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Celiac Disease

Celiac Disease – General Information

Celiac Disease is considered to be a digestive disorder provoked by the consumption of a well known protein called gluten. This protein can be found in bread, pasta, cookies, pizza crust and several other products containing wheat, barley or rye. Oats can also contain this protein. When the patients suffering from Celiac Disease eat products with gluten in their composition, an immune reaction takes place in the organism’s small intestine, causing damage to the surface of the small intestine and the inability to absorb certain nutrients from them. After this, the decreased absorption of nutrients, called malabsorption, can lead to vitamin deficiencies that deprive the patient’s brain, peripheral nervous system, bones, liver or any other organ of vital nourishment, which can lead to the appearance of other diseases. The decreased absorption of the nutrients that takes place in this kind of disease is particularly severe in children, who need proper nutrition to develop and grow. There is no treatment that can cure this type of disease. But, the patient can effectively cope with the disease by changing his or her diet. Celiac Disease can affect anyone, but it tends to be more encountered in people of European descent and people with diseases caused by a reaction of the immune system, called autoimmune disorders (that generally include lupus erythematosus, diabetes type one, rheumatoid arthritis, autoimmune thyroid disease or microscopic colitis). Patients suffering from this type of disease who do not maintain a gluten free diet also have a increased chance of developing one of the many forms of cancer, particularly the intestinal lymphoma and the bowel cancer.

Celiac Disease – Symptoms

There are no typical signs and symptoms for Celiac Disease. Most patients suffering from the disease experience several signs and symptoms, such as intermittent diarrhea, abdominal pain and bloating. In some cases, patients with this type of disease can have no gastrointestinal signs and symptoms at all. Celiac Disease’s symptoms are also similar to those of other medical conditions (that include irritable bowel syndrome, gastric ulcers, Crohn's disease, parasite infections, anemia, skin disorders or a nervous disorder). This kind of disease can also present itself in less obvious ways, such as irritability or depression, anemia, stomach upset, joint pain, muscle cramps, skin rash, mouth sores, dental and bone disorders, including osteoporosis, or tingling in the legs and feet (generally known as neuropathy). Many sings of malabsorption that can result from this disease include weight loss, diarrhea, abdominal cramps, gas and bloating, general weakness, foul smelling or grayish stools that can be fatty and oily, stunted growth, in young patients or osteoporosis. Dermatitis herpetiformis is considered to be an itchy, blistering skin condition that also stems from gluten intolerance. The rash generally appears on the elbows, knees and buttocks. Dermatitis herpetiformis can lead to a significant intestinal damage similar to the one of Celiac Disease, but it can not produce any noticeable digestive signs and symptoms. This condition is also treated with a gluten free diet, in combination with medication to control the rash. If someone in the patient’s family is diagnosed with this kind of disease, he may need to be tested. Starting the treatment early will help the patients effectively avoid at least the most common complications that are related with the disease (including osteoporosis, anemia and some types of cancer). We recommend all parents to give their child professional medical attention if he or she is pale, irritable, fails to grow and has flat buttocks and malodorous or bulky stools.

Celiac Disease – Treatment

Generally, Celiac Disease has no cure, but the patient can easily manage the condition by changing his diet. If gluten is removed from the patient’s diet, the inflammation in the small intestine will begin to decrease, in most of the cases, in a few weeks. If the nutritional deficiencies are chronic, the patient will have to take in vitamin and mineral supplements that ought to be prescribed by a doctor or a dietitian, to help correct these deficiencies. Complete curing and rebuilt up of the villi can last for several months in younger patients and more than two - three years in older patients. Any positive effects after starting a diet without gluten can be particularly dramatic in the case of very young patients who are suffering from Celiac Disease. Not only do their physical symptoms improve, but also their behavior improves, and their growth starts to pick up. To effectively handle the condition and prevent any complications, it is essential that the patient avoids all foods that can contain gluten. This means that all foods or food ingredients obtained from many grains, such as wheat, barley and rye, have to be excluded from the diet. This also includes all types of wheat, such as farina, graham flour, semolina and durum, barley, rye, bulgur, Kamut, kasha, matzo meal, spelt or triticale. Amaranth, buckwheat and quinoa have no gluten in their composition, but can be contaminated by other grains during the harvesting and processing procedures.

Cross contamination can also occur if any products without gluten are prepared in unwashed containers previously containing a gluten product. Oats are not harmful for most patients suffering from Celiac Disease. However, in some cases, oat products have become contaminated with wheat, so it might be recommended to avoid oats as well. The doctor can advise the patient to consult a dietitian who can prescribe him a diet without any gluten products. There are still several basic products permitted in such diets (that do not contain any gluten) and can include fresh meats, fish and poultry (that have not been breaded or marinated), most dairy products, fruits, vegetables, rice, potatoes and gluten free flours such as rice, soy, corn. Most products are made from grains that can contain gluten in their composition. A patient suffering from Celiac Disease has to avoid these products, or consume them only if they are labeled as gluten free or prepared with corn, rice, soy or with other grain without gluten such as breads, cereals, crackers, pasta, cookies, cakes and pies, gravies and sauces. There are many other products which can have ingredients that can contain gluten. Many grains with gluten in their composition are usually used in food additives, like malt flavoring, modified food starch and others. There are also various sources of gluten that are surprising for most patients. They include medications and vitamins that use gluten as a binding enzyme, lipsticks, postage stamps and also the contamination of foods without gluten with products containing gluten. Cross contamination can take place anywhere where ingredients come together, like on a cutting board. Patients suffering from, Celiac Disease can also be exposed to gluten by using the same utensils as others, such as the bread knife, or sharing the same condiment bowls.




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