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Complete Guide To Celiac Disease

Celiac disease is a type of autoimmune disorder that triggers when we eat gluten. Some people also call this order gluten-sensitive enteropathy, celiac sprue, or nontropical sprue. In this guide, we are going to give a detailed overview of celiac disease. We will also delve into its symptoms, causes, risk factors, and treatment options. 

What is Gluten? 

Gluten is a protein, which is present in barley and wheat along with other grains. This substance is the reason behind the chewy texture of bread and the elasticity of pizza dough. When an individual with celiac disease consumes food with gluten, the body overreacts to the protein and damages the villi. The small finger-like projections, or villi, are present along the wall of the small intestine. 

As a result, the small intestine is unable to absorb nutrients from food. Over time, this condition leads to malnutrition and other complications. Some of these complications include infertility, miscarriages, loss of bone density, a few neurological diseases, and even cancer.

Going gluten-free is the best way to avoid celiac disease. However, if the disease doesn’t get better even after you stop consuming foods with gluten, it is called non-responsive or refractory celiac disease.

Facts and Figures

Here are some interesting data about this disease. 

  • The disease affects one person in 113 people.
  • Nearly three million American individuals suffer from celiac disease.
  • The disorder is hereditary, so all first and second-degree relatives are more susceptible to this disorder.
  • Almost 83% of individuals with celiac disease do not receive a diagnosis. 
  • The average time it takes for an average American to get a correct diagnosis is six to ten years. 
  • The U.S. economy wastes billions of dollars in healthcare costs to test and treat people who are showing symptoms of this disease.
  • Celiac disease also leads to other autoimmune diseases.

Currently, adopting a 100% gluten-free diet is the only way to control the celiac disease. Medical scientists are working on designing a pharmaceutical treatment for curing celiac disease. 

What are the Symptoms of Celiac Disease?

Interestingly, a large population of patients doesn’t ever get a diagnosis. Researchers believe that there are as few as 20% of individuals who get the correct diagnosis. Since the damage to the intestine is slow and the symptoms vary in each case, it can take years for an affected person to receive a diagnosis.

Remember that celiac disease is different from gluten sensitivity or gluten intolerance. In some cases, individuals with gluten intolerance may have the same symptoms as celiac disease. However, there is no damage to the small intestine or an immune response. People may also confuse this disease with food allergy. But when you are allergic to a substance, you experience breathing problems or have watery eyes, which is not the case with celiac disease. 

Symptoms of Celiac Disease in Adults 

Here are the most common symptoms that arise when an adult, who has celiac disease, accidentally eats something with gluten in it. 

  • A feeling of fullness or bloating
  • Anemia
  • Abdominal pain
  • Joint pain
  • Diarrhea
  • Constipation
  • Heartburn
  • Flatulence
  • Blistery or an itchy rash (Dermatitis Herpetiformis)
  • Fatigue or headaches 
  • Nausea
  • Mouth ulcers
  • Smelly or floaty stools
  • Weight loss
  • Reduced spleen function 
  • Loss of bone density

What are the Symptoms of Celiac Disease in Children? 

Children who have this disease are likely to have these symptoms:

  • Belly swelling or bloating 
  • Diarrhea or Constipation
  • Foul-smelling and pale poop
  • Vomiting or upset stomach
  • Weight loss

Malnutrition is another common symptom in children because they fail to absorb the nutrients they need for growth.

Some of these symptoms include:

  • Delayed puberty
  • Failure to thrive (infants)
  • Damaged tooth enamel
  • Anemia
  • Mood changes or crankiness
  • Cognitive or neurological problems like ADHG or learning disabilities 
  • Short height and slow growth

It is important to remember that not all individuals with this disease show these symptoms. 

Since many people don’t experience any significant symptoms, it’s difficult to diagnose the condition.

What is Celiac Rash or Dermatitis Herpetiformis?

This rash is an indication of gluten intolerance. If you notice itchy or blistering skin, it may not be a skin condition but a symptom of celiac disease. Typically, the rash occurs on the buttocks, scalp, torso, knees, and elbows. The rash is usually because of the changes in the small intestine but does not trigger any other digestive symptoms.

Around one in four individuals with celiac disease get this rash. More adults than children and more men than women have Dermatitis Herpetiformis. Visit your family doctor if you notice blisters or itchy skin near the elbows, buttocks, scalp, or lower back. Most doctors recommend medication or a gluten-free diet (or both) for controlling the rash. 

What are the Causes of Celiac Disease?

Medical science has yet to discover a definite cause of celiac disease. However, it can be hereditary and linked to certain genes. Surgery, a viral infection, or a stressful medical event can also cause this disease. Pregnancy and emotional traumas are other common causes. 

Schedule an appointment with your doctor if one or any of your close family members have this disease. That’s because having a parent or a sibling with celiac disease means you have a one in ten chance of acquiring this disease. 

What are the Risk Factors for Celiac Disease? 

Celiac disease is most common among Caucasians. It also affects individuals who are suffering from other diseases, including:

  • Addison’s disease
  • Rheumatoid arthritis
  • Type 1 diabetes
  • Hashimoto’s thyroiditis
  • Multiple sclerosis 
  • Down syndrome
  • Autoimmune hepatitis
  • Idiopathic dilated cardiomyopathy
  • Turner syndrome 
  • Sjogren’s syndrome
  • IgA nephropathy
  • Psoriasis
  • Irritable bowel syndrome (IBS)
  • Lupus
  • Williams syndrome
  • Scleroderma
  • Primary biliary cirrhosis
  • Chronic pancreatitis
  • Lactose intolerance
  • Intestinal cancer
  • Intestinal lymphoma

What are the Complications of Celiac Disease?

Failure to seek treatment for celiac disease can lead to complications. Some of these include:

  • Malnutrition
  • Miscarriage or infertility
  • Small bowel cancer
  • Lactose intolerance
  • Intestinal lymphoma
  • Damaged tooth enamel
  • Weak bones
  • Pancreatic disease
  • Nervous system problems including pain, numbness, seizures or pain, and tingling of feet and hands (peripheral neuropathy)

When Should You See a Doctor?

If you are experiencing digestive discomfort or have diarrhea for more than two weeks, consulting your family doctor will help you get a diagnosis. Don’t overlook any symptoms in children because it could lead to other complications. Furthermore, it’s important to consult your doctor before adopting a gluten-free diet. Reducing or eliminating the amount of gluten from your diet can affect the results of tests that your doctor ordered for diagnosis. 

Since this disease runs in families, consult a doctor if you have a family history of celiac disease. Patients with Type 1 Diabetes should also seek medical assistance because they are at risk of this disease. 

How to Get a Diagnosis

Typically, a doctor will ask for two blood tests to verify the diagnosis. 

  • HLA-DQ2 and HLA-DQ8 or genetic testing for human leukocyte antigens to rule out celiac disease
  • Serology test to detect increased levels of certain antibodies in the blood, indicating an immune reaction to gluten.

In case the results of these tests confirm that you have celiac disease, the doctor will probably order some more tests. Here are some tests that your doctor will require, according to your symptoms and family history. 

Capsule endoscopy: The test involves a tiny wireless camera for capturing images of the entire small infesting. The patient swallows a tiny camera that sits in a vitamin-sized capsule. Next, this capsule travels through the digestive tract and clicks thousands of pictures. All these images transmit to a recording device that the patient wears around his waist. The camera will pass out in the stool within two to six hours. 

Endoscopy: In this test, the doctor puts a long tube with a tiny camera into the patient’s mouth. The tube passes down the patient’s throat, and the doctor is able to view the small intestine. He then takes a small tissue sample for analyzing the extent of damage to the villi. This process is also called a biopsy.

Similarly, if a doctor suspects that a patient has dermatitis herpetiformis, he will take a small sample of the skin tissue for examining it under a microscope. This process is called a skin biopsy.

In some cases, the doctor asks for other tests that check if you have any nutritional shortages. For example, they may ask for a blood test that detects iron deficiency. Anemia is a common symptom of celiac disease and can make it difficult for patients, especially children, to live a healthy life.

Is it Difficult to Diagnose?

Celiac disease is difficult to diagnose because its symptoms are fairly the same as many other conditions. Some of these include:

  • IBS or irritable bowel syndrome 
  • Gluten intolerance 
  • Lactose intolerance
  • Pancreatic insufficiency
  • Crohn’s disease of the small intestine
  • Bacterial overgrowth in the small intestine

What Is Refractory Celiac Disease?

When someone has refractory celiac disease, their small intestine fails to heal. In that case, a doctor will have to evaluate your condition in a specialized center. This disease can lead to serious complications, and there is no proven treatment to treat this condition. However, steroids can help treat this disease to some extent.

What is the Difference between Non-Celiac Gluten Sensitivity and Celiac Disease?

Small intestinal damage is a result of celiac disease, and many specific markers in the blood can confirm the diagnosis of celiac disease diagnosis. The most common symptoms of non-celiac gluten sensitivity are vomiting, nausea, abdominal pain, diarrhea, headaches, fatigue, and brain fog. While these symptoms may be severe or mild, they do not cause any damage to the intestines. Hence, there are no specific markers in the blood. Any individual who suffers from non-celiac gluten sensitivity will need to follow a diet plan to notice any improvements in the symptoms for getting a correct diagnosis.

Treatments for Celiac Disease

Unfortunately, there is no definite cure for celiac disease. The only way to treat this disease is to avoid gluten for the rest of your life. Sticking to a non-gluten diet is the only way to prevent damage to the small intestine due to gluten.

If you want to consume a gluten-free diet, you will have to avoid all foods that contain any traces of gluten. For example, avoid eating rye, wheat, and barley in all forms. It is crucial to check the labels of all products carefully before buying them because these ingredients may be present in them under less common names. For instance, many products contain wheat but have it under other names in the ingredients list. Some of these are: 

  • Bread crumbs
  • Semolina
  • Durum
  • Triticale
  • Spelt
  • Khorasan 
  • Couscous

People who suffer from this disease can improve their digestion and quality of life by eating a well-balanced diet. They can include a wide range of foods in their diet. For example, gluten-free pasta and bread can be safer alternatives for people dealing with celiac disease. 

Consumers can easily find several gluten-free alternatives. These alternatives comprise rice, potato, and bean flour instead of wheat and barley. Plus, you can also have fruits, fish, and meat. Ask your doctor and a qualified nutritionist who can help you live a better life after getting a diagnosis. 

What Foods should you Avoid?

Pay close attention to the labels of products you are buying from your local supermarket. People with celiac disease must avoid all types of processed items such as bread, pasta, etc. Most of us don’t know that wheat flour is a common ingredient in many popular items that we consume daily.

Some of these foods that contain gluten include: 

  • Ice cream 
  • Salad dressing
  • Canned soups
  • Instant coffee
  • Canned or processed meats
  • Ketchup and mustard
  • Pasta
  • Yogurt
  • Pastries

Gluten is also present in other foods, medicines, and products that some people use regularly. Vitamin supplements, over-the-counter medicines, and prescription medication may contain gluten. In many capsules and tablets, wheat starch is common, which can be detrimental to the health of people with celiac disease. Whenever you buy vitamin supplements, remember to check the labels and choose capsules free of gluten or starch. Many types of herbal supplements, mouthwashes, and toothpaste have gluten. Cosmetic products like lipsticks may also contain gluten. 

Talk to a dietician about the best gluten-free foods you can consume for eating a well-balanced diet. Your doctor can also recommend you the best supplements and teach you how to read the labels of common products. 

Treating Malnutrition due to Celiac Disease 

Since the disease affects the body’s ability to absorb nutrients, an individual with celiac disease may develop certain nutrient deficiencies. Some of the most common deficiencies include: 

  • Fiber
  • Zinc
  • Vitamin D
  • Calcium
  • Folate
  • Magnesium
  • Niacin
  • Iron

As soon as you switch to a gluten-free diet, the small intestine will begin to recover. That will help the body to absorb important nutrients once again. But you can also ask your doctor to recommend you a gluten-free vitamin supplement. 

Medications for Controlling Intestinal Inflammation

When someone’s small intestine gets severely injured due to celiac disease, the doctor will suggest steroids for controlling inflammation. Steroids relieve severe symptoms and signs of celiac disease as well as heal intestinal damage. Your doctor may also recommend other drugs, such as azathioprine or budesonide. When you have a skin rash because of celiac disease, your doctor will recommend a gluten-free diet and medication such as dapsone. While you can take this medication by mouth, you will need regular blood tests to monitor its side effects. 

Bottom Line

Once you go on a non-gluten diet, you will start noticing significant changes in your symptoms. However, if your symptoms do not subside or improve within two weeks, inform your doctor. 

Children respond to medication and dietary changes better than adults. Symptoms like abdominal pain and diarrhea go away automatically. Parents will also observe a noticeable improvement in their behavioral issues and progress in growth. Follow our guide if you or your loved ones are at risk of acquiring celiac disease in the future. 

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535670/

https://pubmed.ncbi.nlm.nih.gov/18803427/

https://everydayhealth.com/celiac-disease/causes-risk-factors-what-know/ 

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