Celiac disease is a chronic autoimmune disorder affecting approximately 1 in 100 people worldwide. When an individual with celiac disease ingests gluten, an immune response is activated, causing inflammation and damage to the villi in the small intestine. This damage to the intestines in turn prevents nutrients from being absorbed into the body. A diagnosis of celiac disease is made through an initial screening of blood testing, followed by an esophagogastroduodenoscopy (a procedure to examine the upper GI tract using an endoscope). A biopsy may be completed to examine the villi in the small intestine. Genetic testing may also be used, especially in asymptomatic family members of an individual with confirmed celiac disease.
- Symptoms of celiac disease may include:
- Poor growth / weight loss / malnutrition
- Nausea / vomiting
- Abdominal pain
- Bloating
- Fatigue
- Headaches/Joint pain
- Altered bowel habits
- Mood / behavioral difficulties
Those with celiac disease are also at a predisposition for additional autoimmune conditions and can have psychological comorbidities such as anxiety and depression. Additionally, research has shown that individuals with celiac disease have a much higher prevalence of symptoms like those in Disorders of Gut-Brain Interaction (DGBIs), which can also increase psychological comorbidity and health care use. Left untreated, long-term complications may develop such as mineral deficiency contributing to anemia and loss of bone density. Treatment for celiac disease consists of lifelong adherence to a gluten-free diet. This can be challenging for a number of reasons, and research suggests that a large percentage of individuals with celiac disease are not adhering to treatment guidelines adequately.3
How Can GI Psychology Help?
A primary treatment goal for this population is to improve adherence to a gluten-free diet. GI Psychology’s team of behavioral health clinicians have a deep understanding of GI conditions and utilize gut-focused CBT and gut-focused clinical hypnosis, two evidence-based treatments that are effective in facilitating behavioral change and reducing symptoms in DGBIs.3,5 We offer time-limited treatment that prioritizes collaboration with other healthcare providers as we help patients to:
- Identify sources of motivation to adhere to gluten-free diet
- Identify barriers to adherence
- Build skills to manage anxiety associated with gluten-exposure and physical symptoms
- Develop strategies to improve brain-gut connection to facilitate healthy digestion
- Develop strategies to cope with associated mental health concerns
- Celiac Disease Foundation. (2024, February 15). What is Celiac Disease? https://celiac.org/
- Martínez-Martínez, M. I., Alegre-Martínez, A., García-Ibánez, J., & Cauli, O. (2019). Quality of life in people with coeliac disease: psychological and Socio-economic aspects. Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current Drug Targets-Immune, Endocrine & Metabolic Disorders), 19(2), 116-120.
- Parker, Sophie, Olafur Palsson, David S. Sanders, Magnus Simren, Ami D. Sperber, Hans Törnblom, Heidi Urwin, William Whitehead, and Imran Aziz. 2022. “Functional Gastrointestinal Disorders and Associated Health Impairment in Individuals with Celiac Disease.” Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association 20 (6): 1315-1325.e4.
- Sainsbury, K., Mullan, B., & Sharpe, L. (2013). A randomized controlled trial of an online intervention to improve gluten-free diet adherence in celiac disease. The American journal of gastroenterology, 108, 811-817.
- Shull, M. H., Ediger, T. R., Hill, I. D., & Schroedl, R. L. (2019). Health-related quality of life in newly diagnosed pediatric patients with celiac disease. Journal of pediatric gastroenterology and nutrition, 69(6), 690-695.
- Yavuz, S., Kocamaz, H., & Hizli, S. (2022). A Review of Pediatric Celiac Patients in Southeastern Turkey: A Single-Center Experience. European Journal of Therapeutics