Celiac disease or celiac disease is a constant intolerance to gluten in patients with a genetic predisposition that causes alteration of the mucosa of the small intestine. This pathology affects all ages, from infancy when gluten is introduced into the diet or at any time of life. According to recent epidemiological data, almost 1% of the Spanish population has celiac disease.
What are the symptoms?
The disease is due to the fact that the body generates a defense response against a protein fraction of gluten called gliadin, which causes damage to the intestinal mucosa. The main symptoms are digestive, such as chronic diarrhea, bloating and abdominal pain, although the patient may also have other symptoms such as iron deficiency anemia, vitamin B12 deficiency, altered liver tests, among others. However, it should be noted that a high percentage of celiac disease sufferers have no symptoms.
How does celiac disease appear all at once?
When the disease appears in adulthood, the “trigger effect” occurs, in which the patient begins to recognize gluten as a harmful element for his or her body that causes inflammation of the intestinal mucosa. This “trigger effect” can be a virus infection or other stimulus that activates the patient’s immune system.
Another factor to take into account is that celiac disease is not hereditary, but that there is a genetic predisposition to suffer from it that combines with other external factors such as environmental and immunological factors to develop the disease.
Diagnosis of celiac disease
The diagnosis of celiac disease requires in most cases multiple duodenal biopsies for confirmation. These biopsies are performed by gastroscopy, which consists of introducing an endoscope through the patient’s mouth to see the inside of the upper intestine, which nowadays does not cause any discomfort to the patient.
If celiac disease is suspected, a blood test should first be performed to observe the anti-tissue transglutaminase antibodies Ig A or Ig G and the deamidated peptides Ig G. These antibodies are very specific for the disease and their positivity will indicate the need for an intestinal biopsy.
There are also celiac patients with negative antibodies, called negative celiac serology, and, for this reason, the diagnosis can be completed with a genetic study, the histocompatibility antigen test (HLA), to confirm their possible genetic predisposition, whose negativity almost excludes the diagnosis with certainty.
Treatment of celiac disease
Treatment is based on a strict, lifelong gluten-free diet. This involves explaining to both the patient and his or her relatives the short- and long-term benefits of a gluten-free diet. For this reason, it is necessary for patients to make regular visits to the Digestive System physician to take into account the determination of celiac disease antibodies and thus know the response and adequate compliance to the gluten-free diet.
In addition, in recent years new treatments have been developed, both drugs and vaccines, to desensitize celiac patients to the toxic effect of gluten or to modify the inflammatory response generated by gluten.
What basic foods cannot be consumed by a celiac patient?
Gluten is mainly found in wheat, rye, triticale (a cross between wheat and rye), barley and, to a lesser extent, in oats. Thus, the foods that a celiac cannot consume are:
- Bread
- Pastries
- Cookies and pastry products
- Italian pasta
- Milk
- Malted beverages (beer, whisky, barley water)
- Manufactured products containing the above-mentioned flours or derivatives such as starches.
At present, there are numerous computer applications that allow to know the composition of manufactured foods, which count on celiac associations to inform and update celiac patients of all the news.
The consumption of gluten by a celiac patient can lead to malabsorption of nutrients that can cause anemia, vitamin deficiencies and favor the development of tumors, mainly at the level of the intestine, such as lymphomas or adenocarcinomas.
In addition, the ingestion of small amounts of gluten in the diet is sufficient to lose the protection provided by a strict diet against the development of malignant processes, so it is vital to follow a strictly gluten-free diet.
Where can we turn to if celiac disease is detected?
The specialist doctors in charge of the management and follow-up of celiac patients are pediatricians for children up to 14 years of age, and gastroenterologists, specialists in the digestive tract, for patients in adulthood. Both medical areas are assisted by professional experts in nutrition and celiac associations that provide great support and help in the day-to-day life of these patients.
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