Celiac disease: aeromedical considerations

Celiac disease (CD) is an illness that affects up to 2% of the population. It primarily causes gastrointestinal symptoms, but it can also cause malabsorption, resulting in anemia and loss of bone mass. There is also an association with other illness such as Type 1 diabetes, autoimmune diseases, and neurological illness. The gold standard for diagnosis is endoscopic biopsy with serological testing sometimes employed for diagnosis and screening. The signs and symptoms of CD can be very broad, making diagnosis problematical. Treatment consists of a gluten-free diet, which is extremely effective although compliance with the diet can be very difficult. Aeromedical disposition of aircrews engaged in military and civil aviation would depend upon the nature of operations and, in some cases, could be liberal. However, for spaceflight, disqualification would be most prudent.