Overview and Facts
Celiac disease is a condition of the immune system in which consumption of gluten – a protein found in cereal grains like wheat, rye and barley – damages the small intestine. It affects 1% of the people all over the world. Around 2.5 million Americans are believed to be undiagnosed but are susceptible to develop long-term health issues due to the condition.
This condition gets triggered in people with celiac disease when they consume gluten, which makes the dough elastic and makes the bread chewy. When people with celiac disease eat anything with gluten, the body reacts to it and damages the villi – small finger-like protrusions present along the walls of the small intestine.
Because of injury to the villi, the body loses its ability to absorb nutrients from the food. This results in undernourishment, loss of bone density, infertility, miscarriage and several types of cancer. It is an autoimmune disorder, in which the immune system mistake healthy cells for harmful ones and creates antibodies against the same.
Celiac Disease can affect men and women of all ages. It is also known by other names like coeliac disease, celiac sprue, gluten sensitive enteropathy and non-tropical sprue. Genetics has got a lot to do with this condition as people, who have a first degree relative (parent, child or sibling) having the condition, have 10% greater chances of developing the disease. There are 1 in 39 chances of having the condition if a second degree relative (uncle, aunt or cousin) has the condition.
Types and Symptoms of Celiac Disease
Types of Celiac Disease:
Following are the types of celiac disease:
- Silent
- Latent
- Typical
- Atypical
- Non-Responsive
Silent: This type occurs if one does not experience symptoms of celiac disease, but one gets tested positive for it. It may be the case that the person has gone to the doctor for some other condition and coincidentally, the doctor examining the person for some other condition may discover that the person has celiac disease.
Latent: In this type, the person is tested negative in the current scenario. But, may eventually develop the condition.
Typical: In this, all symptoms are seen that are associated with intolerance of gluten or celiac disease. Examples of such symptoms can be gas, diarrhea, constipation and bloating. Celiac disease clearly presents itself through its characteristic symptoms. The condition manifests itself along the intestinal tract.
Atypical: In this type, the patient is tested positive for the condition, but does not show symptoms. When a person has atypical celiac disease, symptoms develop beyond the gut and in areas other than intestines. For example, they may experience migraine, joint pain and neuropathy.
Non-Responsive: It develops when celiac disease does not respond to a gluten-free diet. It has been found that some cases of non-responsive celiac disease may result from contamination of gluten-free grains with some amount of gluten.
Symptoms of Celiac Disease:
Digestive symptoms are more prevalent in children and infants. Symptoms of celiac disease in children are given below:
- Chronic diarrhea
- Constipation
- Vomiting
- Abdominal pain and bloating
- Weight loss
- Bad smelling stool
- Unexplained weight loss
- Short stature
- Delay in puberty and not attaining growth
- General tiredness
The following symptoms may be noted in adults:
- Fatigue
- Joint pain or pain in bones
- Arthritis
- Anemia
- Skin rashes
- Mouth sores
- Missing periods; infertility
- Migraine
- Tingling or numbness in hands or feet
- Liver diseases
- Depression and Anxiety
- Seizures
Risk Factors for Celiac Disease
Men and women are equally at a risk for developing celiac disease. It can affect people of any age or race. There are some factors that can increase the risk of the development of celiac disease that are discussed below:
- Having a Relative with Celiac Disease: This condition is known to run in families. So, if a person has a blood relative with celiac disease, his chances of having the condition also increase. It occurs in about 5-10% of family members of those, who have been diagnosed with the disease.
- Presence of HLA-DQ2 and HLA-DQ8 Gene: Having these genes ups the chances of getting celiac disease. The presence, however, does not mean that one will necessarily develop the condition.
A positive genetic test must be followed by celiac disease blood panel for finding out if one has celiac disease. If genetic test comes out as negative, then he/she may rule out the possibility of celiac disease. - Having Some Autoimmune Disease: Having an autoimmune disease increases the likelihood of having other autoimmune diseases like celiac disease. Some examples of autoimmune disease are thyroid disease and type 1 diabetes.
Do I have Celiac Disease?
There are some conditions that are similar to Celiac Disease with respect to symptoms. Conditions that may present themselves with symptoms similar to those of Celiac disease are as follows:
- Crohn’s disease
- Cystic fibrosis
- Food intolerance
- Irritable bowel syndrome
- Some types of colitis
- Non-celiac gluten insensitivity
In order to correctly diagnose the condition and rule out other possibilities, it is advised to consult a doctor or health care professional.
Causes and Prevention of Celiac Disease
Causes of Celiac Disease:
Celiac Disease occurs due to interaction between genes, consuming foods having gluten and environmental factors. The exact cause of the condition is not known till date. Practices related to feeding infants, bacteria in gut, infections of the gastrointestinal tract are believed to associated with the development of celiac disease.
A lot many times celiac disease shows up for the very first time after pregnancy, surgery, birth of a child or emotional stress. The body reacts by damaging the tiny hair-like projections in the small intestine, known as villi, which is responsible for absorbing the nutrients present in food. Thus, its damage leads to not being able to absorb the vitamins and minerals and other nutrients from the food consumed.
Having some gene variants increases the chances of getting celiac disease. But, this does not mean that you will necessarily get the condition. This means, there are some other factors also at play. For example, one may develop celiac disease if one has had some infection of the digestive system during childhood. It has been found that if gluten-containing foods are fed to the child before he/she has turned 3 months old, the chances of having celiac disease increases.
There are many health conditions that can increase the chances of having celiac disease. These include type 1 diabetes, ulcerative colitis, epilepsy, thyroid conditions and Down’s syndrome.
Prevention of Celiac Disease:
The only way to prevent celiac disease and prevent further damage to the small intestine is to eat gluten-free diet. However, gluten-free diet should not be initiated before diagnosis. There are plenty of foods that people with celiac disease can still consume.
One can have fruits, vegetables, rice, maize, corn, fish, flax and nuts. Wheat, barley and rye that contain gluten can be substituted with rice, soy and potato. Preventing celiac disease is next to impossible as it is hereditary in nature, but one can definitely reverse the damage caused by the disease.
Thus, it can be concluded that celiac disease cannot be prevented. Only thing one can do is to prevent the symptoms and damage caused to small intestine by eating a gluten-free diet.
Diagnosis and Tests for Celiac Disease
In order to diagnose celiac disease, a doctor may ask a person to go for:
- Blood Test: This check is done to know the amount of antibodies present in blood, which in case of celiac disease are at higher than normal levels.
- HLA Genetic Testing: It finds HLA-DQ2 and HLA-DQ8 genes. If these genes are not present, the chances of having celiac disease is next to none. One may get a blood test done or saliva test.
- Endoscopy: This is used to check small intestine for damage. In this test, doctors insert a scope, fixed with a camera, into the mouth down the esophagus and intestinal tract. They may isolate tissue from the lining of small intestine for further study. This is known as biopsy.
Treatment and Care for Celiac Disease
Treatment of Celiac Disease:
The condition is usually treated by removing gluten-containing foods from the diet. This prevents damage to the inner lining of the gut and related symptoms like diarrhea and stomach ache. With celiac disease, one has to give up on all sources of gluten. One must meet a consultant dietitian on being diagnosed with celiac disease, who would ensure that your diet contains all necessary nutrients without gluten.
Apart from going gluten free, other treatments are also available. In some cases of celiac disease, spleen does not work so effectively, leaving you vulnerable to getting infections. Thus, some vaccinations might be recommended to you:
- Flu (influenza)
- Hib/MenC vaccine, which offers protection against sepsis (blood poisoning), pneumonia, meningitis (infection in brain lining)
- Pneumococcal vaccine
Supplements: After removing gluten from the diet, dietitian may recommend taking vitamin and mineral supplements for at least six months after the diagnosis of the condition. This would make sure that one gets all the nutrients as digestive system goes in the repairing mode.
In case of refractory coeliac disease, treatment includes steroid medications (corticosteroids) like prednisolone that block the harmful effects of the immune system. Medication is not required normally. It is needed in cases of dermatitis herpetiformis in which medicines like dapsone or sulfapyridine can be taken to remove the rash.
Caring for People with Celiac Disease
When you are taking care of someone with celiac disease, it must be borne in mind that maintaining a gluten free diet can be very challenging for the patient. Giving up gluten can bring in feelings of anxiety which can cause symptoms like breath shortness and palpitations.
As the patient tries to cope with his situation, the care taker must be patient and a little support from him/her could be highly beneficial. People with allergy to gluten may complain of foggy brain when they consume gluten. If your loved one is facing trouble like mental fogginess, make sure you review his/her diet to identify hidden sources of gluten and eliminating them. Small changes like cooking in separate utensils for patients with celiac disease may also be helpful.
Everyone handles change differently. For instance, transition to a gluten free diet may be easy for some while it may not be very easy for some others. The best what one can do as a caregiver is to be supportive and patient through the process.
OTC Medications and Self-Management Methods for Celiac Disease
Over-the-counter (OTC) medicines are not available for celiac disease. Stuff like over-the-counter medicines and prescription drugs as well as supplements and vitamins may contain gluten. Often times, wheat starch is used to bind the tablets and capsules together. Gluten is also present in some herbal nutritional supplements and cosmetic products.
As far as self-management is concerned, there is no better way to manage the condition than going gluten free. Get help from a naturopath for healing the gut, so that nutrients can be absorbed from the food. You can take select supplements for making up for lost nutrients and also eat healthy food.
Natural Ways to Cure Celiac Disease
The following natural or home remedies can be used for the treatment of celiac disease:
- Fish Oil: It is used for a number of health conditions, but, the most prominent one is its usage as a coating for the lining of intestine. When one consumes fish oil, it prevents the small intestine from getting inflamed, and thus, painful attack of celiac disease can also be prevented if someone takes gluten by mistake.
- Yogurt: It is known to activate healthy and useful bacteria and promote healing of digestive tract. So, it is often advised to increase the intake of yogurt.
- Vitamin and Mineral Supplements: If any deficiencies are detected by the doctor, he/she may put the patient on supplements like calcium, iron, vitamin D, K, zinc and so on. These supplements are to be given through injections as pills might damage the intestinal tract.
- Herbal Treatments: Some herbs like goldenseal and extracts of olive leaves are used to treat celiac disease as these regulate and protect the immune system, and reduce the intensity of celiac disease. Chamomile is another herb that is known to fix digestive imbalances and stomach conditions associated with celiac disease.
- Horsetail Tea: This is associated with reducing the digestive tract inflammation and at the same time, enhancing the strength of the digestive system; thereby, making the system less sensitive to gluten.
Heath Tip by Experts
Maintain a journal to list down whatever you eat and the resulting symptoms. Plan your diet without gluten. If you are taking some medicines, make sure they are gluten free. While eating out, be wary of gluten-containing food. All in all, you need to cut out on consumption of gluten through various sources.
