When gluten-free is not about fashion: what is celiac disease and how to live with it
Kyiv • UNN
Celiac disease is an autoimmune disease that affects 1.4% of the world's population. The doctor spoke about the symptoms, diagnosis and treatment of the disease, as well as who else should give up gluten.
May is Celiac Awareness Month, an autoimmune disease that affects 1.4% of the world's population. However, it is diagnosed in only 0.7%, which means that approximately half of the people with celiac disease worldwide are undiagnosed. UNN spoke with gastroenterologist Pavlo Andriushchenko to find out how dangerous this disease is and whether there are methods of treating it.
What causes the disease
Gluten is a group of proteins that are naturally found in cereals such as wheat, barley, rye and some others. In people with increased sensitivity to gluten, these proteins are able to cause an immune reaction that causes inflammation of the lining of the small intestine.
In the process of inflammation, intestinal villi are damaged, which are responsible for the absorption of nutrients: proteins, fats, carbohydrates, vitamins and minerals. When they are damaged, the body loses the ability to fully absorb food, which leads to impaired absorption of nutrients, regardless of the amount of food consumed.
Celiac disease can occur in people of any age and gender. In children, in addition to symptoms similar to adults, there is often a delay in growth and development due to a lack of nutrients.
It is believed that the development of celiac disease is associated with a genetic predisposition. However, it is not enough to start the disease, an additional factor is needed. This can be surgery, pregnancy, acute infections, and even severe stress.
Celiac disease is quite common: in the world, it occurs in approximately one in 100-300 people. The risk of developing it increases in those who have close relatives with celiac disease, suffer from autoimmune diseases of the liver or thyroid gland, type 1 diabetes and microscopic colitis.
Symptoms
According to the doctor, the classic symptoms that may indicate the presence of the disease are diarrhea, bloating and weight loss. However, Andriushchenko adds that there are also symptoms that are not specific to gastrointestinal diseases.
Anemia, fatigue, osteopathy, infertility, rash - herpetiform dermatitis. In children - growth retardation. Sometimes it is difficult to suspect the disease, because the symptoms are not always classic from the gastrointestinal tract
So, given that the symptoms are similar to many other diseases, celiac disease is most often diagnosed in the laboratory. One way is to test the blood for certain antibodies.
Diagnosis is based on blood tests for certain antibodies, genetic testing, and gastroscopy with examination of biopsy material from the small intestine. Importantly, tests are carried out against the background of gluten consumption, there is no need to follow a gluten-free diet during testing
If the disease is not diagnosed in time and taken under control, it can cause quite serious complications.
This can lead to osteoporosis, infertility, growth retardation (in children), chronic anemia, vitamin and mineral deficiencies, and in severe cases, even intestinal lymphoma.
Treatment and control of the disease
However, there is no invasive treatment as such. The basis of treatment is lifelong adherence to a gluten-free diet. Bread, crackers, cookies, confectionery flour and pasta products, pates, sausages are excluded. It is worth adding that the industrial production of gluten-free products has now been established in the world.
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As of today, the only effective treatment is a strict gluten-free diet for life. Other methods are also available, such as immunosuppressive drugs, but they have not been widely used.
If a gluten-free diet is followed, patients' weight usually begins to gradually normalize after three weeks. At the same time, complete restoration of the intestinal mucosa and the disappearance of histological changes usually occurs within 2–2.5 years. Along with the prescription of gluten-free nutrition, symptomatic therapy is also sometimes carried out, which includes the use of vitamins, calcium and iron preparations, enzymes, probiotics. Sometimes physiotherapeutic methods are also used - massage and therapeutic gymnastics.
It is important to take into account that starch, which may contain residual amounts of gluten, is often included in food and medicines. Therefore, with strict adherence to the diet, it is necessary to carefully check the composition of medicines, in particular tablet coatings, for the presence of gluten-containing components.
The prognosis for celiac disease is favorable provided that a gluten-free diet is followed for life. Incomplete adherence to the diet leads to the progression of the disease and increases the risk of complications, including ulcerative jejunum and malignant tumors of the intestine.
Who else is advised to give up gluten
He also added that it is also advisable to give up gluten in the presence of sensitivity to this component, not caused by celiac disease.
Refusal of gluten-containing products is possible in case of non-celiac gluten sensitivity (tests are negative, but a person feels better on a diet), or in case of allergy to wheat, but here the problem will not be gluten, but wheat itself.
But the prerequisites for abandoning gluten must be medically justified, because the currently fashionable gluten-free diet, according to the doctor, has no proven benefits. Moreover, it can even be harmful.
In people without celiac disease or wheat allergy, a gluten-free diet has no proven benefits and can lead to a deficiency of fiber, B vitamins, iron. This is more of a fashion trend than a medical necessity.
