Celiac Disease

Celiac disease is a severe reaction to gluten that triggers an autoimmune response from the body.  An autoimmune disease differs from an allergy in that the immune system attacks the tissues of the body.  So how does a system designed to protect the body instead malfunction to the point at which it performs the exact opposite of its intended purpose?  The answer lies in the fact that proteins exist throughout the body to perform specific functions.

When gluten-containing foods are eaten the body does not recognize the protein and an immune response is issued to remove the protein from the body.  When food particles go undigested, as is the case with celiac disease, the proteins enter the bloodstream.  The body expects proteins to be digested into their component amino acid parts before they enter the bloodstream, but what it receives are fully- or partially-intact proteins that it does not recognize.  Some of these proteins resemble other proteins in the body such as those in the digestive tract and the body cannot tell the difference between the two.  The immune system creates antibodies specific to these proteins and begins searching the body for them to make sure they cannot persist and cause harm to the body.  It finds the proteins causing the problems, but also the normal, beneficial proteins in body tissues.

When the proteins resemble those of the small intestine the immune response takes the form of inflammation, whereby cells in the small intestine notify the body to send white blood cells to stave off an attack from a hostile substance.  These cells, known as villi, are small, wave-like structures in the small intestine whose primary function is to aid digestion.

Normally functioning villi absorb nutrients as food makes its way through the small intestine.  The process entails utilizing the villi to increase the surface area available for food absorption to speed the rate at which nutrients enter the blood stream.  Without the presence of villi the rate of absorption would slow to a point where diffusion cannot occur.  In effect, the damage done by celiac disease reduces the surface area available for nutrient absorption through villi atrophy that reduces villi exposure to food.  You may be feeding your body a high nutrient diet, but your body thinks you’re consuming empty calories.

Compromised by the presence of gluten, the villi are unable to perform their digestive duties, leading to celiac disease’s most pernicious symptom:  malabsorption.  The compromised cells lining the intestinal wall are unable to fully absorb the beneficial nutrients from food.  In turn, malabsorption leads to malnutrition, specific vitamin and mineral deficiencies that can lead to bone loss, dental problems, skin conditions, neurological and psychiatric conditions, organ diseases and more.

Damage to the intestinal villi is classified on a spectrum using the Marsh scale, with Marsh 0 representing no mucosal damage and Marsh IIIc representing complete villi atrophy.  A formal diagnosis of celiac disease can only be made in the presence of intestinal damage corresponding to Marsh III.

The only means of treating celiac disease is by eating strictly gluten free foods.  Fortunately, if a gluten free diet is maintained, all of the symptoms of celiac disease cease.