Why You Need a Diagnosis Before Cutting Out Gluten
Celiac disease is an autoimmune condition that causes your body’s immune system to attack itself when you ingest gluten. Continuous ingestion of gluten will eventually cause the small bowel of your digestive tract to develop villous atrophy. Villous atrophy is the flattening of your villi: tiny finger-like structures in your small bowel that absorb nutrients in your food. The flatter the villi the less nutrients you can absorb. If you are diagnosed with Celiac disease you’ll know that you have to follow a strict gluten-free diet for life. While on a gluten-free diet your body will begin reverse the villous atrophy over the next 6 to 12 months and regain the ability to effectively absorb nutrients.
It is important to know that Celiac disease is not a food allergy, sensitivity or intolerance. Why is this important? Unlike a sensitivity or intolerance, Celiac disease can increase your chances of developing conditions such as anemia, osteoporosis, infertility, and even small bowel cancer. A wheat allergy (not Celiac disease) means you could be allergic to the gluten in wheat only but not allergic to the gluten in other whole grains such as barley or rye. In this case, without a diagnosis of Celiac disease you might over restrict these other grains and miss out on the nutrients that they contain.
Many symptoms associated with Celiac disease can also be present if you have conditions like irritable bowel syndrome, a wheat allergy or gluten sensitivity. For example: a gluten sensitivity would not cause villous atrophy or severe malabsorption despite having diarrhea or other symptoms.
Undiagnosed Celiac Disease Could Lead to a Second Autoimmune Condition
A second reason it’s important to distinguish an autoimmune condition from an intolerance is that having one autoimmune disease greatly increases your chances of developing a second autoimmune disease like diabetes or a thyroid condition. So while an intolerance may cause you to feel uncomfortable or even ill undiagnosed and untreated Celiac disease could increase your risk of developing more harmful conditions like malnutrition, anemia, diabetes, or cancer.
We live in the age of social media which makes it tempting to use the internet to self-diagnose our physical symptoms. It’s important to avoid this. The internet is full of misinformation and people who benefit by offering products or services that don’t properly treat a disease. Self-diagnoses aren’t always right so even if you feel somewhat better you may not have gotten to the root of your problem.
There are numerous symptoms of Celiac disease and we don’t all experience the same ones. Most people associate diarrhea, constipation or abdominal pain with Celiac disease but there are a host of other symptoms.
Some of these include:
bone or joint pain
nausea and vomiting
itchy blistering rash
numbness or swelling of hands and feet
mood swings and/or depression
If you have some or all of these symptoms ask your family doctor for a Celiac screen (a simple blood test). If your Celiac screen is positive you’ll be referred to a gastroenterologist who will perform an endoscopy with a camera for biopsy samples. This is the gold standard in Canada (and many other countries).
The Gluten Challenge
On a more practical note: do not stop eating gluten if you suspect you have Celiac disease. Get the Celiac screen done first. It might feel empowering to take your health into your own hands, but if you stop eating gluten before a Celiac screen or an endoscopy you could receive a ‘false negative’. This means your test could show that you don’t have Celiac disease even if you actually do. Your doctor would instruct you to resume eating food with gluten in it for an accurate test. This would make you feel worse than if you had kept gluten in your diet because your body would become more sensitive to it after a short absence. Wait for a diagnosis and quit for good if your test comes back positive for Celiac disease.
The correct diagnosis important for you, for your immediate family, your children, or your future children. It is a hereditary condition that can possibly affect everyone around you whether or not a family member is more at risk for the disease or simply needs to help you maintain a gluten-free kitchen.