A small percentage of people with diarrhea and bloating have celiac disease, but when you add it up the disease still affects many people.

In celiac disease, the lining of the small intestine is inflamed so foods are poorly absorbed and pass along to the large intestine. The poor absorption can cause nutritional deficiency and weight loss. And the extra food in the large intestine can cause bloating, flatulence and diarrhea.

It is an immune system problem that is inherited to some degree. The risk of getting it increases if a family member has it. More severe cases are usually diagnosed to childhood, but many people are not diagnosed until they are in their 40s.

The inflammation of the intestinal lining is caused by contact with gluten. Gluten is the protein component of grains such as barley, oats, rye and wheat, and it is used as a food additive in many prepared foods.

A blood test for antibodies against gluten helps determine whether someone has celiac disease. But this test is positive in other disorders. A biopsy of the lining of the small intestine will confirm the diagnosis.

In addition to the intestinal problems, about 10% of these people have a burning, itchy rash called dermatitis herpetiformis. Although everyone with this rash also has celiac disease, their intestinal symptoms are often mild.

Treatment is straightforward – eliminate gluten from the diet. However, this may require the advice of a dietician or other nutritional expert because gluten is found in many foods. In addition, the rash may also benefit from using medications called sulphones.

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