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Gluten, a protein present in wheat, barley, and rye, causes an immunological response in people with celiac disease, also known as celiac sprue or gluten-sensitive enteropathy.
Consuming gluten inflicts an immunological reaction on a person with celiac disease in their small intestine. This process damages the lining of your small intestine over time and renders it incapable of absorbing some nutrients (malabsorption). Diarrhea, exhaustion, weight loss, bloating, anemia, and other common symptoms of intestinal injury might be significant problems.
In addition to causing the symptoms experienced in adults, malabsorption in children can impede growth and development.
Wheat, barley, and rye are the grains that contain the protein known as gluten. Many of the staple items of the typical Western diet—from breads and cereals to pasta and baked goods—contain these grains, notably wheat. In addition, gluten frequently occurs as an additive in foods like sauces, soups and packaged foods. Rye or barley are typically used to make beer.
Although there is no known treatment for celiac disease, most people find that adhering to a strict gluten-free diet can help control their symptoms and encourage intestinal recovery.
Symptoms
Children and adults may experience different celiac disease signs and symptoms, which might vary substantially. Adults’ digestive warning signs and symptoms include:
- Nausea and vomiting
- Diarrhea
- Losing weight
- Bloating and farting
- Pain in the abdomen
- Constipation
- Fatigue
The following signs and symptoms are present in more than 50% of adults with celiac disease but are not connected to the digestive system:
- Anemia, commonly brought on by a lack of iron
- Bone softening (osteomalacia) or loss of density (osteoporosis)
- Extreme exhaustion
- Ulcers in the mouth
- Pain of the joint
- Headaches
- Dermatitis herpetiformis, a skin rash that is itchy and blistery.
- Reduced splenic function (hyposplenism)
- Nervous system damage, which may result in tingling and numbness in the hands and feet, balance issues, and cognitive decline.
Children
Digestive issues in children with celiac disease are more prevalent than in adults and include:
- Chronic diarrhea
- Bloating
- Nausea
- Vomiting
- Constipation
- Enlarged belly
- Stools that are pale and have foul smell
The consequences of inadequate nutrients absorption could be:
- Anemia
- Failure to thrive
- Short stature
- Losing weight
- Delayed puberty
- Tooth enamel damage
- Neurological problems, such as seizures, headaches, migraines, learning difficulties, and attention-deficit/hyperactivity disorder (ADHD)
- Being irritable
Dermatitis herpetiformis
This itchy rash resembles clusters of bumps or blisters can be brought on by gluten intolerance. It also called gluten rash or celiac rash. The elbows, knees, torso, scalp, and buttocks are the typical locations for the rash. Although the skin condition may not result in digestive symptoms, it is frequently linked to small intestinal lining abnormalities that are analogous to those of celiac disease.
In order to control the rash, medical professionals treat dermatitis herpetiformis with a gluten-free diet, medication, or both.
If you experience diarrhea or stomach pain for longer than two weeks, see a doctor. If your child is pale, agitated, not growing, or is failing to thrive, or has a potbelly, foul-smelling, bulky feces, you should take them to the doctor.
Before attempting a gluten-free diet, make sure to check with your doctor. Before getting tested for celiac disease, cutting back on your intake of gluten has the potential to alter the results.
Typically, celiac disease runs in families. Ask your doctor if you should be tested if someone in your family has the disorder. If you or a member of your family has a risk factor for celiac disease, such as type 1 diabetes, talk to your doctor about getting tested.
Causes
Celiac disease may be caused by your genes, eating gluten-containing foods, and other things, but the exact cause is unknown. Additionally, infant feeding patterns, gastrointestinal diseases, and gut flora may be involved. After an operation, a pregnancy, childbirth, viral illness, or a period of intense mental stress, celiac disease can occasionally become active.
The fine, hair-like projections (villi) that line the small intestine are harmed when the body’s immune system overreacts to gluten in diet. Vitamins, minerals, and other nutrients are absorbed by villi from the food you ingest. No matter how much you eat, you can’t obtain enough nutrients if your villi are damaged.
Risk factors
People who have these factors seem to be more susceptible to celiac disease:
- A family member who suffers from dermatitis herpetiformis or celiac illness
- Diabetes mellitus type 1
- Microscopic colitis (lymphocytic or collagenous colitis)
- Autoimmune thyroid disease
- Down syndrome
- Turner syndrome
- Addison’s disease
Diagnosis
Many celiac disease sufferers are unaware of their condition. It can be detected using two blood tests:
- Serology testing examines your blood for antibodies. A gluten-induced immune response is indicated by elevated levels of certain antibody proteins.
- Genetic testing to rule out celiac disease, hence why tests for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can be performed.
Before experimenting with a gluten-free diet, it’s crucial to get tested for celiac disease. Eliminating gluten from your diet may cause blood test results to show as normal.
Your doctor will likely request one of the following tests if the results of these tests show celiac disease:
- Endoscopy. Upper endoscopy is a test that involves inserting a long tube with a small camera into your mouth and passing it down your throat. Your doctor can inspect your small intestine using the camera and obtain a little tissue sample (biopsy) to check for damage to the villi.
- Capsule endoscopy. This procedure employs a miniature wireless camera to capture images of your complete small intestine. The camera is enclosed within a capsule that is comparable in size to a vitamin, and you ingest it. While the capsule makes its way through your gastrointestinal system, the camera takes numerous photographs, which are then conveyed to a recorder.
A skin biopsy may be performed if your doctor suspects you have dermatitis herpetiformis in order to study the skin tissue under a microscope.
Treatment
The only treatment for celiac disease is a strict gluten-free diet. In addition to wheat, foods containing gluten include graham flour, barley, farina, malt, bulgur, rye, durum, triticale, spelt, and semolina.
You can get assistance from a dietician who specializes in celiac disease in creating a nutritious gluten-free diet. Even if you don’t have any signs or symptoms from gluten in your diet, even minimal amounts might be harmful.
Foods, pharmaceuticals, and nonfood items can all contain gluten, including:
- Vitamin and mineral supplements
- Nutritional and herbal supplements
- Over-the-counter medications
- Food stabilizers, preservatives, and modified food starches
- Play dough
- Toothpaste
- Mouthwash
- Lipstick
- Envelope and stamp glue
Your small intestine’s inflammation will progressively decrease as you cut out gluten from your diet, improving your symptoms and allowing your body to recuperate. Children typically recover faster than adults do.
Vitamin and mineral supplements
Your small intestine’s inflammation will progressively decrease as you cut out gluten from your diet, improving your symptoms and allowing your body to recuperate. Children typically recover faster than adults do.
In the event of severe anemia or nutritional deficiencies, your healthcare provider or nutritionist may suggest the use of supplements, which may include:
- Vitamin B-12
- Vitamin K
- Vitamin D
- Iron
- Zinc
- Copper
- Folate
Most vitamins and supplements are taken orally as pills. Your doctor may inject vitamins if your digestive system has difficulties absorbing them.
Follow-up care
Regular medical checkups can make sure that your symptoms have improved since switching to a gluten-free diet. Blood tests will be used by your doctor to track your reaction.
A gluten-free diet will typically help celiac disease patients’ small intestines heal. That typically takes three to six months for kids. Complete recovery may take several years for adults.
You may require an endoscopy with biopsies if your symptoms persist or if they come back in order to establish whether your intestine has healed.
Medications to control intestinal inflammation
Your doctor might advise using steroids to reduce inflammation if your small intestine is significantly damaged or if you have celiac disease that is not responding to treatment. While the intestines heal, steroids can help with severe celiac disease symptoms.
Budesonide or azathioprine may also be used.
Treating dermatitis herpetiformis
Your doctor could advise a gluten-free diet and an oral medicine like dapsone if you have this skin rash. You will require routine blood tests to check for side effects if you use dapsone.
Refractory celiac disease
Your small intestine won’t repair itself if you have celiac disease that is refractory. You’ll then probably need to be assessed in a specialized facility. Refractory celiac disease is a serious condition for which there is currently no established treatment.
