Do you sometimes get stomach aches or upset stomachs when you eat something like bread or biscuits? Or do some people have a tendency to not eat anything? Today we are going to talk about a condition that can be related to something like that. That is Celiac Disease. Although this may seem a bit complicated, let's understand it simply.
What is celiac disease?
Simply put, celiac disease is a condition caused by
a problem in our own immune system . This is called an ``autoimmune disorder``. What happens in this is that when we eat food that contains a protein called ``gluten``, our body's immune system turns against it. To be precise, our body thinks that this gluten is an enemy. Then it produces antibodies to attack that enemy. However, these ``antibodies`` damage
the inner wall (mucosa) of our own small intestine . Due to this damage, the small intestine cannot properly absorb the nutrients in the food. That is when
nutritional deficiencies occur. This protein called ``gluten`` is mainly found in grains. Especially in things like
wheat, barley, and rye . You know, most of the foods we eat, like bread, pasta, cakes, and biscuits, are made from these grains. Not only that, but sometimes even sauces, soups, and packaged foods that we don't even think about can contain this gluten. Beer is also often made from barley or rye.
How does celiac disease affect my body?
Celiac disease mainly affects your
small intestine . This is where most of the nutrients in the food we eat are absorbed. This includes proteins like gluten. But if you have celiac disease, when gluten enters your small intestine, your immune system responds. That is, the immune system sends out cells and antibodies to destroy the gluten molecules. These cells damage the inner lining of the small intestine, the mucosa. Think about it, the inside of our small intestine is incredibly well-designed. Its inner wall is not just smooth. It has lots of folds, and it's full of little finger-like projections, called
villi . These villi give your food a large surface area to absorb as many nutrients as possible during digestion. It could be as big as a tennis court if you stretched it out! But the immune cells that come with celiac disease
flatten and flatten all of these `(villi)`, reducing the surface area available for absorbing nutrients.
Is celiac disease dangerous?
Yes, damage to the small intestine can have
serious consequences . As I said before, the small intestine is where the nutrients in food are absorbed through the `(mucosa)`. So when the `(mucosa)` is damaged, it doesn't work properly. We call this
This is called 'malabsorption'. This `(malabsorption)` can cause 'malnutrition' . Also, many other diseases can occur due to the lack of various nutrients. If this condition affects young children in particular, their growth and development can be impaired. Who gets celiac disease?
Celiac disease is most common in people of Northern European descent. It is estimated that about 1% of the population in Europe and North America has the disease. If someone in your family (a first-degree relative, such as a mother, father, or child) has the disease, you have about a 10% chance of developing it too. 97% of people diagnosed with celiac disease have a specific gene variant associated with it. These are called either `(HLA-DQ2)` or `(HLA-DQ8)`. Are there other risk factors?
Celiac disease is more common in people with certain inherited chromosomal disorders , such as Down syndrome. It is also more common in people with certain other autoimmune diseases . These diseases often share genes, and they can trigger each other. Like other autoimmune diseases, celiac disease is more common in women than in men . The ratio is about two to one (2:1). You are more likely to develop celiac disease if you have:
- If you are white.
- If anyone in your family has this disease.
- If you have a chromosomal abnormality such as `(Turner syndrome)`, `(Williams syndrome)` or `(Down syndrome)`.
- If you have another autoimmune disease such as `(Type 1 diabetes)`, `(rheumatoid arthritis )`, `(microscopic colitis)` or `(Addison's disease)`.
- If you are a woman.
What causes celiac disease?
Many autoimmune diseases, like celiac disease, are at least partly genetic disorders . That is, you are more likely to develop it because of a particular gene variant that is passed down from generation to generation in families. However, not everyone who has that gene variant will develop the disease, and not everyone who does develop the disease will have that identified gene variant. It seems that other factors also play a role in the onset of the disease. How does someone get celiac disease?
One theory is that significant physical stress can damage our immune system.It is believed that it can be triggered by a traumatic event. Doctors have observed that this disease appears after a physical event such as surgery, illness, pregnancy, or severe psychological trauma. Another theory is that microorganisms living in our intestines (microorganisms in your gut) are involved. This theory needs further research. When does celiac disease appear?
Celiac disease can develop at any age after you or your child starts eating gluten . Doctors see it most often in two age groups: early childhood, between 8 and 12 months , and middle age, between 40 and 60 years . The reason it appears early is because children usually start eating solid foods, such as biscuits and cereals, which contain gluten. What are the symptoms of celiac disease?
The symptoms of celiac disease can vary greatly from person to person, so it can be difficult to diagnose. Some people don't have any symptoms at all. Some people experience gastrointestinal (GI) symptoms after eating gluten. Others may only experience vague symptoms of nutritional deficiencies after the damage has been done. In these people, anemia may be the first sign of the condition. You may have symptoms like these:
Gastrointestinal symptoms:
Symptoms of iron-deficiency anemia:
- Weakness and fatigue
- Pale appearance (Pallor)
- Cold hands and feet
- Brittle or concave nails
- Headache
- Mouth sores
Other symptoms of malnutrition:
- Unintentional weight loss
- Delayed growth and stunted development in children (Failure to thrive)
- Muscle wasting or low muscle tone
- Dental enamel defects, for example, pitting, staining, or a translucent appearance
- Irregular menstruation or difficulty getting pregnant
- Mood swings, most commonly anxiety in children and depression in adults
About 15% of people with celiac disease develop this chronic skin condition as a side effect. It is also called a 'gluten rash' or 'celiac rash' . The same gluten antibodies that damage the small intestine in celiac disease cause this condition. Dermatitis herpetiformis is an itchy, clustered rash that looks like blisters or eczema. It usually appears on the elbows, knees, buttocks, or scalp. How do you know if you have celiac disease?
If you experience digestive problems after eating gluten, you may suspect you have celiac disease. Many people seem to have a sensitivity to gluten or wheat products in their diet. Food intolerances can cause uncomfortable symptoms after eating foods, but they don't cause damage to the intestines like celiac disease. To diagnose celiac disease, doctors look for evidence of this damage. The most important thing is to get tested for celiac disease before you start a gluten-free diet. That's when the tests will reveal how gluten is really affecting your body. Once you stop eating gluten, your gut will start to heal. Healing is good, but then the evidence of celiac disease will disappear. You and your doctor need to know for sure if you have it, so that you can decide what kind of treatment you need going forward.
How do doctors test for celiac disease?
Doctors use two methods to test for celiac disease. They like to use both together to confirm the diagnosis. The first is a blood test . Doctors look for antibodies in your blood that are produced against gluten. Then, they look for damage. This involves taking a small sample of tissue (a biopsy) from your small intestine and examining it under a microscope. To take this sample, a gastroenterologist will do an endoscopic examination of your small intestine. An endoscopy is a test that involves inserting a long, thin tube with a small camera inside. During an upper endoscopy , an endoscope is passed down the throat and into the upper part of the small intestine, called the duodenum . Based on the images seen from the camera, the doctor performing the endoscopy can pass instruments through the tube and take a biopsy. Additional tests
Once celiac disease is confirmed, your doctor will want to check your blood for specific vitamin and mineral deficiencies . Severe deficiencies can have a variety of effects on your body and may need to be treated directly with supplements. The most common are iron-deficiency anemia , vitamin-deficiency anemia , and vitamin D deficiency . You may also have low levels of electrolytes, such as calcium. How is celiac disease treated?
The first and most important step in treating celiac disease is to completely stop eating gluten . You can't change the way your body reacts to gluten, but you can prevent gluten from causing that reaction. Once you stop eating gluten, your small intestine will begin to heal and will soon be able to absorb nutrients again. However, you will need to maintain a strict gluten-free diet for the rest of your life to prevent further damage to your small intestine. Additional treatments may include:
* If there are serious deficiencies, take nutritional supplements to correct them.
* Treat dermatitis herpetiformis with specific medications like dapsone.
* Corticosteroids for severe inflammation that does not respond quickly to diet.
* Continuous follow-up care, including regular check-ups, to ensure the disease is under control.
How long does it take to recover from treatment?
For most people , symptoms begin to improve almost immediately after starting a gluten-free diet . It can take a few weeks for your nutritional deficiencies to be addressed, and it can take a few months for your gut to fully heal. In some cases, it can take longer, depending on the extent of the damage and how long it has been there. If you don't follow a strict diet, recovery can be delayed. What is the outlook for people with celiac disease?
Many people who are diagnosed and stop eating gluten can expect to recover very well . Much of the damage caused by celiac disease can be reversed. If you continue to have symptoms, you may be eating small amounts of gluten without realizing it, or you may have a secondary condition. Only about 5% of people have truly refractory celiac disease, which does not respond to dietary control. What happens if you don't stop eating gluten? What are the long-term complications?
If you are diagnosed years late, or if you are unable to avoid eating gluten afterward, the effects of celiac disease can be more severe and long-lasting . Complications of chronic malnutrition:
- Rickets in children or osteomalacia in adults.
- Osteopenia ( thinning of the bones) and osteoporosis ( bone loss).
- Permanent tooth enamel defects.
- Effects on the nervous system (peripheral neuropathy), including numbness and tingling, muscle twitching, and balance and coordination problems (ataxia).
- Delayed growth and development in children, stunting.
- Difficulty concentrating and learning.
Complications of chronic inflammation:
- Compromised immunity : When your immune system is constantly overactive, it has fewer resources to deal with emergencies like infections. This can increase your risk of getting sick.
- Additional food intolerances : As your intestinal lining continues to be damaged, you may become unable to digest nutrients that you were previously able to digest. For example , lactose intolerance may develop.
- Ulceration and scarring : Severe inflammation can cause ulcers in your small intestine. A severe ulcer can even go through the intestinal wall (gastrointestinal perforation), which is a medical emergency. The inflammation can cause scarring inside the intestine and narrow the intestine (stricture), which can cause bowel obstruction .
- Collagenous sprue : This rare disease causes permanent collagen deposits in the small intestine, which can permanently impair nutrient absorption.
- Liver disease : Over time, you can develop chronic liver disease and progressive liver damage.
- Cancer : Chronic inflammation increases your risk of developing small intestine cancers (intestinal lymphomas, intestinal adenocarcinoma) and esophageal cancers .
How do you get used to a gluten-free diet?
At first, avoiding all gluten can seem overwhelming. You have to learn to read labels and be careful about accidental gluten contamination. The good news is that there are plenty of resources available to help you get started on your new diet. Your doctor can refer you to a registered dietitian , who can help you get started. What foods trigger celiac symptoms?
Gluten is naturally found in some grains and products made from grains. That means:- Wheat (all types such as semolina, durum, bulgur, spelt, couscous)
- Barley (and malt made from barley)
- Rye
These grains are used to make:- Bread and bakery products
- Hot and cold cereals
- Types of noodles and pasta
- Beer, Lager and Ale
- Malt-containing alcohol
- Malt vinegar
Additionally, gluten is also added to many processed food products . For example:- Soups and sauces
- Salad dressings and condiments
- Processed meats (like hot dogs, deli meats)
- Processed cheese, yogurt and ice cream products
- Packaged meals
- Sweet food
Important: Before eating processed foods, check the label to make sure there is no hidden gluten.
Some quick tips for living with celiac disease:
- Create a go-to home menu. Look through recipe books and choose a few recipes that you can eat regularly and that are easy to make. Make a habit of always keeping the ingredients you need at home.
- Keep a few gluten-free snacks in your car, bag, or office desk. They'll come in handy if you can't find anything else to eat when you leave the house.
- Find a few restaurants that have reliable gluten-free menus or that you know you can safely order from.
- When you're not sure exactly what's in a new food, it's also a good idea to keep gluten test strips handy to check if it contains gluten.
Finally, what to remember
A diagnosis of celiac disease will change your diet and lifestyle forever. And it will change your life for the better . Before you were diagnosed, you were probably eating gluten and slowly damaging your small intestine. You may have had strange, uncomfortable symptoms for years without even knowing what they were. Now that you know, you have the power to rebuild your health. Don't worry, if you manage it properly, you can stay healthy!
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