Celiac Disease: A Hidden Threat to Your Health
Celiac disease is a chronic immune disorder that affects about 1% of the world's population, but only 30% of them are properly diagnosed. It is caused by an abnormal reaction to gluten, a protein found in wheat, barley, and rye. Gluten triggers an immune response that damages the lining of the small intestine, leading to malabsorption of nutrients and various symptoms and complications.
What are the symptoms of celiac disease?
The symptoms of celiac disease can vary greatly depending on the age, severity, and duration of the condition. Some people may have no symptoms at all, while others may experience digestive problems, such as:
- Diarrhoea
- Constipation
- Bloating
- Gas
- Abdominal pain
- Nausea and vomiting
- Weight loss
However, celiac disease can also affect other parts of the body, causing non-digestive symptoms, such as:
- Anaemia
- Osteoporosis or osteomalacia
- Dermatitis herpetiformis (an itchy skin rash)
- Mouth ulcers
- Headaches and fatigue
- Nervous system injury (numbness, tingling, seizures, cognitive impairment)
- Joint pain
- Reduced spleen function (hyposplenism)
- Elevated liver enzymes
- Acid reflux and heartburn
In children, celiac disease can also interfere with growth and development, causing:
- Failure to thrive
- Damage to tooth enamel
- Irritability
- Short stature
- Delayed puberty
- Neurological problems (ADHD, learning disabilities, seizures)
What causes celiac disease?
Celiac disease is an autoimmune disorder, meaning that the body's immune system mistakenly attacks its own tissues. The exact cause of celiac disease is not known, but both genetic and environmental factors play a role.
- Genetic factors: Celiac disease is hereditary, meaning that it runs in families. Almost all people with celiac disease have certain variants of human leukocyte antigens (HLA), called HLA-DQ2 or HLA-DQ8. These are molecules that help the immune system recognize foreign substances. However, not everyone with these variants develops celiac disease, suggesting that other genes are also involved.
- Environmental factors: Celiac disease can be triggered or worsened by factors such as:
- Gluten ingestion: Gluten is the main trigger for celiac disease. It is a protein found in wheat, barley, and rye, and it can be present in many foods and products.
- Infections: Some viral or bacterial infections can activate the immune system and increase the risk of developing celiac disease.
- Pregnancy: Hormonal changes during pregnancy can affect the immune system and trigger celiac disease in some women.
- Stress: Physical or emotional stress can also alter the immune system and trigger or aggravate celiac disease.
How is celiac disease diagnosed?
Celiac disease can be difficult to diagnose because its symptoms are often similar to those of other conditions. To diagnose celiac disease, doctors usually perform:
- Blood tests: These tests measure the levels of antibodies that the body produces against gluten. High levels of these antibodies indicate celiac disease.
- Genetic tests: These tests look for the presence of HLA-DQ2 or HLA-DQ8 variants that are associated with celiac disease.
- Biopsy: This test involves taking a small sample of tissue from the small intestine and examining it under a microscope. Damage to the villi (small fingerlike projections that absorb nutrients) confirms celiac disease.
How is celiac disease treated?
The only treatment for celiac disease is a lifelong adherence to a strict gluten-free diet. This means avoiding all foods and products that contain gluten, such as bread, pasta, cereals, cakes, cookies, beer, sauces, soups, etc. Even small amounts of gluten can cause damage to the intestine and symptoms.
A gluten-free diet can help heal the intestine and prevent further complications. However, some people may need additional treatments or supplements to manage their symptoms or complications, such as:
- Lactose-free diet: Some people with celiac disease may also develop lactose intolerance due to damage to the intestine. This means that they cannot digest lactose (a sugar found in dairy products). A lactose-free diet can help reduce digestive symptoms.
- Multivitamins and minerals: Some people with celiac disease may have deficiencies in vitamins and minerals due to malabsorption. Taking supplements can help restore the levels of these nutrients and prevent complications such as anaemia or osteoporosis.
- Medications: Some people with celiac disease may need medications to treat specific symptoms or complications, such as:
- Steroids: These drugs can help reduce inflammation and pain in the intestine.
- Antibiotics: These drugs can help treat infections that may occur due to reduced immunity or damage to the intestine.
- Antihistamines: These drugs can help relieve itching and rash caused by dermatitis herpetiformis.
What are the complications of celiac disease?
If left untreated, celiac disease can lead to serious and sometimes life-threatening complications, such as:
- Malnutrition: This is a condition where the body does not get enough nutrients to function properly. Malnutrition can cause weakness, fatigue, weight loss, stunted growth, and increased susceptibility to infections.
- Cancer: People with celiac disease have a higher risk of developing certain types of cancer, especially in the small intestine, oesophagus, stomach, colon, and lymph nodes.
- Neurological problems: Celiac disease can affect the nervous system and cause problems such as seizures, peripheral neuropathy (damage to the nerves in the hands and feet), ataxia (loss of balance and coordination), dementia (loss of memory and cognitive function), and multifocal leukoencephalopathy (damage to the white matter of the brain).
- Infertility and miscarriage: Celiac disease can affect the reproductive system and cause problems such as irregular periods, infertility, or recurrent miscarriage.
How can celiac disease be prevented?
There is no known way to prevent celiac disease, but some measures may help reduce the risk or delay the onset of the condition, such as:
- Breastfeeding: Breastfeeding may protect infants from developing celiac disease by introducing gluten gradually and boosting their immunity.
- Delaying gluten introduction: Introducing gluten to infants after 6 months of age may reduce the risk of developing celiac disease.
- Avoiding gluten contamination: People with celiac disease should avoid cross-contamination of gluten in their food or products by using separate utensils, cutting boards, toasters, etc., and reading labels carefully.
Conclusion
Celiac disease is a serious condition that affects millions of people worldwide. It is caused by an immune reaction to gluten that damages the small intestine and causes various symptoms and complications. The only treatment is a strict gluten-free diet that can help heal the intestine and prevent further damage. People with celiac disease should consult their doctors regularly and follow their advice to manage their condition and improve their quality of life.
Sources
https://www.msn.com/en-us/health/condition/Celiac-disease/hp-Celiac-disease?source=conditioncdx
https://celiac.org/about-celiac-disease/what-is-celiac-disease/
https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220