Understanding Celiac Disease: An Evidence-Based Approach

Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is a complex autoimmune disorder triggered by the ingestion of gluten in genetically susceptible individuals¹².

What is Celiac Disease?

Celiac disease is characterized by a specific serological and histological profile¹. Gluten, the general term for alcohol-soluble proteins present in various cereals including wheat, rye, barley, spelt, and kamut, triggers an immune response in the small intestine of individuals with celiac disease¹. This immune response leads to inflammation and damage to the lining of the small intestine, which can interfere with nutrient absorption¹.

Genetic and Environmental Factors

A genetic background is a mandatory determinant of the development of celiac disease¹. The most important genetic factors are the human leukocyte antigen (HLA) genes known as HLA-DQ2 and HLA-DQ8¹. However, not everyone with these genes develops celiac disease, which suggests that additional environmental factors play a role. These may include early feeding practices, gut microbiota composition, and viral infections¹.

Symptoms of Celiac Disease

The symptoms of celiac disease can vary greatly among individuals. They often include:

– Digestive problems such as abdominal bloating and pain, chronic diarrhea, vomiting, constipation, and pale, foul-smelling stool.

– Weight loss.

– Iron-deficiency anemia.

– Fatigue.

– Bone or joint pain.

– Arthritis.

– Osteoporosis or osteopenia (bone loss).

– Depression or anxiety.

– Tingling numbness in the hands and feet.

– Seizures.

– Missed menstrual periods.

– Infertility or recurrent miscarriage.

– Canker sores inside the mouth.

– An itchy skin rash called dermatitis herpetiformis.

Diagnosis of Celiac Disease

The diagnosis of celiac disease involves both serological testing and an intestinal biopsy¹. Serological tests look for certain antibodies in the blood that are typically elevated in people with celiac disease. If these tests are positive, a biopsy of the small intestine is usually performed to confirm the diagnosis¹.

Treatment of Celiac Disease

Currently, the only treatment for celiac disease is a lifelong strict gluten-free diet¹. This means avoiding all foods that contain wheat, rye, and barley. A gluten-free diet helps heal the damage to the small intestine and prevents further damage. This usually leads to symptom relief and a decrease in the risk of developing complications associated with celiac disease¹.

Conclusion

Celiac disease is a serious autoimmune disorder that can cause severe health problems if not diagnosed and treated properly. If you suspect you have celiac disease or have been recently diagnosed with it, it’s important to seek medical advice before making any significant changes to your diet or lifestyle.

Remember, everyone’s body is unique and what works for one person may not work for another. It’s important to listen to your body and make dietary adjustments that suit your individual needs.

References

(1) Celiac disease: a comprehensive current review – BMC Medicine. https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1380-z.

(2) Celiac disease and non-celiac gluten sensitivity | The BMJ. https://www.bmj.com/content/351/bmj.h4347.

(3) Frontiers | Gut Microbiota in Celiac Disease: Is There Any Role for …. https://www.frontiersin.org/articles/10.3389/fimmu.2020.00957/full.

(4) Frontiers | Celiac Disease: A Review of Current Concepts in …. https://www.frontiersin.org/articles/10.3389/fped.2018.00350/full.

(5) undefined. https://doi.org/10.1136/bmj.h4347.