Celiac Awareness Day: A Chat with Dr. Benjamin Lebwohl

September 13, 2017

On this Celiac Awareness Day, CUIMC gastroenterologist Benjamin Lebwohl, MD, answered questions about celiac disease and gluten sensitivity on Twitter. Excerpts are below; follow #NYPCeliacChat on Twitter for the full conversation.

Dr. Lebwohl is the Herbert Irving Assistant Professor of Medicine at Columbia and a physician with the Celiac Disease Center at Columbia University.

Q: What are common symptoms associated with celiac disease, and how is the disease diagnosed?

Symptoms can be intestinal (abdominal pain, bowel problems, bloating), but some with celiac have no intestinal symptoms.

Non-intestinal symptoms can be related to malabsorption of iron, vitamin B12, and calcium. So: anemia, osteoporosis.

Some symptoms — migraines, infertility/miscarriages, neuropathy — are related to chronic inflammation or unknown mechanisms.

Q: What is the difference between a gluten intolerance and celiac disease?

Gluten intolerance is a term that some use to denote celiac disease but often refers to non-celiac gluten sensitivity.

People with symptoms may report gluten intolerance and may not know if it's celiac disease or non-celiac gluten insensitivity.

Celiac disease has defined markers: a blood test, characteristic biopsy finding. Non-celiac gluten sensitivity does not.

Q: What is the treatment for celiac disease? Are new therapies under investigation?

Non-dietary therapies in testing include enzymes that digest gluten and a vaccine that may allow people with celiac to tolerate gluten.

Personalized medicine may come to celiac disease, since we know that symptoms and intestinal damage vary.

Patients interested in a trial should come to a celiac center.