Celiac disease or coeliac disease is an autoimmune disease that mainly affects the small intestines. Celiac disease occurs when there is a negative reaction to gluten (proteins which are found in wheat and other grains such as rye and barley). Oats (in moderate quantity) are usually well tolerated. Celiac disease usually occurs among individuals who are genetically predisposed to it. Once there is an exposure to gluten, the immune system responds abnormally by producing several types of autoantibodies that can affect many different organs. In the small intestines, it leads to an inflammatory reaction and possibly villous atrophy (the shortening of the villi lining in the small intestines). Villous atrophy can cause issues such as malabsorption of nutrients which then lead to problems such as anemia. The diagnosis of celiac disease can be achieved through blood antibody tests, intestinal biopsies, and genetic testing.
There are some patients who only have minor intestinal changes while some may experience severe symptoms before a diagnosis is achieved. However, increased screening has resulted in many diagnoses made among individuals without symptoms. The condition is managed through a strict lifelong gluten free diet. This helps the intestinal mucosa to recover, improves symptoms, and lowers the risk of complications in most patients. If left untreated, the condition may lead to cancers such as intestinal lymphoma and a slight increase in risk of early death. The prevalence of celiac disease differs in varying regions of the world. In developed countries, approximately 80% of cases are undiagnosed due to minimal symptoms or poor awareness. It is more commonly seen among women.
Celiac Disease Symptom #1: Steatorrhea
Steatorrhea is a term that describes the presence of an excessive amount of fat in the feces causing stools to be bulky and hard to flush (floats). It also looks pale and appears to be oily. These stools also smell foul. In patients with steatorrhea, some may experience oily anal leakage or fecal incontinence. The increased fat excretion can be measured by determining the level of fecal fat.
Steatorrhea can be caused by many conditions such as exocrine pancreatic insufficiency, poor digestion due to lack of lipases, loss of bile salts, conditions with intestinal malabsorption (such as celiac disease), and more.