Many people haven’t ever heard of celiac disease, but for the millions of people unable to eat bread, cookies, pizza crust and pasta, it’s a reality they have to live with every day.

Celiac disease is an autoimmune digestive disorder that wreaks havoc on the body’s intestines when foods containing gluten are consumed. It affects roughly twice as many women as men. In the United States, it affects two million people or about one in 133 people.

It may seem like an easy condition to manage, but gluten is a protein found in many grains and is in a multitude of foods that include wheat, rye, barley or oats. When foods with gluten are digested, an immune reaction is triggered that damages the surface of the small intestine, resulting in the body’s inability to absorb needed vitamins and nutrients from food.

The other problem is that celiac disease is difficult to diagnose. “In the United States, many cases remain undiagnosed because symptoms vary from person to person and because physicians have not been adequately trained in what to look for,” reports Alessio Fasano, M.D., professor of pediatrics, medicine and physiology at the University of Maryland School of Medicine in Baltimore and director of its Center for Celiac Research, in the center’s newsletter.

Celiac disease can develop at any time in a person’s life. It is more common in Caucasian people and those of European descent. If a family member has the disease, the risk for other members increases, as well. Celiac disease is associated with other autoimmune conditions, including lupus, Type 1 diabetes, rheumatoid arthritis, colitis and thyroid disease.

Although there are no prototypical symptoms of celiac disease, many people with the condition complain of diarrhea, bloating and abdominal pain. One complication of the disease is malabsorption which can present with: weight loss, foul-smelling stools, gas, bloating, weakness and poor growth (in children).

Diagnosing celiac disease is extremely important because strict dietary restriction can prevent serious complications. “A diagnosis means that patients can be advised to eat a gluten-free diet in order to stop the progression of celiac disease. If the chronic symptoms continue, patients are at risk of long-term complications such as anemia, infertility, osteoporosis or even cancer,” Fasano said.

A simple blood test can screen for the disease. Sometimes to confirm the diagnosis, it’s necessary to examine a sample of intestinal tissue to look for damage. Although there is currently no cure for celiac disease, it can be effectively managed by excluding gluten from the diet.

It isn’t an easy task because gluten is found in so many foods, but food labeling has come a long way in the last five years. In 2006, the FDA mandated labels on any products containing wheat, milk, soy, peanuts, shellfish and eggs.

According to the Rochester, Minn., based Mayo Clinic, the FDA is supposed to issue a standard definition of “gluten-free” in August 2008 to facilitate shopping for people with celiac disease. These efforts will help those suffering from the condition and their family members effectively manage important dietary restrictions. 

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