What I need to know about

Celiac Disease

NATIONAL INSTITUTES OF HEALTH

U.S. Department 

of Health and 

Human Services National Digestive Diseases 

Information Clearinghouse

 

What I need to know about 

Celiac Disease 

U.S. Department 

of Health and
�

Human Services
�

NATIONAL INSTITUTES OF HEALTH 

National Digestive Diseases 

Information Clearinghouse
Contents 

What is celiac disease?............................................ 1
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Is celiac disease serious?......................................... 2
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What are the symptoms of celiac disease?............ 3
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How is celiac disease diagnosed?........................... 4
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How is celiac disease treated?................................ 5
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Eating, Diet, and Nutrition .................................... 6
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Points to Remember ............................................... 8
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Hope through Research ......................................... 9
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Pronunciation Guide............................................. 10
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For More Information .......................................... 11
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Acknowledgments ................................................. 13
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What is celiac disease? 

Celiac disease* is an immune disease in which 

people can’t eat gluten because it will damage 

their small intestine. Gluten is a protein found in 

wheat, rye, and barley. Gluten may also be used in 

products such as vitamin and nutrient supplements, 

lip balms, and some medicines. Other names 

for celiac disease are celiac sprue and gluten 

intolerance. 

Your body’s natural defense system, called the 

immune system, keeps you healthy by fighting 

against things that can make you sick, such as 

bacteria and viruses. When people with celiac 

disease eat gluten, their body’s immune system 

reacts to the gluten by attacking the lining of the 

small intestine. The immune system’s reaction to 

gluten damages small, fingerlike growths called 

villi. When the villi are damaged, the body cannot 

get the nutrients it needs. 

*See page 10 for tips on how to say the words in 

bold type. 

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Celiac disease is hereditary, meaning it runs in 

families. Adults and children can have celiac 

disease. As many as 2 million Americans may have 

celiac disease, but most don’t know it. 

 

 

 

 

 

 

Small intestine 

Villi 

Villi on the lining of the small intestine help absorb 

nutrients. 

Is celiac disease serious? 

Yes. Celiac disease can be very serious. It often 

causes long-lasting digestive problems and keeps 

your body from getting all the nutrition it needs. 

Over time, celiac disease can cause anemia, 

infertility, weak and brittle bones, an itchy skin 

rash, and other health problems. 

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What are the symptoms of celiac 

disease? 

Symptoms of celiac disease include 

● stomach pain 

● gas 

● diarrhea 

● extreme tiredness 

● change in mood 

● weight loss 

● an itchy, blistering skin rash 

● slowed growth 

Some people with celiac disease may not feel sick 

or have symptoms. Or if they feel sick, they don’t 

know celiac disease is the cause. Most people with 

celiac disease have one or more symptoms. Not all 

people with celiac disease have digestive problems. 

Having one or more of these symptoms does not 

always mean a person has celiac disease because 

other disorders can cause these symptoms. 

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How is celiac disease diagnosed? 

Celiac disease can be hard to diagnose because 

some of its symptoms are like the symptoms of 

other diseases. People with celiac disease may go 

undiagnosed and untreated for many years. If your 

doctor thinks you have celiac disease, you will need 

a blood test. You must be on your regular diet 

before the test. If not, the results could be wrong. 

If your blood test results show you might have 

celiac disease, your doctor will perform a biopsy, 

which involves taking a tiny piece of tissue from 

your small intestine. A biopsy may be performed 

at a hospital or outpatient center. 

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Your doctor will provide you instructions about 

how to prepare for a biopsy. Generally, no eating 

or drinking is allowed 8 hours before a biopsy. 

Smoking and chewing gum are also prohibited 

during this time. Tell your doctor about any health 

conditions you may have, especially heart and lung 

problems, diabetes, and allergies. Also tell your 

doctor about any medicines you take. You may be 

asked to stop taking them for a short time before 

and after the test. 

To perform the biopsy, the doctor inserts a long, 

narrow tube into your mouth, down through your 

stomach, and into your small intestine. At the end 

of the tube are small tools that the doctor uses 

to snip out a bit of tissue. The tissue will then be 

viewed with a microscope to look for signs of celiac 

disease damage. You will take medicine before the 

biopsy that makes you sleepy and keeps you from 

feeling any pain. Many people sleep through the 

procedure. 

How is celiac disease treated? 

The only treatment for celiac disease is a glutenfree diet. If you avoid gluten, your small intestine 

will heal. If you eat gluten or use items that 

contain gluten, celiac disease will continue to harm 

your small intestine. 

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Have regular checkups so your doctor can diagnose 

and treat problems from celiac disease. Celiac 

disease can cause problems, such as weak or brittle 

bones, even if you are on a gluten-free diet. 

Eating, Diet, and Nutrition 

A dietitian can help you select gluten-free foods. 

A dietitian is an expert in food and healthy eating. 

You will learn how to check labels of foods and 

other items for gluten. 

The following chart lists examples of foods you 

can eat and foods you should stay away from if you 

have celiac disease. This list is not complete. A 

dietitian can help you learn what other foods you 

can and can’t eat on a gluten-free diet. 

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Foods You Can Eat 

Amaranth 

Arrowroot 

Buckwheat 

Cassava 

Corn 

Flax 

Indian rice grass 

Job’s tears 

Legumes 

Millet 

Nuts 

Potatoes 

Quinoa 

Rice 

Sago 

Seeds 

Soy 

Sorghum 

Tapioca 

Wild Rice 

Yucca 

Foods that Contain Gluten 

Wheat 

• Including einkorn, emmer, spelt, 

kamut 

• Wheat starch, wheat bran, wheat 

germ, cracked wheat, hydrolyzed 

wheat protein 

Barley 

Rye 

Triticale (a cross between wheat 

and rye) 

Other Wheat Products that Contain Gluten 

Bromated flour 

Durum flour 

Enriched flour 

Farina 

Graham flour 

Phosphated flour 

Plain flour 

Self-rising flour 

Semolina 

White flour 

Processed Foods that May Contain Wheat, Barley, or Rye* 

Bouillon cubes 

Brown rice syrup 

Chips/potato chips 

Candy 

Cold cuts, hot dogs, salami, sausage 

Communion wafer 

French fries 

Gravy 

Imitation fish 

Matzo 

Rice mixes 

Sauces 

Seasoned tortilla chips 

Self-basting turkey 

Soups 

Soy sauce 

Vegetables in sauce 

*Most of these foods can be found gluten-free. When in doubt, check with the food 

manufacturer. 

Source: Thompson T. Celiac Disease Nutrition Guide, 2nd ed. Chicago: American 

Dietetic Association; 2006. © American Dietetic Association. Adapted with permission. 

For a complete copy of the Celiac Disease Nutrition Guide, please visit www.eatright.org. 

7 
Points to Remember 

● Celiac disease is an immune disease in which 

people can’t eat gluten or use items with gluten 

in them. 

● Celiac disease harms the small intestine. 

●	 People with untreated celiac disease can’t get 

needed nutrients. 

●	 Without treatment, people with celiac disease 

can develop other health problems. 

●	 Celiac disease is diagnosed by blood tests and a 

biopsy of the small intestine. 

●	 The only treatment for celiac disease is to avoid 

gluten. 

●	 A dietitian can help people choose the right 

foods. 

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Hope through Research 

The National Institute of Diabetes and Digestive 

and Kidney Diseases (NIDDK) conducts and 

supports research on celiac disease. Researchers 

are studying new options for diagnosing celiac 

disease, including capsule endoscopy, which 

involves patients swallowing a capsule containing a 

tiny video camera that records images of the small 

intestine. 

Several drug treatments for celiac disease are 

being studied. Researchers are also studying 

a combination of enzymes—proteins that aid 

chemical reactions in the body—that might 

change gluten in ways that prevent it from causing 

an immune reaction before it enters the small 

intestine. 

Scientists are also developing educational 

materials for standardized medical training to raise 

awareness among health care providers. The hope 

is that increased understanding and awareness will 

lead to earlier diagnosis and treatment of celiac 

disease. 

Participants in clinical trials can play a more 

active role in their own health care, gain access to 

new research treatments before they are widely 

available, and help others by contributing to 

medical research. For information about current 

studies, visit www.ClinicalTrials.gov. 

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Pronunciation Guide 

biopsy (BY-op-see)

celiac disease (SEE-lee-ak) (dih-ZEEZ)

dietitian (dy-uh-TISH-uhn)

gluten (GLOO-tuhn)

intestine (in-TESS-tin)

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For More Information 

Celiac Disease Awareness Campaign 

2 Information Way
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Bethesda, MD 20892–3570
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Phone: 1–800–891–5389 

TTY: 1–866–569–1162
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Fax: 703–738–4929
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Email: celiac@info.niddk.nih.gov
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Internet: www.celiac.nih.gov
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American Celiac Society 

P.O. Box 23455 

New Orleans, LA 70183–0455 

Phone: 504–737–3293 

Email: info@americanceliacsociety.org 

Internet: www.americanceliacsociety.org 

American Dietetic Association 

120 South Riverside Plaza, Suite 2000 

Chicago, IL 60606–6995 

Internet: www.eatright.org 

Celiac Disease Foundation 

13251 Ventura Boulevard, #1 

Studio City, CA 91604 

Phone: 818–990–2354 

Fax: 818–990–2379 

Email: cdf@celiac.org 

Internet: www.celiac.org 

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Celiac Sprue Association/USA, Inc. 

P.O. Box 31700 

Omaha, NE 68131–0700 

Phone: 1–877–CSA–4CSA (1–877–272–4272) 

or 402–558–0600 

Fax: 402–558–1347 

Email: celiacs@csaceliacs.org 

Internet: www.csaceliacs.org 

Gluten Intolerance Group of North America 

31214 124th Avenue SE 

Auburn, WA 98092 

Phone: 253–833–6655 

Fax: 253–833–6675 

Email: info@gluten.net 

Internet: www.gluten.net 

National Foundation for Celiac Awareness 

P.O. Box 544 

Ambler, PA 19002–0544 

Phone: 215–325–1306 

Fax: 215–643–1707 

Email: info@CeliacCentral.org 

Internet: www.CeliacCentral.org 

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Acknowledgments 

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists and 

outside experts. The National Digestive Diseases 

Information Clearinghouse would like to thank 

William F. Stenson, M.D., Washington University, 

for assisting with the scientific and editorial review 

of the original version of this publication. Thank 

you also to Alice Bast and Nancy Dickens, National 

Foundation for Celiac Awareness; Cynthia Kupper, 

R.D., C.D., Gluten Intolerance Group; and 

Elaine Monarch, Celiac Disease Foundation, for 

reviewing the food chart. 

Thank you also to Joseph Murray, M.D., at the 

Mayo Clinic College of Medicine, Rochester, MN, 

for facilitating field-testing of the original version 

of this publication. 

The U.S. Government does not endorse or favor any specific 

commercial product or company. Trade, proprietary, or 

company names appearing in this document are used only 

because they are considered necessary in the context of 

the information provided. If a product is not mentioned, 

the omission does not mean or imply that the product is 

unsatisfactory. 

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The Celiac Disease Awareness Campaign 

The National Institutes of Health Celiac 

Disease Awareness Campaign provides current, 

comprehensive, science-based information about 

the symptoms, diagnosis, and treatment of celiac 

disease, also known as celiac sprue, nontropical 

sprue, and gluten-sensitive enteropathy. The 

Awareness Campaign is an initiative of the 

National Digestive Diseases Information 

Clearinghouse, a service of the National Institute 

of Diabetes and Digestive and Kidney Diseases. 

Download this publication and learn more about 

the Awareness Campaign at www.celiac.nih.gov. 

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National Digestive Diseases 

Information Clearinghouse 

2 Information Way 

Bethesda, MD 20892–3570 

Phone: 1–800–891–5389 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: nddic@info.niddk.nih.gov 

Internet: www.digestive.niddk.nih.gov 

The National Digestive Diseases Information Clearinghouse 

(NDDIC) is a service of the National Institute of Diabetes and 

Digestive and Kidney Diseases (NIDDK). The NIDDK is part of 

the National Institutes of Health of the U.S. Department of Health 

and Human Services. Established in 1980, the Clearinghouse 

provides information about digestive diseases to people with 

digestive disorders and to their families, health care professionals, 

and the public. The NDDIC answers inquiries, develops and 

distributes publications, and works closely with professional and 

patient organizations and Government agencies to coordinate 

resources about digestive diseases. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this publication to duplicate and distribute 

as many copies as desired. 

This publication is available at www.digestive.niddk.nih.gov. 

This publication may contain information about medications. 

When prepared, this publication included the most current 

information available. For updates or for questions about any 

medications, contact the U.S. Food and Drug Administration 

toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit 

www.fda.gov. Consult your health care provider for more 

information. 
U.S. DEpArTmENT OF HEALTH 

AND HUmAN SErVICES 

National Institutes of Health 

NIH Publication No. 11–5755

March 2011 

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