For years, Elisabeth Hasselbeck, the television host and former “Survivor” contestant, couldn’t figure out what made her sick with unrelenting bloating, cramps and diarrhea.

Then while starving as a contestant on “Survivor,” her symptoms vanished. The culprit, it turns out, was celiac disease, an abnormal reaction to gluten.

Ninety-five percent of celiac sufferers go undiagnosed or misdiagnosed, according to the National Foundation for Celiac Awareness. CD is a genetic autoimmune response to gluten, a protein found in wheat, barley and rye, among other grains, that damages the small intestine and hinders food absorption. Left untreated, CD can trigger complications ranging from infertility to osteoporosis and small intestine lymphoma, among others.

Symptoms vary widely, says Dr. Jianmin Tian, a gastroenterologist with St.Vincent Medical Group. Patients may experience recurring abdominal pain, diarrhea, anemia, and delayed development in children. Infertility, joint pain, skin rash and fatigue also plague some patients, who tend to fall into four categories:

•Classic: Characterized by classic symptoms like diarrhea, malabsorption, weight loss, and abdominal discomfort.

•Atypical: May have minor intestinal symptoms, but may also have anemia, dental enamel defects, osteoporosis, arthritis, increased liver enzyme levels, neurological symptoms or infertility.

•Silent: Symptom-free, but abnormalities show up in blood test and small intestine biopsy.

•Latent: Also symptom-free, but only detectable in blood tests.

“Unfortunately, classic cases are the tip of the iceberg,” Tian said. Many cases are difficult to diagnose, partly because symptoms mimic other conditions, such as irritable bowel syndrome. Type 1 diabetics and people with a first-degree relative with CD are at higher risk. Otherwise, the general population has approximately a one-in-140 chance of developing CD.

Once diagnosed, a lifelong gluten-free diet is the only treatment. The Celiac Disease Foundation (www.celiac.org) has more information.  Armed with knowledge, celiacs can heal their problem and enjoy a vibrant, symptom-free life.

For more information, contact St.Vincent Gastroenterology at 582-8931.