CELIAC DISEASE (GLUTEN INTOLERANCE)
What you need to know about celiac disease.
What is Celiac Disease? What happens with Celiac Disease? How does Celiac Disease effects the body?
Celiac disease is a chronic digestive disorder that causes damage to the small intestine and prevents the proper absorption of nutrients from the food we eat. Since the body’s own immune system causes the intestinal damage, it is classified as an
autoimmune disorder. Due to the inability of the body to properly absorb nutrients celiac disease is a
disease of malabsorption. Celiac disease is also called celiac sprue,
nontropical sprue, and gluten sensitive enteropathy.
The function of the small intestine is the absorption of basic nutrients into the bloodstream. Some of these nutrients are carbohydrates, fats, minerals, proteins, and vitamins. This absorption occurs through tiny hair like projections on the mucosal lining of the small intestine. These projections, called
villi, are crucial to the proper absorption of nutrients into the bloodstream and, without these
villi we become malnourished regardless of the amount of food one eats.
When people with celiac disease eat food that contains a certain type of protein called gluten, an autoimmune response is triggered and the
villi are damaged. This damage is known as villous atrophy and can be very slow in developing but, if left untreated; the damage to the small intestine can become chronic and life threatening, causing an increase risk of associated disorders, both nutritional and immune related.
Celiac disease is a genetic inheritable disorder which means it runs in families. Celiac disease is most commonly found in genetically susceptible Caucasians of European ancestry. It is estimated that about 1 in 135 people in the United States suffer from some form of celiac disease although many may be undiagnosed or go for years without major symptoms. Celiac disease occurs in up to 15% of offspring of people with celiac disease and persons who already have an autoimmune disease are at a 25% increased risk of having celiac disease. Although it is not known what activates celiac disease some suggestions are pregnancy or childbirth, surgery, experiencing a severely emotionally stressful situation or developing a bacterial or viral infection.
What is Gluten?
Gluten is a generic term for the storage proteins that are found in certain cereal grains. This includes all forms of wheat along with barley, rye and oats. The more specific names are
gliadin in wheat, hordein in barley, secalin in rye and avenin in oats. The specific cause of celiac disease is not known but research suggests that the above named glutens contain a particular amino acid sequence that stimulates
T-cells to produce antibodies which, in turn, attack the villi in the small intestine, reducing their ability to absorb nutrients.
What is the difference between a Wheat Allergy and Celiac Disease?
Wheat allergy is one of the top seven food protein allergies in the United States. The other top allergies are dairy, eggs, fish, soy, tree nuts, and shellfish. Peanut allergy is fast moving up to becoming number eight on the list. Symptoms of wheat allergy can include skin rash, wheezing, abdominal pain, diarrhea and swelling of the lips and or
tongue. People who have celiac disease and those with an allergy to wheat have one thing in common; they must remove wheat from their diet. But there the similarity ends. The branch of the immune system that is activated by an allergic reaction to wheat is different from the branch thought to be responsible for the autoimmune reactions to gluten.
What are Celiac Disease Symptoms?
Celiac disease symptoms are as varied as the people who have the disease and can appear at any age. Celiac disease symptoms in children usually appear as irritability, delayed growth and weight loss since malnutrition affects growing children more than mature adults. Excessive weight loss in women can lead to missed menstrual periods. Also infertility and miscarriage can result from malnutrition. Other symptoms may include bone or joint pain, muscle cramps, fatigue and lack of energy, chronic diarrhea, abdominal bloating and pain, anemia, apthous
ulcers (sores inside the mouth), depression and dermatitis herpetiformis (a painful skin rash).
What other Medical Conditions are associated with Celiac Disease??
People with celiac disease may develop other autoimmune diseases including but not limited to dermatitis herpetiformis, type 1 diabetes, liver disease, thyroid disease or rheumatoid arthritis. Other food intolerances can also develop, the major one being lactose intolerance. Iron deficiency anemia is a major complication of celiac disease. Osteoporosis and osteopenia (which is a loss of bone mineral density) are also serious complications for persons with celiac disease. The former affects both men and women while the latter affects post-menopausal women at a higher rate.
How is Celiac Disease Diagnosed?
Anyone who feels that they may have celiac disease should not simply stop eating gluten. Diagnosis should be made by a physician who is familiar with celiac disease and the methods to diagnose it. Also gluten must be in the patient’s system for the diagnosis to be accurate.
What is the Treatment For Celiac Disease?
While much research has been done there is no medication to prevent or counter the effects of gluten on a person’s system. The only lasting treatment for celiac disease is a completely gluten free diet. The complete elimination of gluten will allow the small intestine to begin to heal and overall health will improve. Other medical conditions associated with celiac diseases should also be addressed as soon as possible. Nutritional supplements should be added to one’s diet to adjust for vitamin and mineral deficiencies. A bone densitometry (bone density scan) should be taken to locate any bone and joint deficiencies.
Unfortunately the complete elimination of gluten is not as simple as it sounds.
What is a Gluten Free Diet?
A person starts by not eating wheat, barley, rye and oats. But the offending gluten is also found in spelt, kamut, semolina, durum, enkom, faro, graham and triticale (a high-protein high-yielding cereal plant that is an artificial or man-made hybrid of wheat and rye). Gluten (like lactose in milk) can be extracted from wheat and used as ingredients in other food products. Gluten can be found in soups, salad dressings, processed foods and many candies. Gluten is used as fillers and binders in medications and vitamin supplements. Other hidden sources of gluten are hydrolyzed vegetable protein, not distilled grain vinegars and alcohols, natural flavorings, modified food starch binders, fillers and natural flavorings. More precise food labeling laws are being introduced into the U. S. Congress but until these laws are passed every person with celiac disease must learn to read food labels carefully and ask questions about everything he or she eats.
Cross contamination is a term that ever person with celiac disease must learn to understand and be ever mindful of. Gluten free foods must never come in contact with foods containing gluten. Cross contamination can occur if foods are prepared on common surfaces or if the same utensils are used in the preparation of gluten containing and gluten free foods. Sharing a bread machine, flour sifter, bread toaster or deep fryer are cross contamination issues. Wheat flour can stay airborne for hours in a home kitchen or food manufacturing facility and contaminate exposed preparation surfaces, equipment and uncovered gluten free products.
Living with celiac disease is a lifelong process and dealing with it is a major commitment. Celiac disease cannot be cured, but with the help of knowledgeable medical professionals, supportive loved ones and self-discipline it can be managed.
|
