Celiac disease (gluten intolerance)

The Celiac disease, better known as Gluten intolerance, Gluten allergy or native sprue, is an autoimmune disease of the lining of the small intestine.

What is Celiac Disease?

Celiac disease or. Gluten intolerance is genetic and people affected have this disease for life. It can occur in childhood or even in adulthood.

Environmental influences such as stress and infectious diseases can promote celiac disease. Gluten can be found in many types of grain, such as rye, wheat, spelled, malt, oats and green spelled. There is a debate among medical professionals as to whether a missing enzyme can also be the cause of celiac disease.

causes

As the cause of Celiac disease one assumes genetic predispositions. This leads to an autoimmune reaction, in particular an antigen-antibody reaction to gluten in food.

Similar to an allergy, the immune system then overreacts. With the constant fight of the immune system against gluten, inflammation of the small intestinal mucosa then occurs.

In a healthy person, the surface of the mucous membrane of the small intestine is enlarged by numerous folds of the mucous membrane (villi of the small intestine), this ensures that the nutrients from our food are fully absorbed into the blood.

Celiac disease damages the villi of the small intestinal mucosa and flattens them. As celiac disease progresses, the small intestinal villi completely recede. The nutrients can no longer be sufficiently absorbed and transported into the blood. This can lead to various deficiency symptoms.

Symptoms, ailments & signs

Celiac disease manifests itself in a variety of unspecific symptoms, which can vary considerably from patient to patient. Doctors therefore call the disease the "chameleon of gastroenterology". The first signs are digestive disorders such as cramping abdominal pain, flatulence, diarrhea or constipation after eating gluten-free foods.

The most common symptoms are weight loss, bloating, nausea, and vomiting. Those affected often complain of loss of appetite and heartburn. Over 50 percent of people with celiac disease experience symptoms that do not affect the gastrointestinal tract.

Due to the malabsorption in the small intestine, patients suffer from an iron deficiency, which leads to paleness, tiredness and anemia. The psyche can also be affected by this immunological disease of the small intestine: some sufferers suffer from irritability, bad temper, anxiety or depression.

Dermatitis herpetiformis Duhring is directly causally related to celiac disease. It is a chronic blistering skin condition that is associated with excruciating itching. The rash primarily affects the extensor sides of the extremities, knees and elbows, hairy scalp, and buttocks.

Sick children who do not follow a gluten-free diet are at increased risk of developing mental and physical disorders. These can take the form of ADHD, learning disabilities, tooth enamel defects, and delays in growth.

Diagnosis & course

There are two different options for complaints in the gastrointestinal area Celiac disease to investigate. On the one hand, the doctor can draw blood to test for antibodies against components of gluten. If these antibodies are present, it is celiac disease. The antibody test is not recommended for children as it is only of limited use in these cases.

The second way to diagnose celiac disease is to do a biopsy of the small intestine. A sample is taken from the mucous membrane of the small intestine. The patient is given a local anesthetic and swallows a tube to which a capsule is attached. The tube is passed through the esophagus and stomach into the small intestine and the sample is taken from there. The sample is examined for inflammation under the microscope.

Symptoms of celiac disease include diarrhea, gas, nausea, vomiting, depression, loss of appetite, weight loss, muscle pain, weakness, and fatigue. In babies and toddlers, growth is often disturbed, the teeth are underdeveloped, the children often have tearful facial expressions and can develop muscle weakness.

These symptoms are often not taken seriously and are certainly not associated with celiac disease. For this reason, the disease is recognized late in many cases. What makes it difficult to find the right diagnosis is that several symptoms can occur at the same time. This is why there are numerous misdiagnoses or incorrect treatments for celiac disease.

The symptoms of celiac disease usually do not appear at the same time and are often not specific. Very often those affected only suffer from typical gastrointestinal complaints. If celiac disease is detected too late or if no treatment is given, deficiency symptoms and chronic infectious diseases are often the result. Celiac disease weakens the entire organism until it is completely emaciated.

Complications

Celiac disease is particularly associated with complications if those affected do not consistently adhere to the gluten-free diet prescribed by the doctor. In this case, there is an increased risk of various secondary and concomitant diseases, including type 1 diabetes mellitus, rheumatoid arthritis and various autoimmune diseases of the thyroid. In addition, patients with celiac disease who consume foods containing gluten, contrary to all recommendations, are more likely to develop what is known as T-cell lymphoma, a malignant disease of the lymphatic system.

At the beginning of therapy, many sufferers complain of complications such as abdominal pain and diarrhea. These complaints are mostly caused by the reconstruction of the small intestinal mucosa and are easily treatable - provided that the patient informs the treating doctor immediately so that he can take the necessary steps. If the side effects of the therapy are completely ignored, however, further complications such as an intestinal obstruction or disturbances in the electrolyte balance can be expected.

If the patient adheres to his gluten-free diet consistently and, above all, over the long term, the prognosis is very good. In this case, celiac disease has no impact on life expectancy. Instead, the inflammatory processes recede completely over the course of a few weeks to months. Only if it is a so-called diet-resistant celiac disease must additional immunosuppressants (drugs that reduce the immune system) be administered.

When should you go to the doctor?

If health changes occur after ingesting food, these should be monitored further. In the event of repeated flatulence, diarrhea, vomiting or nausea, the abnormalities should be discussed with a doctor. The person affected should be able to summarize what foods or meals he has consumed. If abnormalities or parallels are noticed, they should be reported to the doctor. The emergence of cramps, a general feeling of illness and malaise indicate a health disorder. If there is an increase in the symptoms or if the health problems occur at regular intervals, a doctor must be informed. In the case of loss of appetite, weight loss, internal weakness and sleep disorders, the affected person needs medical care.

Medical tests must be carried out to determine the cause. In the event of constipation, a feeling of fullness, tiredness or internal irritability, a visit to a doctor is advisable. States of fear, mood swings, or other emotional abnormalities are other health disorders that should be investigated further. In the event of a depressive state, indifference or loss of joie de vivre, a doctor should be consulted. If there are changes in the skin texture, itching, cognitive impairments or disorders of the tooth enamel, a doctor is required. If children experience delays in development or growth, a medical examination is also advisable.

Treatment & Therapy

The Celiac disease is not curable. It is only possible to alleviate the discomfort. To support the mucous membrane of the intestine, it is necessary to avoid foods containing gluten. Cereal products, pasta, pudding, cookies, cakes, beer, pizza, and chocolate contain plenty of gluten.

Vegetables, fruits, rice, lettuce, nuts, dairy products, vegetable oils or wine are suitable for people with celiac disease. An extensive range of gluten-free, packaged foods is available in health food stores and now also in many supermarkets, which must be marked with the note "gluten-free". If you don't want to go without grains despite celiac disease, you can find alternatives in millet, buckwheat, soy, carob flour, amaranth or quinoa.

The likelihood that children of a parent with celiac disease will also develop celiac disease is 10%. Breast milk is said to prevent celiac disease from progressing in infants and later in toddlers.

If you have celiac disease, it is advisable to see your doctor at least once a year to have your blood checked for vitamin B12 and vitamin D and to monitor your weight. Those affected can also take active preventive measures themselves by comprehensively informing themselves about their illness. The German Celiac Society (DZG), which also has an internet presence, offers guidance.

prevention

So far there are no procedures or options Celiac disease to prevent completely. Concerned parents must independently request a preventive examination for babies and toddlers from their pediatrician. Furthermore, people with suspected celiac disease should pay attention to the symptoms and symptoms listed above and then consult a doctor. For babies, it makes sense to breastfeed at least until they are six months old and to avoid foods containing gluten during this time.

You can do that yourself

After a diagnosis of celiac disease, a major change in diet is due. At first glance, this seems frightening. All products that contain wheat, rye, barley, oats, spelled, green spelled, ancient grain, kamut or emmer contain gluten. Commercially available pasta such as rolls, noodles, bread, cakes and pastries also contain gluten. Ready meals and soups cannot be eaten either.

But 90 percent of all food is naturally gluten-free, which is why changing your diet doesn't have to be difficult. Potatoes, rice, quinoa, millet, buckwheat and amaranth are just a few of the foods that can be eaten as a side dish instead of pasta - a whole lot. All fruits, vegetables and nuts also contain no gluten. This means that everyday life can run normally even after the diagnosis of celiac disease.

However, it is difficult to find suitable food on the go, as flour is used as a thickening agent in most sauces. It is therefore advisable to prepare meals the day before and take them with you. If you are invited to dinner, it becomes just as difficult. Acquaintances and friends should therefore be informed about the disease, or you should contribute something to the meal. You should also be able to recognize the first signs of an attack and to be able to act if you have consumed foods containing gluten.