Dr. Hugo Rams Jr

Hugo Rams Jr., MD

Celiac Disease


Celiac disease is an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats.



The symptoms of celiac disease can vary significantly from person to person. This is part of the reason the diagnosis is frequently delayed. For example, one person may have constipation, a second may have diarrhea, and a third may have no irregularity in stools.

A partial listing of gastrointestinal symptoms:

·     Abdominal pain

·     Abdominal distention, bloating, gas, indigestion

·     Constipation

·     Decreased appetite (may also be increased or unchanged)

·     Diarrhea, chronic or occasional

·     Lactose intolerance (common upon diagnosis, usually goes away following treatment)

·     Nausea and vomiting

·     Stools that float, are foul smelling or “fatty”

·     Unexplained weight loss (although people can be overweight or of normal weight upon diagnosis)

A partial listing of nonintestinal symptoms:

·     Anemia (low blood count)

·     Bone and joint pain

·     Bone disease (osteoporosis, fracture)

·     Breathlessness (due to anemia)

·     Bruising easily

·     Dental enamel defects and discoloration

·     Depression

·     Fatigue

·     Growth delay in children

·     Hair loss

·     Hypoglycemia (low blood sugar)

·     Irritability and behavioral changes

·     Malnutrition

·     Mouth ulcers

·     Muscle cramps

·     Nosebleed

·     Seizures

·     Short stature, unexplained

·     Skin disorders (dermatitis herpetiformis)

·     Swelling, general or abdominal

·     Vitamin or mineral deficiency, single or multiple nutrient (for example, iron, folate, vitamin K)



You must follow a lifelong gluten-free diet. This allows the intestinal villi to heal. Eliminate foods, beverages, and medications that contain wheat, barley, rye, and possibly oats.

You must read food and medication labels carefully to look for hidden sources of these grains and their derivatives. Since wheat and barley grains are found abundantly in the American diet, keeping to this diet is challenging. With education and planning, you will achieve the goal of healing.

You should NOT begin the gluten-free diet before a diagnosis is made. Doing so will affect future testing for the disease.

The health care provider may prescribe vitamin and mineral supplements to correct nutritional deficiencies. Occasionally, corticosteroids (such as prednisone) may also be prescribed for short-term use or if you have refractory sprue. Following a well-balanced, gluten-free diet is generally the only treatment needed to stay healthy.

Upon diagnosis, get help from a registered dietitian who specializes in celiac disease and the gluten-free diet. A support group may also help you cope with the disease and diet.