/sturti
Approximately one in every 100 Americans has celiac disease, a condition in which the gluten in food triggers an immune response that damages the small intestine, which affects its ability to absorb nutrients. While the disease is common, it’s shockingly underdiagnosed—with 85 percent of people with celiac unaware they even have it. That’s not surprising considering that celiac disease affects each person differently. “Celiac disease symptoms may come on gradually or they may appear suddenly and dramatically,” explains Peter H.R. Green, MD, director of the Celiac Disease Center at Columbia University, in his book Celiac Disease: A Hidden Epidemic. “They may also wax and wane over a long period of time.” Compounding the diagnostic challenge is the fact that there are six “silent” or asymptomatic cases of celiac for each symptomatic one. Still, since celiac disease puts you at risk for a host of long-term complications, it’s important to get diagnosed and treated—especially because delay of treatment increases your chances of developing another autoimmune disorder (scarily, most patients have symptoms for nine years before they’re diagnosed). There are more than 200 signs of celiac disease, but it’s most common to have one or more of the following symptoms.
Bouts of diarrheaiStock/gpointstudio
The “classic” celiac disease symptoms may be intestinal problems, but only about one-third of adults with the disease actually experience diarrhea (it’s more common in children because their digestive tracts are shorter and they have less area to compensate for tissue damage). When diarrhea occurs, it tends to show up as stools that are a bit looser (versus very watery stools) and more frequent than usual. It also tends to be a recurring problem. “’I had five episodes of gastroenteritis last year’ is a common refrain,” notes Dr. Green. There are a myriad of causes of diarrhea: prolonged inflammation of the intestine; poor absorption of dietary sugars and fat, which draw so much water into the colon that the stool remains liquid; lactose intolerance, which results when damage to the intestine destroys the enzymes that digest milk products; and bacterial overgrowth. It’s unclear why, but people with celiac disease have more bacteria in their small intestine than usual, says Dr. Green. Read up on effective home remedies for diarrhea.