All about Celiac disease

Imagine eating a slice of pizza or a warm loaf of bread, only to have your body treat it like an invader. That’s what happens to people with celiac disease—an autoimmune disorder (a condition where the immune system mistakenly attacks the body) triggered by gluten, a protein found in wheat, barley, and rye. When someone with celiac disease consumes gluten, their immune system attacks the small intestine, specifically damaging tiny structures called villi (small finger-like projections that help absorb nutrients). These villi are responsible for absorbing nutrients from food, and their damage can lead to serious health complications.

Causes of Celiac Disease

The exact cause of celiac disease is not fully understood, but it is believed to result from a combination of genetic and environmental factors. Individuals with a family history of celiac disease are at a higher risk, as certain genes, particularly HLA-DQ2 and HLA-DQ8, are associated with the condition. However, not everyone with these genes develops the disease, suggesting that environmental triggers also play a role. Factors such as viral infections, gut microbiome imbalances (disruptions in the natural bacteria in the digestive system), and early exposure to gluten in infancy may contribute to its onset.

Symptoms and Complications

Celiac disease can present in various ways, making diagnosis challenging. Common digestive symptoms include diarrhea, bloating, gas, and stomach pain. However, some people experience symptoms that are not directly related to digestion, such as fatigue, joint pain, headaches, depression, and skin rashes. In some cases, individuals may have no noticeable symptoms at all.

If left untreated, celiac disease can lead to complications such as malnutrition (a condition caused by lack of proper nutrients), osteoporosis (a disease that weakens bones), infertility (difficulty in conceiving), and neurological disorders (conditions that affect the brain and nervous system). It also increases the risk of developing other autoimmune diseases.

Diagnosing Celiac Disease

Since symptoms can overlap with other conditions, diagnosing celiac disease requires specific tests. Blood tests can detect certain antibodies (proteins produced by the immune system in response to harmful substances) that are present in individuals with celiac disease. If these tests indicate a possible diagnosis, a doctor may recommend an intestinal biopsy (a procedure that removes a small tissue sample for examination) to confirm damage to the villi.

It is important to continue eating gluten before undergoing testing. Removing gluten from the diet before testing can result in inaccurate results and delay proper diagnosis.

Treatment: A Strict Gluten-Free Diet

The only effective treatment for celiac disease is a strict, lifelong gluten-free diet. This means avoiding all foods containing wheat, barley, and rye. Many processed foods contain hidden sources of gluten, so careful label reading is necessary. Additionally, cross-contamination (when gluten-free food comes into contact with gluten-containing food) is a concern, meaning even small traces of gluten from shared cooking surfaces or utensils can cause symptoms.

Fortunately, there are now many gluten-free alternatives available, and restaurants are increasingly accommodating dietary restrictions. With careful meal planning, people with celiac disease can maintain a balanced and nutritious diet while still enjoying a variety of foods. Support from dietitians and celiac disease communities can also make managing the condition easier.

Celiac Disease vs. Gluten Sensitivity

Not everyone who reacts to gluten has celiac disease. Some individuals have non-celiac gluten sensitivity, which causes similar symptoms but does not result in intestinal damage or trigger an autoimmune response. While gluten sensitivity can cause discomfort, it does not carry the same long-term health risks as celiac disease. The key difference lies in the body’s immune response—celiac disease involves an autoimmune reaction that damages the intestines, while gluten sensitivity does not.

Even though the conditions differ, both require avoiding gluten to alleviate symptoms. Because symptoms can overlap, it is essential to seek medical advice to determine whether celiac disease or gluten sensitivity is the cause of discomfort.

Raising Awareness and Understanding

Celiac disease affects approximately 1% of the global population, but many cases go undiagnosed. Raising awareness is essential for improving diagnosis rates and ensuring better support for those with the condition. Many people underestimate the severity of celiac disease, assuming it is merely a dietary preference rather than a medical necessity. In reality, even a small amount of gluten can trigger symptoms and long-term damage in those with the disease.

Understanding the seriousness of gluten exposure can help friends, family, and food service providers accommodate individuals with celiac disease more effectively. Schools, workplaces, and restaurants should take extra care to provide safe gluten-free options and prevent cross-contamination. Increased awareness can lead to better policies and support systems for those with celiac disease.

Conclusion

Living with celiac disease requires careful dietary management, but with the right knowledge and support, individuals can maintain a healthy and fulfilling lifestyle. The transition to a gluten-free diet may be challenging at first, but with time, it becomes second nature. Many people with celiac disease find that their health improves significantly once they eliminate gluten from their diet.

Beyond dietary adjustments, emotional and social support play a vital role in managing celiac disease. Connecting with others who share similar experiences can help individuals navigate challenges and stay informed about the latest research and food options. Awareness, proper diagnosis, and adherence to a gluten-free diet are key to preventing complications and improving overall well-being.

Written By: Tarleen Chhatwal

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Works Cited

Murray, J. A., Watson, T., Clearman, B., & Mitros, F. (2004). Effect of a gluten-free diet on gastrointestinal symptoms in celiac disease. American Journal of Clinical Nutrition, 79(4), 669-673.

Rubio-Tapia, A., Hill, I. D., Kelly, C. P., Calderwood, A. H., & Murray, J. A. (2013). ACG clinical guidelines: Diagnosis and management of celiac disease. American Journal of Gastroenterology, 108(5), 656-676.

Fasano, A., & Catassi, C. (2012). Celiac disease. New England Journal of Medicine, 367(25), 2419-2426.

Lebwohl, B., Sanders, D. S., & Green, P. H. (2018). Coeliac disease. The Lancet, 391(10115), 70-81.

Caio, G., Volta, U., Sapone, A., Leffler, D. A., De Giorgio, R., Catassi, C., & Fasano, A. (2019). Celiac disease: A comprehensive current review. BMC Medicine, 17(1), 142.