Last updated date: 12-Jun-2023
Originally Written in English
Celiac disease is also known as celiac sprue or gluten-sensitive enteropathy. It is an immunological reaction to gluten, a protein present in wheat, rye, and barley. Gluten usually causes an immune response in the small intestine in patients with celiac disease. Such a reaction destroys the lining of the small intestine with time, preventing it from absorbing certain essential nutrients (malabsorption).
Diarrhea, weight loss, exhaustion, anemia, and bloating are the common symptoms of intestinal damage, which can progress to significant complications. Malabsorption in children can impact their growth and development, in addition to triggering the symptoms evident in adults.
Celiac disease has no cure. However, maintaining a gluten-free diet might help control symptoms and enhance intestinal recovery in most patients.
Signs and Symptoms of Celiac Disease
The signs and symptoms of celiac disease usually affect the intestines and gastrointestinal system. However, they can also involve other regions of the body. Adults and children with celiac disease often experience varying symptoms.
In children, celiac disease can make them fatigued and cranky. They might also be underweight and have delayed puberty. Other common symptoms of celiac disease in children include;
- Weight loss
- Stomach ache
- Constipation or diarrhea that persists
- Faeces that are pale, fatty, and smell bad
In adults, celiac disease can cause digestive problems. Symptoms, in most cases, also affect other parts of the body. These signs and symptoms of celiac disease in adults can include the following;
- Stiffness and joint pain
- Iron deficiency anemia
- Weak and brittle bones
- Skin diseases
- Tingling and numbness in hands and feet
- Tooth discoloration or enamel loss
- Sores that are pale inside the mouth
- Irregular menstrual cycles
- Miscarriage and infertility
It's crucial to understand that symptoms differ from person to person and are influenced by a variety of circumstances, such as;
- The amount of time a child was breastfed as a baby
- The age at which someone began consuming gluten
- The quantity of gluten consumed
- The degree to which intestinal damage has occurred
Celiac disease can affect other people without causing any symptoms. They may, however, experience prolonged complications due to the sickness. Therefore, if you think that you or your kid has celiac disease, consult your medical provider immediately. The chances of complications emerging tend to increase when diagnosis and treatment delay.
Causes of Celiac Disease
Celiac disease can occur due to genes combined with gluten-containing foods and other contributing factors. However, the exact cause is unknown. Gastrointestinal infections, practices in infant feeding, and gut microorganisms may all play a role. After pregnancy, childbirth, surgical procedure, viral infection, or extreme mental stress, celiac disease might be active.
The microscopic, hair-like projections (villi) lining the small intestine are damaged when the body's defence system responds to gluten in the diet. The villi usually take in minerals, vitamins, and other vital nutrients from the meals you ingest. However, you cannot acquire sufficient nutrients if your villi are damaged, regardless of the amount of food you consume.
Risk Factors of Celiac Disease
People with the following risk factors are more likely to develop celiac disease;
- Addison's disease
- Autoimmune thyroid disease
- Having a family member who has celiac disease or dermatitis herpetiformis
- Microscopic colitis (lymphocytic or collagenous colitis)
- Turner syndrome or Down syndrome
- Type 1 diabetes
Celiac Disease Diagnosis
Most individuals who have celiac disease are not aware of their condition. However, doctors can use the following celiac disease blood tests to diagnose the condition;
- Serology testing: This is a test used to check for antibodies present in the bloodstream. Increased levels of particular antibody proteins show a gluten-induced immunological response.
- Genetic testing: Your doctor can use a genetic test of human leukocyte antigens (HLA-DQ2 and HLA-DQ8) to rule out celiac disease.
Before attempting a gluten-free diet, you should first undergo a test for celiac disease. This is because removing gluten from your routine diet may normalize blood test results.
In addition, your doctor can order additional tests if the results of serology and genetic testing indicate celiac disease. These tests can include;
- Endoscopy: A celiac disease endoscopy test involves inserting a long tube with a small camera into the mouth and passing it down the throat (upper endoscopy). The doctor will then use the camera to examine the small intestine and extract a small sample of the tissue (biopsy) to check for villi damage.
- Capsule endoscopy: This technique takes photos of the whole small intestine using a small wireless camera. You will be required to swallow the camera, which is placed in a vitamin-sized capsule. The camera in the capsule captures hundreds of images as it goes through the digestive system and sends them to a recorder.
Celiac Disease Treatment
There is no cure for celiac disease. However, the only method of controlling celiac disease symptoms is to follow a gluten-free diet. Consuming gluten-free foods allows your small intestine to repair and prevents inflammation and problem in the future.
You must avoid all foods containing wheat or wheat flour. Also, you cannot take foods that have rye, barley, durum, graham, farina, malt, graham flour, and semolina since they contain gluten.
Consult your medical provider to know if you can consume oats. Since other people with celiac disease don’t usually have any problem with oats, they could be a good addition to the routine diet. The doctor would probably advise you to exclusively consume gluten-free oats to rule out their potential to get contaminated with wheat.
If you have celiac disease, it's critical to keep an eye on the processed foods as much as possible. Wheat flour is commonly used in a variety of products, including some you may not actually expect. Gluten can be found in a variety of foods, including:
- Canned soups
- Salad dressings
- Ice cream
- Candy bars
- Instant coffee
- Luncheons meats and canned or processed meats
- Mustard and ketchup
Gluten may also be present in various meals, medicines, and goods that you may frequently use. For instance, gluten can be found in over-the-counter and prescription drugs, as well as supplements and vitamins. In pills and capsules, wheat starch is often used as a binding content. Certain nutritional and herbal supplements, toothpaste, and mouthwashes, as well as cosmetics like lipstick, may also contain gluten.
You should consult a dietitian to determine which gluten-free meals are best for you and how you can meet all nutritional requirements. They can as well show you how to read food and other product labels appropriately.
Use of supplements:
Since the bodies of other people with celiac disease do not absorb some nutrients well, they may lack certain vital nutrients. The doctor can thus recommend taking the supplement to compensate for the nutrients. The most common are calcium, iron, fiber, vitamin D, zinc, magnesium, niacin, and folate.
Your intestines should start healing, and your body can absorb the nutrients once you begin a gluten-free diet. However, consult your doctor to determine whether you require a gluten-free multivitamin or supplement.
Follow Up Care
Regular medical checkups can guarantee that your symptoms have improved after switching to a gluten-free diet. Blood tests will be used to track your progress. A gluten-free diet enables the small intestine to recover in most patients with celiac disease. This normally takes about three to six months for children, while adults may take several years to heal fully.
If your symptoms persist or recur, endoscopy with biopsies may be required to establish whether your small intestines are healed.
Complications of Celiac Disease
If left untreated, the celiac disease might result in the following complications;
- Malnutrition: When the small intestines are unable to take up adequate nutrients, malnutrition happens. Anemia and weight loss can result from malnutrition. Also, malnutrition in children can lead to stunted growth and shorter stature.
- Infertility and miscarriage: Vitamin D and calcium malabsorption can cause reproductive problems in women.
- Bone deterioration: Calcium and vitamin D malabsorption can cause bone softening (osteomalacia or rickets) in children and loss of bone density in adults (osteopenia or osteoporosis).
- Lactose intolerance: After consuming or drinking lactose-containing dairy products, you may experience abdominal pain and diarrhea due to damage to the small intestine. However, you may endure dairy products again once your intestine recovers.
- Problems with the nervous system: Seizures or any condition of the nerves in the hands and feet can occur in patients who have celiac disease (peripheral neuropathy).
- Cancer: Celiac disease patients who do not follow a gluten-free diet are at a higher risk of getting cancers such as small bowel cancer and intestinal lymphoma.
Celiac disease is a type of autoimmune disease. When you have celiac disease and consume gluten-containing foods, your immune system reacts by causing damage to the small intestine. Gluten is a protein that is usually present in grains such as rye, wheat, and barley. Vitamins and supplements, toothpaste, skin and hair products, and lip balm could also contain gluten.
Celiac disease can affect every person in different ways. The symptoms might appear in the digestive system or elsewhere in the body. Although there is no cure, adhering to a gluten-free celiac disease diet can help to alleviate the symptoms.