By For Life and Health of HITN
29 Sep 2023, 09:36 AM EDT
This month marks awareness of Celiac disease, a chronic autoimmune disease that affects genetically susceptible individuals and in which the body has a negative reaction to gluten, a protein present in wheat, barley, rye and some other grains.
When a person with celiac disease consumes gluten, their immune system responds by damaging the lining of the small intestine, which can make it difficult to properly absorb nutrients.
It is one of the most widespread digestive disorders in the world and one of the most common genetically transmitted diseases. The prevalence in Western countries is around 1% of the population, which in the United States is equivalent to around 3 million people.
The average age of diagnosis in this country is 40 to 50 years, and it is diagnosed more frequently in women than in men. Its prevalence is also higher in people with a family history or in those who have other autoimmune diseases, such as type 1 diabetes.
Research suggests that the incidence of celiac disease is increasing in the United States, although it is not known if this is due to increased awareness and testing or if there is a true increasing trend in the disease. The availability of gluten-free foods and awareness initiatives have also increased in the United States in recent years, making it easier for people with celiac disease to follow a gluten-free diet.
The last three decades have seen how celiac disease has gone from being a rare and almost exclusive pathology of childhood to being one of the most common autoimmune diseases on the entire planet. The main reasons for this change have been:
- The improvement of the diagnostic process with the arrival of serological antibody tests in the 1990s, which contributed to the detection of suspected cases and also made it possible to simplify the diagnostic strategy by reducing the number of duodenal biopsies necessary to confirm celiac disease to the point of being able to do without them in certain cases.
- The screening studies carried out thanks to these serological tests revealed the true prevalence of the disease in different regions of the planet, showing that it is present on all 5 continents, affecting, on average, 1% of the population.
- The recognition of celiac disease as a pathology that can appear at any age and that in fact is increasingly diagnosed in older adults.
- The consideration of celiac disease as a systemic pathology that can present with all types of digestive and extradigestive manifestations, affecting organs as diverse as the liver, skin or brain.
A wide variety of symptoms
The symptoms of celiac disease can be very varied. Although symptoms may be similar to other gastrointestinal diseases, celiac disease is diagnosed through specific antibody testing and a biopsy of the small intestine.
The main digestive symptoms related to celiac disease are:
- Chronic diarrhea.
- Weightloss.
- Fatigue.
- Malnutrition.
- Poor digestion.
- Meteorism or excess gases in the intestine.
- Alterations in blood tests: such as lack of iron or elevated transaminase levels.
- Recurrent canker sores in the mouth.
This is as far as the digestive system is concerned. But there are another series of non-digestive symptoms that can give clues that gluten is causing problems:
- Delayed growth in children.
- Association with autoimmune thyroid diseases.
- Association with type 1 diabetes.
- Dermatitis.
- Anemia or iron deficiency.
- Problems in pregnancy.
- Osteoporosis or osteopenia.
- Neuropsychiatric symptoms: such as neuropathy, difficulty walking, depression or epilepsy.
The difficulty in identifying the symptoms and the lack of reliable tests that confirm the disease before the patient is greatly affected in their quality of life are the two great milestones to overcome to improve the diagnosis of a disease that can have a great impact on people’s health.
Diet as a solution
The only known treatment for celiac disease is to follow a gluten-free diet for life. This means avoiding all foods containing wheat, barley, rye, and some other grains.
People with celiac disease should read food labels carefully and be careful with processed foods that may contain gluten. Nutritional supplements may also be necessary to correct nutritional deficiencies that may have developed due to intestinal malabsorption.
“Usually and due to external information, it is the patient himself who eliminates gluten from his diet without medical supervision,” explains Dr. Francesc Casellas, head of the Nutrition Committee of the Spanish Digestive System Foundation (FEAD), who emphasizes that Exclusion of gluten from the diet should always be done after consulting with a specialist for a correct diagnosis and treatment of celiac disease.
“Maintaining a gluten-free diet, on your own and without being celiac, does not provide benefits to the person’s health: not only are you following a poorly indicated, unbalanced and unhealthy diet, but excluding gluten from the diet has been linked to with certain cardiovascular risk factors,” says the expert, who adds that it does not make sense, from a medical point of view, to remove gluten from the diet if one does not suffer from a gluten-related disease.
About Vida y Salud: This content has been created by the editorial team of VidaySalud.com, a space founded more than ten years ago under the editorial direction of Dr. Aliza Lifshitz with the mission of informing, educating and raising awareness on issues of health and well-being. A unique resource for the Hispanic community in the United States, Vida y Salud includes the digital platform VidaySalud.com and Vida y Salud TV that airs regularly on the public TV network HITN.