Celiac disease, better known as gluten intolerance, gluten allergy or native sprue, describes an autoimmune disease of the small intestinal mucosa.
What is celiac disease?
Celiac disease or gluten intolerance is genetic and the affected people have this disease their whole lives. For mikulicz syndrome definition and meaning, please visit howsmb.com.
It can appear in childhood or even in adulthood.
Environmental influences such as stress and infectious diseases can promote celiac disease.
Gluten is present in many types of grain, such as rye, wheat, spelt, malt, oats or unripe spelt.
There is a debate among physicians as to whether a missing enzyme could also be the cause of celiac disease.
Genetic predisposition is assumed to be the cause of celiac disease . This leads to an autoimmune reaction, in particular an antigen-antibody reaction to gluten in food.
Similar to an allergy, the immune system then overreacts. In the constant fight of the immune system against gluten, inflammation of the small intestine then occurs as a result.
In a healthy person, the surface of the small intestinal mucosa increases with numerous mucosal folds (small intestinal villi), which ensures that the nutrients from our food are fully absorbed into the blood.
Celiac disease damages the villi of the small intestinal mucosa and flattens them. As celiac disease progresses, the villi of the small intestine recede completely. The nutrients can no longer be sufficiently absorbed and transported into the blood. As a result, various deficiency symptoms can occur.
Symptoms, Ailments & Signs
Celiac disease manifests itself in a variety of non-specific symptoms that can vary considerably from patient to patient. Doctors therefore call the disease the “chameleon of gastroenterology”. The first signs are digestive disorders such as cramping abdominal pain, flatulence, diarrhea or constipation after eating foods containing gluten.
The most common complaints include weight loss, bloating, nausea, and vomiting. Patients often complain of loss of appetite and heartburn. More than 50 percent of celiac disease patients experience symptoms that do not affect the gastrointestinal tract.
Due to malabsorption in the small intestine, sufferers suffer from iron deficiency, which results in paleness, fatigue and anaemia. The psyche can also be affected by this immunological disease of the small intestine: Some of those affected suffer from irritability, bad mood, anxiety or depression.
Dermatitis herpetiformis Duhring has a direct causal connection with celiac disease. It is a chronic blistering skin disease that is accompanied by excruciating itching. The rash primarily affects the extensor surfaces of the extremities, knees and elbows, the hairy scalp and buttocks.
Sick children who do not follow a gluten-free diet have an increased risk of developing mental and physical disorders. These can show up in the form of ADHD, learning disabilities, enamel defects, and growth retardation.
Diagnosis & History
There are two different ways to check for celiac disease in the case of gastrointestinal problems. On the one hand, the doctor can draw blood to test for antibodies against components of gluten. If these antibodies are present, it is celiac disease. The antibody test is not recommended for children, as it is only suitable to a limited extent in these cases.
The second way to infer celiac disease is a biopsy of the small intestine. A sample is taken from the lining of the small intestine. The patient is given a local anesthetic and swallows a tube to which a capsule is attached. The tube is passed through the esophagus and stomach into the small intestine, where the sample is taken. The sample is examined under the microscope for inflammation.
Symptoms of celiac disease include diarrhea, bloating, nausea, vomiting, depression, loss of appetite, weight loss, muscle pain, lack of energy and fatigue. Babies and small children often have stunted growth, underdeveloped teeth, children often show tearful facial expressions and can develop muscle weakness.
These symptoms are often not taken seriously and are certainly not associated with celiac disease. For this reason, the disease is often not recognized until late. Finding the right diagnosis is made more difficult by the fact that several symptoms can occur at the same time. This is why there are numerous misdiagnoses or wrong treatments for celiac disease.
The symptoms of celiac disease usually do not appear at the same time and are often not specific. Very often those affected only suffer from typical gastrointestinal complaints. If celiac disease is recognized too late or if no treatment is given, deficiency symptoms and chronic infectious diseases are often the result. Celiac disease weakens the entire organism until it is completely exhausted.
Celiac disease is particularly associated with complications if those affected do not consistently follow the gluten-free diet prescribed by the doctor. In this case, there is an increased risk of various secondary and concomitant diseases, including type 1 diabetes mellitus, rheumatoid arthritis and various autoimmune diseases of the thyroid gland. In addition, patients with celiac disease who, contrary to all recommendations, eat foods containing gluten are more likely to develop what is known as T-cell lymphoma, a malignant disease of the lymphatic system.
At the beginning of therapy, many sufferers complain of complications such as abdominal pain and diarrhea. These complaints are usually caused by the mucous membrane of the small intestine that is in the process of rebuilding and can be easily treated – provided the patient informs the doctor treating him immediately so that he can take the necessary steps. If the side effects of the therapy are completely ignored, however, further complications such as an intestinal obstruction or disturbances in the electrolyte balance can be expected.
If the patient sticks to his gluten-free diet consistently and, above all, over the long term, the prognosis is very good. In this case, celiac disease has no effect on life expectancy. Instead, the inflammatory processes recede completely over the course of a few weeks or months. Immunosuppressants (medicines that suppress the immune system) must also be administered if the disease is so-called diet-resistant celiac disease.
When should you go to the doctor?
If health changes occur after ingestion of food, these should be monitored further. In the event of repeated flatulence, diarrhea, vomiting or nausea, the abnormalities should be discussed with a doctor. The person concerned should be able to summarize well what foods or meals he has eaten. If any abnormalities or parallels are noticed, these must be reported to the doctor. The development of cramps, a general feeling of illness and a feeling of being unwell indicate a health problem. If the symptoms increase or if the health impairments occur at regular intervals, a doctor must be informed. Loss of appetite, weight loss,
Medical tests must be carried out to clarify the cause. In case of constipation, a feeling of fullness, tiredness or inner irritability, a doctor’s visit is advisable. States of anxiety, mood swings or other emotional abnormalities are other health disorders that should be investigated further. If you are depressed, apathetic or lose your zest for life, you should consult a doctor. If there are changes in the complexion, itching, cognitive impairment or tooth enamel disorders, a doctor is needed. If children show delays in development or growth, a medical examination is also advisable.
Treatment & Therapy
Celiac disease cannot be cured. It is only possible to alleviate the discomfort. In order to support the mucous membrane of the intestine, it is necessary to avoid foods containing gluten. Grain products, pasta, puddings, biscuits, cakes, beer, pizza and chocolate contain plenty of gluten.
Vegetables, fruit, rice, salad, nuts, dairy products, vegetable oils or wine are suitable for people with celiac disease. A wide range of gluten-free, packaged foods is available in health food stores and now also in many supermarkets, which must be labeled “gluten-free”. If you don’t want to do without grains despite celiac disease, you will find alternatives in millet, buckwheat, soy, carob flour, amaranth or quinoa.
There is a 10% chance that children born to a parent who has celiac disease will also develop celiac disease. Breast milk is said to prevent celiac disease from progressing in infants and later in toddlers.
If you have celiac disease, it is advisable to visit your doctor at least once a year to have your blood checked for vitamin B12 and vitamin D levels and to check your weight. Those affected can also actively take preventive measures themselves by finding out more about their illness. The German Celiac Society (DZG), which also has an online presence, offers guidance.
So far, there are no methods or ways to completely prevent celiac disease. Concerned parents must request a preventive check-up for babies and small children from the pediatrician themselves . Furthermore, people with suspected celiac disease should pay attention to the symptoms and symptoms listed above in order to then consult a doctor. It makes sense for babies to breastfeed until they are at least six months old and to avoid foods containing gluten during this time.
You can do that yourself
After a diagnosis of celiac disease, a major change in diet is required. At first glance, this seems scary. All products containing wheat, rye, barley, oats, spelt, unripe spelt, ancient grain, kamut or emmer are gluten-containing. Commercial pasta such as rolls, pasta, bread, cakes and pastries also contain gluten. Ready meals and soups can also not be eaten.
But 90 percent of all foods are naturally gluten-free, so making the change in diet doesn’t have to be difficult. Potatoes, rice, quinoa, millet, buckwheat, and amaranth are just a few of the foods that can be eaten as side dishes in place of pasta—that’s a whole lot. All fruits, vegetables and nuts also contain no gluten. This means that everyday life can continue normally even after the diagnosis of celiac disease.
It is still difficult to find suitable food on the go, however, since flour is used as a thickening agent in most sauces. It is therefore advisable to prepare meals the day before and take them with you. If you’re invited to dinner, it’s just as difficult. Acquaintances and friends should therefore be informed about the disease, or they should contribute something to eat. You should also be able to recognize the first signs of an attack and be able to act if you have eaten foods containing gluten.