Celiac Disease

Recently I discovered that I have celiac disease, an auto-immune disorder provoked by wheat gluten and similar grain proteins. Wheat, rye and barley are not tolerated by celiacs and must be avoided for life. Some are exquisitely sensitive and a trace will provoke strong symptoms; others can tolerate very small quantities of these proteins but the intolerance is never outgrown. Unfortunately many processed foods contain traces of gluten. For example some, but not all, soy sauces use wheat. Obviously this makes eating in Asian restaurants and any other place not careful with food cross- contamination a potential problem. Some bread crumbs dropped on a "gluten free" dish may be all it takes to provoke severe diarrhea and further bowel damage.

Cells lining bowel are harmed because of the body turning on itself (auto-immunity.) This can lead to chronic diarrhea, bloating, weight loss, fatigue, an unusual skin rash and malnutrition due to essential nutrients not being well absorbed. Anemia, various vitamin deficiencies and osteoporosis are all common sequelae and may be associated with depression.

Several genes have been identified as important in the development of celiac disease but many people with those genes don't develop the disease. Ireland has one of highest rates of celiac disease in the world but exact numbers are not known. In the United States the incidence is estimated at little less than 1%, with most cases undiagnosed. Celiac disease may first present at any age from infancy on, and other auto-immune diseases like type 1 diabetes and thyroiditis are not uncommon. Diagnosis is by a combination of family and medical history, blood antibody tests and small bowel biopsy. A confirmed diagnosis requires strict lifelong gluten abstinence even if symptoms are mild since progression with possible severe outcomes like cancer and lymphoma can occur.

https://en.wikipedia.org/wiki/Coeliac_disease  (British spelling of celiac)