Celiac is an autoimmune disease. The immune system is triggered by gluten (a protein in wheat, rye and barley) and attacks the tissues of the body among people who are genetically susceptible. This autoimmune reaction interferes with the absorption of nutrients from food by damaging part of the small intestine called villi (fingerlike projections that help digest food). Damaged villi make it nearly impossible for the body to absorb nutrients into the bloodstream, leading to malnourishment and a host of other problems which may include anemia, bone disease , additional autoimmune conditions and certain types of cancers.
Celiac isn’t a food allergy, like the one people have with peanuts (allergies to wheat do exist, but mainly start in childhood and often disappear by adulthood, according to Food Allergy & Research Education). And it’s not an intolerance like lactose intolerance. Emphasizing the word “autoimmune” can clear up many misconceptions about the disease, says Daniel Leffler, MD, MS, director of clinical research at the Celiac Center at Beth Israel Deaconess Medical Center in Boston. Celiac disease is distinct from both allergies and intolerances, he says. “It’s more similar to other autoimmune conditions like type 1 diabetes or rheumatoid arthritis.”
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