Absolutely no one wishes to be in a scenario where a favourite meal or grocery is blacklisted among foods not to eat. An autoimmune disorder known as Celiac disease puts one in a condition of having restricted meals or groceries to be consumed.
Celiac disease is triggered when gluten is consumed. It occurs in genetically predisposed people, where the body’s immune system (the body's defence against infection) overreacts to the ingestion of gluten, causing inflammation, which leads to damage in the small intestine.
Celiac (or Coeliac) disease, also known as celiac sprue, nontropical sprue or gluten-sensitive enteropathy, is a rare condition that is estimated to affect 1% of the world’s population.
What is Gluten?
Gluten is a group of proteins, called prolamins and glutelins. It is primarily found in wheat, barley and rye.
It serves as a glue that binds or keeps food together (preserving its shape) and is also that which makes dough elastic and gives bread its spongy or chewy texture.
What Causes Celiac Disease?
There is no definite cause of celiac disease but research suggests that it tends to run in families and might be linked to certain genes.
When people with celiac disease eat gluten, their body mounts an immune response that attacks the small intestine. It's not entirely clear what causes the immune system to act this way.
Over time, the immune reaction to eating gluten creates inflammation that damages the small intestine's lining, leading to medical complications. This reaction to gluten particularly affects the tiny, hair-like projections (villi) that line the small intestine. The villi control the absorption of vitamins, minerals and other nutrients from the food consumed. When the villi get damaged, nutrients cannot be absorbed (malabsorption) properly into the body.
Celiac disease can develop at any age after people start consuming foods or medicines that contain gluten.
Risk factors
Celiac disease runs in families, which makes it hereditary. People with a first-degree relative (such as parent, child, sibling) with celiac disease, have a 1 in 10 risk of developing celiac disease.
Celiac disease tends to be more common also in people who have:
Type 1 diabetes
Down syndrome or Turner syndrome
Autoimmune thyroid disease
Microscopic colitis (inflammation of the colon or large intestine)
Addison's disease
Sjogren’s syndrome (immune disorder)
Likelihood of developing celiac disease can also be triggered by pregnancy, childbirth, surgery, viral infection, bacterial gastroenteritis, severe mental or emotional stress.
Signs and Symptoms of Celiac Disease
The classic symptom of celiac disease is diarrhoea. Other symptoms include:
Fat in stool
Bloating
Belching
Constipation
Flatulence
Indigestion
Heartburn
Abdominal pain
Bone or joint pain
Vomiting
Depression or anxiety
Heartburn or acid reflux
Headache or migraine
Fatigues
Mouth sores
Nausea
Missed or irregular menstrual periods
Itchy skin rash (dermatitis herpetiformis)
Dermatitis herpetiformis (DH) is an intensely itchy skin rash made up of bumps and blisters. It may develop on the elbows, knees, torso, scalp and buttocks. DH affects approximately 15 to 25 percent of people with celiac disease. Those who do experience DH usually don’t have digestive symptoms.
Other common symptoms found especially in infants and children are;
Developmental problems (delayed puberty or slow growth/short height)
Chronic diarrhoea, which can be bloody
Weight loss
Irritability
Behavioural issues
It’s important to note that symptoms can vary from person to person. For some people, there could be no symptom, which is referred to as silent or asymptomatic celiac disease. People with celiac disease who have no symptoms can still develop complications from the disease over time if they do not get treatment.
Complications
If left untreated, celiac disease can lead to additional serious health problems, such as:
Irritable bowel syndrome (IBS)
Infertility and miscarriage
Lactose intolerance
Small intestinal bacterial overgrowth
Malnutrition
Defects in dental enamel
Attention Deficit Hyperactivity Disorder (ADHD)
Nervous system problems like seizures or pain and numbness in your hands and feet (peripheral neuropathy)
Osteoporosis or osteopenia (bone loss)
Osteomalacia (softening of the bone)
Hyposplenism (excessive loss of lymphocytes)
Hepatitis (inflammation of the liver)
Anaemia, usually from iron deficiency
Pancreatic disease or dysfunction of the pancreas
Cancer; which includes intestinal lymphoma and small bowel cancer
Diagnosing Celiac Disease
Many people with celiac disease don't know they have it. Two blood tests can help find out if one has celiac disease:
Serology testing that looks for certain antibodies, and
Genetic testing to look for human leukocyte antigens to rule out celiac disease
It's important not to try a gluten-free diet before being tested for celiac disease. Eliminating gluten from your diet might make the results of blood tests appear normal.
If the results of these tests show celiac disease, the doctor will likely request an endoscopy done. This is a procedure in which the doctor can look at one’s small intestine and take a bit of tissue to see whether it’s damaged.
Treatment of Celiac Disease
After a proper diagnosis has been made, the mainstay of treatment is a lifelong strict gluten-free diet that can help manage symptoms and promote intestinal healing, as there's no cure for celiac disease. However, it may take years for utter healing of the digestive system. Children tend to heal faster than adults.
Besides wheat, barley and rye, other foods that contain gluten include:
Bulgur
Durum
Farina
Graham flour
Malt
Semolina
Spelt (a form of wheat)
Triticale
Avoid packaged foods unless they're labelled as gluten-free or have no gluten-containing ingredients, including emulsifiers and stabilizers that can contain gluten. In addition to cereals and pastas other packaged foods that can contain gluten include:
Beers, lagers, ales and malt vinegars
Bread
Cakes and pies
Cookies
Biscuits and crackers
Croutons
Candies and ice-creams
Gravies
Pasta
Imitation meats or seafood
Processed luncheon meats, sausages and hot dogs
Rice mixes
Salad dressings and sauces, including soy sauce
Seasoned snack foods, such as tortilla and potato chips
Seitan
Self-basting poultry
Soups
Pure oats aren't entirely harmful for most people with celiac disease because oats do not contain gluten, but oats can be contaminated by wheat during growing and processing. Ask your doctor if you can try eating small amounts of pure oat products.
Cross-contamination can occur if gluten-free foods and foods that contain gluten are prepared together or served with the same utensils. One can experience nonresponsive celiac disease, which is often due to contamination of the diet with gluten.
Gluten can be hidden in foods, medications and nonfood products, including:
Modified food starch, preservatives and, food stabilizers
Prescription and over-the-counter medications
Vitamin and mineral supplements
Herbal and nutritional supplements
Cosmetic products such as lipstick, lip gloss and chapstick
Toothpaste and mouthwash
Playdough
Communion wafers
Envelope and stamp glue
Always remember that it is necessary to look out for products labelling, ensure it is gluten-free labelled.
People with celiac disease often have a lactose intolerance, so avoiding lactose may help.
Allowed foods
Many basic foods are allowed in a gluten-free diet, which include:
Eggs
Fresh meats, fish and poultry that aren't breaded, batter-coated or marinated
Fruits
Lentils
Beans
Most dairy products, unless they make one’s symptoms worse
Nuts
Potatoes
Vegetables
Wine, distilled liquors, ciders and spirits
Grains and starches allowed in a gluten-free diet include:
Amaranth
Buckwheat
Corn
Millet
Sorghum
Arrowroot
Flour made from rice, soy, corn, potatoes, or beans
Teff
Cornmeal
Pure corn tortillas
Quinoa
Rice and rice noodles
Tapioca
Wild rice
A nutritionist or dietitian who manages people with celiac disease can help with planning a healthy gluten-free diet. A slight trace of gluten in your diet can be damaging, even in the absence of any sign or symptoms.
If one has a serious lack of nutrients, the doctor may have the patient take gluten-free vitamins and mineral supplements, and medication will be administered if a skin rash is found, especially in the case of having dermatitis herpetiformis.
After you’ve been on a gluten-free diet for a few weeks, your small intestine should begin to heal, and you’ll start to feel better.
If one’s celiac disease isn’t better after at least a year without gluten, it’s called refractory or nonresponsive celiac disease.
Refractory celiac disease is when the intestinal injury caused by the disease doesn’t respond to a strict gluten-free diet, thereby causing the small intestine not to heal. This happens in rare cases.
Prevention
Since, there are no established cause why the body’s immune system overreacts when gluten is ingested and research is still ongoing to find a vaccine for the prevention of this autoimmune disorder, should we all go for a gluten-free diet?
Those who do not have celiac disease or a diagnosed gluten intolerance should speak to their doctor if they are thinking of going gluten free.
A gluten-free diet can lead to other deficiencies, if not followed with care.
In a nutshell:
For those with celiac disease, it is important to ensure that your gluten-free diet is healthy and balanced.
An increase in the range of available gluten-free foods in recent years has made it possible to eat both a healthy and varied gluten-free diet.
....making effort to "STAY WELL"
REFERENCES:
https://www.hse.ie/eng/health/az/c/coeliac-disease/treating-coeliac-disease.html
https://www.everydayhealth.com/celiac-disease/guide/treatment/
https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220
https://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease#1
https://www.healthline.com/health/celiac-disease-sprue
https://www.medicalnewstoday.com/articles/38085
https://en.wikipedia.org/wiki/Coeliac_diseasez
https://celiac.org/about-celiac-disease/symptoms-of-celiac-disease/
https://my.clevelandclinic.org/health/diseases/14240-celiac-disease
https://www.nhs.uk/conditions/coeliac-disease/
https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/symptoms-causes
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