What are the symptoms of celiac disease?

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I have a few comments on your gluten response. Its symptoms are continuous diarrhea, cramping abdominal pain, weight loss, and anemia. These are just some of the possible symptoms and are the most common. However, one may not have these and may have others like constipation. I think you should say these are “possible” symptoms that could include…

Diagnosis may include symptoms and possibly an intestinal biopsy. Here is the current method of diagnosing this condition.

Celiac disease can be screened for with a combination of anti-gliadin (IgA & IgG) and endomysial antibody testing of the blood. It is definitively tested for by a small bowel biopsy, which can be obtained by an endoscopy in the distal duodenum. The patient must be consuming gluten at the time of the tests.

Hydrolyzed vegetable protein (HVP) from wheat contains gluten. HVP from soy does not contain gluten. Problem is much of the HVP is made from wheat or barley and one usually does not know the source (though the USDA is better at requiring this disclosure than the FDA).

Special flour with the gluten part removed (DP Baking Mix, DP Low Protein Wheat Starch). The U.S. and Canadian celiac societies do not approve of the use of this flour. It is not gluten-free, but only low gluten. Studies using this flour have shown many negative effects with many of the participants dropping out because they can’t tolerate it. Only in the U.K., Netherlands, and Scandinavia do they permit the use of this flour, but this is due to tradition and not what the medical studies say.

Hope you find this useful and it is always good to see a mention of gluten somewhere, as it is so unknown that many people think it comes from sugar.

There is a gluten-free mailing list at <listserv@sjuvm.stjohns.edu> with 660+ members. To join, send a message to the electronic mailing list with SUB CELIAC yourfirstname yourlastname in the body of the message. The FAQ (frequently asked question) can be obtained by putting GET CELIAC FAQ in the body of a message to the list server. Even more, information is available if GET NEWCEL PACKAGE is included. Log files and other GETable documents also exist.</listserv@sjuvm.stjohns.edu>

Yes, some people with gluten intolerance can experience constipation, but this seems to involve very fewer people than experience diarrhea.

Diagnosis may also include an endoscopy (which you mention) whereby the doctor inserts a flexible tube with a camera in the mouth to take a biopsy of the intestinal wall. Typically, the villi flatten out in the intestine of people with gluten intolerance. The villi are the absorptive surfaces for nutrients in the intestinal tract and are also responsible for resorbing fluid from waste products prior to excretion.

If you look at your hand with your fingers outspread, that is what your intestinal villi look like. If you then close the spaces between your fingers so that they are touching, that is what hypertrophied villi with reduced absorptive surfaces look like in celiac disease.

You are correct in that soybeans do not contain gluten. If hydrolyzed vegetable protein is listed in the ingredient label, without listing the vegetable source, which could be wheat, then HVP is not recommended for celiac nutrition therapy.

Individuals should contact their doctor if they are having any of the above symptoms rather than diagnosing themselves.