Understanding Celiac Disease

Celiac disease is an autoimmune disorder that affects approximately 1 in 100 people worldwide. It is a serious condition in which the ingestion of gluten, a protein found in wheat, rye, and barley, leads to damage in the small intestine. This damage results in an inability to absorb essential nutrients, causing a wide range of health problems. In this comprehensive article, we will discuss what celiac disease is, its symptoms, and provide a list of foods to avoid and reasons why.

What is Celiac Disease?

Celiac disease is an autoimmune condition that occurs in genetically predisposed individuals. When a person with celiac disease ingests gluten, their immune system mistakenly attacks the lining of the small intestine. This results in inflammation and damage to the villi, the tiny, finger-like projections responsible for nutrient absorption. The exact cause of celiac disease remains unknown, but it is believed that a combination of genetic, environmental, and possibly hormonal factors contribute to the development of the condition. Celiac disease can affect people of any age, although it is more commonly diagnosed in children and young adults.

Symptoms of Celiac Disease

Celiac disease presents with a wide range of symptoms, which can vary greatly from one person to another. Some individuals may experience severe symptoms, while others may have mild or even no noticeable symptoms. The most common symptoms of celiac disease include:

• Gastrointestinal symptoms: These are the most common and include abdominal pain, bloating, diarrhea, constipation, nausea, and vomiting. The severity of these symptoms can range from mild to debilitating.
• Fatigue: Individuals with celiac disease often experience fatigue and a lack of energy, which can be due to malabsorption of essential nutrients.
• Anemia: Iron-deficiency anemia is a common symptom of celiac disease, as the damaged intestinal lining may not absorb iron properly.
• Weight loss: Unintentional weight loss can occur as a result of nutrient malabsorption.
• Dermatitis herpetiformis: This is a chronic, itchy, and blistering skin rash that affects approximately 15-25% of individuals with celiac disease. It is caused by an autoimmune reaction to gluten in the skin.
• Neurological symptoms: These can include headaches, migraines, numbness, tingling, or balance problems. In some cases, individuals with celiac disease may experience brain fog, anxiety, or depression.
• Bone and joint pain: Due to poor nutrient absorption, individuals with celiac disease may develop osteoporosis, osteopenia, or arthritis.
• Dental problems: Enamel defects, recurrent canker sores, and tooth discoloration can be signs of celiac disease.
• Growth and developmental problems: In children, celiac disease can cause delayed growth, failure to thrive, and developmental delays.

Foods to Avoid and Reasons Why

• Wheat: Wheat is one of the primary sources of gluten, and individuals with celiac disease must avoid all forms of wheat, including but not limited to durum, farro, graham, kamut, semolina, and spelt. Wheat contains gluten, which triggers an autoimmune response in individuals with celiac disease, damaging the small intestine and leading to malabsorption of nutrients.
• Barley: Barley is another gluten-containing grain that must be avoided. Barley contains gluten, which can lead to the same autoimmune response and subsequent damage to the small intestine as wheat.
• Rye: Rye is a third gluten-containing grain that individuals with celiac disease must avoid. Similar to wheat and barley, rye contains gluten, which can trigger an autoimmune response and cause damage to the small intestine in those with celiac disease.
• Triticale: Triticale is a hybrid of wheat and rye, and as such, it contains gluten. The gluten content in triticale poses the same risk to individuals with celiac disease as wheat, barley, and rye.
• Malt: Malt is derived from barley and can be found in a variety of products, such as malt vinegar, malted milk, malt syrup, and malted beverages. Since malt is derived from barley, it contains gluten and can cause an autoimmune response in those with celiac disease.
• Processed foods: Many processed foods contain gluten or gluten-containing additives, such as modified food starch, maltodextrin, and artificial flavourings. Processed foods may contain hidden gluten, which can trigger an autoimmune response in individuals with celiac disease.
• Sauces and condiments: Some sauces and condiments, such as soy sauce, salad dressings, and marinades, may contain gluten. Gluten can be used as a thickening agent or stabilizer in sauces and condiments, making them unsafe for individuals with celiac disease.
• Beer: Most beers are made from barley and contain gluten. The gluten content in beer poses a risk to those with celiac disease, as it can trigger an autoimmune response and cause intestinal damage.
• Imitation meats and seafood: Some imitation meats and seafood products, such as vegetarian burgers and imitation crab, may contain gluten. Gluten can be used as a binder or filler in these products, making them unsafe for individuals with celiac disease.

Next Steps, Doctors, and Diagnostic Tests

If you suspect that you may have celiac disease, it is essential to take the appropriate steps to ensure a proper diagnosis and receive the necessary treatment. If your primary care physician suspects celiac disease, they will likely refer you to a gastroenterologist, a doctor who specializes in diagnosing and treating gastrointestinal disorders. The gastroenterologist will review your medical history, perform a physical examination, and order appropriate tests to determine if you have celiac disease. These tests may include: Blood tests, genetic testing, as well as endoscopy and biopsy. Once you have been properly diagnosed with celiac disease, your healthcare team will help you develop a treatment plan, which will primarily involve adhering to a strict gluten-free diet for life. This will help alleviate symptoms, promote intestinal healing, and reduce the risk of complications associated with celiac disease.