Celiac disease: know its causes, symptoms and treatment
Gluten intolerance is known as celiac disease or celiac disease. Here we share information about its causes, symptoms and treatment.
It is a disease that occurs quite frequently, affecting about one person in a hundred, and occurs more often in women than in men. 75 percent of people with celiac disease do not receive an appropriate diagnosis or even do not receive any, and that is why it is so important to know everything related to this disease.
(You may also be interested in: Complete gluten guide: everything you should know)
What is celiac disease?
Also known as gluten sensitive enteropathy. Its main feature is inflammation in the mucosa that lines the small intestine, being a consequence of permanent and immune intolerance to gluten It comes from wheat, rye, and in people who are more genetically predisposed to suffer from this disease, from gluten that comes from oats.
Any person can suffer from celiac disease, causing significant injuries inside the small intestine, thus causing alterations in the absorption of minerals, vitamins and the rest of the nutrients found in food. The inflammation that takes place in the mucosa of the small intestine, prevents the micronutrients from being absorbed correctly.
What causes celiac disease?
Celiac disease is in a way the last result obtained from processes that end up causing damage to the intestine. On the one hand, the disease may be due to genetic defects in the immune system of the person and reactions unfavorable against certain elements of the environment, specifically towards gluten.
Four protein components are found within gluten and they are globulins, albumins, gliadins and glutenins, where gliadins as well as glutenins, which are in greater quantity within wheat. Likewise, glutenins are the element that cause all the damage inside the intestine in those people who suffer from celiac disease.
What are the symptoms of celiac disease?
The symptoms that appear in this disease are diverse. Even so, among the most common are lack of appetite, vomiting, bloating in the abdomen, fatigue, diarrhea, stunted growth, anemia, decreases muscle mass and significant changes in mood, which causes the A person suffering from the disease is always apathetic, sad, enters a state of introversion or is irascible.
Another data worth mentioning in relation to symptoms is that people who suffer from celiac disease are more likely to suffer from diabetes, diseases that affect the thyroid, Down syndrome, among other conditions.
Depending on the age, celiac disease symptoms may evolve.
Most common symptoms in children
– Hair fragility or fragile hair
– Muscular hypotrophy in areas such as the thighs, arms and buttocks.
– Bloating in the abdomen
– Delayed growth
Most common symptoms in teens
In the adolescence stage, some of the mentioned symptoms evolve and the following appear:
– Iron deficiency anemia
– Atopic dermatitis
– aphthous stomatitis
– Abdominal pain
– Late menarche
– Pubertal delay
– Juvenile chronic arthritis
Most common symptoms in adults
Some of the symptoms that appear in childhood appear again in adulthood:
– Lack of appetite
– Digestive cancer
– Early menopause
– Iron deficiency anemia
– irritable colon
Types of celiac disease
Celiac disease has various clinical ways of presenting itself.
Classical celiac disease
The main characteristics of celiac disease at the classical level are severe symptoms that have to do with inadequate absorption of nutrients, very sudden changes in mood, loss of appetite, growth retardation, severe atrophy in the villi appearing through biopsies of the small intestine and positive serum antibody titers. This form of celiac disease is what appears more frequently in children between 9 and 24 months.
The child's behavior will change drastically, which is why it would cause severe depression in certain cases. When she reaches three years of age, she will frequently pass loose stools and have constant iron deficiency anemia that will be resistant to medications. If the disease progresses without treatment, which often occurs in children of about a year or two, more severe symptoms such as bleeding from the skin or digestive bleeding (caused by inappropriate synthesis of vitamin K in the body) and edema caused by hypoalbuminemia will appear. and hypocalcemic tetany.
Celiac disease is milder in adolescence and adulthood, where digestive symptoms will remain absent or not present with the same intensity as in childhood. However, the most common clinical picture is abdominal pain, which is often like repeated colic, along with fluctuating abdomen inflammation, poor digestion, gastroesophageal reflux such as regurgitation, and a strong alteration in the habit of intestine, which is generally constipation.
This is a disease that by many specialists has been classified as a chameleonic disorder. This is because it often behaves like an iron deficiency that cannot be easily explained, presence of predominant skin lesions (also called dermatitis herpetiformis), bone alteration, neurological alterations (cerebellar ataxia, epilepsy, polyneuropathies, among other conditions) or also as an increase in serum transaminases, where digestive symptoms are not present.
The diagnosis of celiac disease is usually complicated, since many of the symptoms are absent or atypical, regardless of the patient's age.
Monosymptomatic celiac disease or pauci
Currently, this It is the most common form of celiac disease among adults., than is characterized by the presence of intestinal symptoms and / or extraintestinal symptoms. The rest of the symptoms vary according to the patient, ranging from lymphocytic enteritis to total atrophy, apart from the fact that the percentage with respect to the positivity of the autoantibodies would be between 15 and 100%, although it will also depend on the severity histological.
Silent celiac disease
There is no clinical manifestation, but there are characteristic histological lesions (atrophy in the villi also occurs). These types of cases are often discovered by determining certain serum markers, indicating clinical suspicion or belonging to risk pools.
Latent celiac disease
The main characteristic of this type of celiac disease is the presence of duodenal mucosa, which is normal for people who consume gluten in their diet when they have to undergo a medical evaluation, regardless of whether or not they have positive antibodies, although at any stage of their life, typical symptoms have been presented or appear of the clinical picture of celiac disease.
Potential celiac disease
These are people who have not had any alteration at the histological level that is part of the disease, although taking into account the characteristics at the immune and genetic level, they have an increased risk of suffering celiac disease.
Refractory celiac disease
These are people who, after having completely removed gluten from their diet, still show symptoms, even after six months have passed.
Celiac disease treatment
There is only one effective treatment for celiac disease, and that is to carry out a very strict diet that does not contain gluten for the rest of life. By doing this, you gain control of the symptoms of the disease and the body will function in a more stable way.
A diet that does not contain gluten, concentrates on two essential points. The first is to remove any foods that contain gluten, such as wheat, barley, oats, spelled, and rye. The second will be to exclude all those foods that are part of the derivatives of the mentioned cereals, such as starch, semolina, pastries, flour, bread, among others.
Similarly, the most suitable diet for a person suffering from celiac disease is based on products of natural origin, such as eggs, legumes, fruits, vegetables, meats and the consumption of cereals that do not contain gluten, such as corn and rice. It is also necessary for the patient to avoid consuming foods that are packaged or processed, since their components do not guarantee that they are gluten-free.
When it comes to celiacs who suffer from anemia, it is recommended that they consume iron, vitamin B12 and phosphate supplements, according to what the doctor prescribes. This is because these patients are more vulnerable and the vitamin deficiency is much lower in their body.
Until now celiac disease has no cure, that is why the only way to control each of the symptoms is through the diet so that the villi that are inside the intestine are repaired.
Diagnosis of celiac disease
Correctly diagnosing celiac disease is quite complicated, since most symptoms that occur are common in other conditions related to the digestive system.
The variability of the symptoms does not allow obtaining specific results that accurately determine that it is celiac disease. Therefore, the diagnosis is usually based on the presence of certain symptoms that are related to an intestinal problem or associated systems or organs, as well as the determination of serological markers, genetic markers, results of intestinal biopsies and the way in which it responds. the body to a diet that does not contain gluten.
What tests are performed?
Among the most widely used serological markers is the detection of tissue anti-transglutaminase antibodies, which act positively against intestinal hair atrophy, but which are also negative in the absence of such atrophy, thus decreasing the diagnostic value significantly. in moderate or light pictures, as it usually happens in adults.
The most used genetic markers are:
Genetic chewers related to what the HLA-II system is, where are DQ2 and DQ8. The first one mentioned is the most common, which is positive in 90% of all cases. Both have a high negative predictive value, although it is not enough to make a good diagnosis, since their presence is also in people who do not suffer from celiac disease. Therefore, an intestinal biopsy is always used to correctly diagnose the disease.
When there are doubtful cases regarding negative serology, it is recommended to implement a gluten-free diet with a duration of at least six months, carrying out a clinical follow-up and also an analytical follow-up, while observing the way in which the body responds and with the results obtained there is a specific diagnosis.
It is necessary to highlight the risk groups, where the patient must have some special sensitivity to determine that he suffers from celiac disease, taking into account all the clinical forms that are not classic, since in certain cases there are very important repercussions in the quality of life and nutrition of the person.
– Autoimmune thyroiditis
– Relatives who are first grade
– Selective IgA deficiency
– Down's Syndrome
– Herpetiform dermatitis
– Presence of one or more other autoimmune diseases, such as Sjögren's Syndrome, Addison's Disease, inflammatory bowel disease, rheumatoid arthritis, vitiligo, chronic autoimmune hepatitis, microscopic colitis, psoriasis, systemic lupus erythematosus, alopecia areata, cirrhosis primary biliary.
– Liver disease
Certain specialists appreciate that the delay in the onset of the symptoms of the disease and the moment in which the diagnosis is made is approximately twenty years old. This being a period in which patients must go through multiple consultations with various doctors, where they generally do not believe that celiac disease is the true cause of all the discomfort that afflicts the person.
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