What is celiac disease?

Celiac disease (also called celiac, nontropical sprue, celiac sprue, gluten intolerant enteropathy, or gluten sensitive enteropathy) is a condition in which there is a chronic reaction to certain protein chains, commonly referred to as glutens, found in some cereal grains. This reaction causes destruction of the villi in the small intestine, with resulting malabsorption of nutrients.
The disease affects both sexes, and it can begin at any age, from infancy (as soon as cereal grains are introduced) to later life (even though the individual has consumed cereal grains all along). The onset of the disease seems to require two components: genetic predisposition (two specific genetic markers, called HLA subfactors, are present in well over 90% of all celiacs in America), and some kind of trigger. The trigger may be environmental (as in overexposure to wheat), situational (perhaps severe emotional stress), physical (such as a pregnancy, an operation), or pathological (a viral infection).

What are the symptoms of celiac disease?

There is no typical celiac. Individuals range from having no symptoms (asymptomatic or “latent” forms of the disease) to extreme cases where patients present to their physicians with gas, bloating, diarrhea, and weight loss due to malabsorption.
In between these two extremes lie a wide variety of symptoms that include:

  • Diarrhea
  • Constipation
  • Steatorrhea (fatty stools that float rather than sink)
  • Abdominal pain
  • Excessive gas
  • Any problem associated with vitamin deficiencies
  • Iron deficiency (anemia)
  • Chronic fatigue
  • Weakness
  • Weight loss
  • Bone pain
  • Easily fractured bones
  • Abnormal or impaired skin sensation (paresthesia),
  • Including burning, prickling, itching or tingling
  • Edema
  • Headaches
  • Peripheral Neuropathy (tingling in fingers and toes)

How is Celiac Disease Treated?

Once the diagnosis of celiac disease (CD) has been confirmed, treatment can begin immediately. It does not require surgery. It does not require an unending dependence on medication. It does not even require repeated visits to the doctor’s office. The best and only known treatment for CD is simply this: a lifelong elimination of “gluten”.

What is Gluten?

The term “gluten” is, in a sense, a generic term for the storage proteins that are found in grains. In reality, each type of protein – gliadin in wheat, hordein in barley, secalin in rye, avenin in oats, zein in corn and oryzenin in rice – is slightly different from the others. The “gluten” in wheat, barley, rye,), contain particular amino acid sequences that are harmful to persons with celiac disease. It is important to note that the gluten found in corn and rice does not cause harm to those with CD.

Gluten Free Foods

Wheat gluten, also known as seitan (SAY-tahn), wheat meat, gluten meat, or simply gluten, is a food made from the gluten of wheat. It is made by washing dough made from wheat flour in water until the starch is rinsed away, leaving only the gluten, which can then be cooked and processed in various ways.
Wheat gluten, although not as well known, is an alternative to soy -based meat substitutes such as tofu; some types may taste even more like meat than tofu due to their chewy and/or stringy texture. It is often used in place of meat in Asian,vegetarian, and macrobiotic cuisines.
Because it was first popularized in western nations during the second half of the 20th century through its promotion by proponents of themacrobiotic diet, seitan (the name by which it is known in macrobiotic circles) is also the name by which wheat gluten is best known in most English-speaking nations. In the West, prepared wheat gluten is generally available only in Asian markerts and health food stores (although gluten flour is commonly available in supermarkets).

What happens if I accidentally eat gluten?

The reason eating gluten makes people with celiac disease ill has to do with the villi, which are finger-like projections in the small intestine. The villi increase the surface area of the intestine for the absorption of food and nutrients. In a normal person these stand on end, but in an undiagnosed celiac they become flattened and thus reduce the surface area of the intestine. If a celiac adheres to a strict gluten-free diet permanently, then the flattened villi will return to normal.
However, if the diet is broken, typical symptoms can include chronic tiredness, lethargy, headache, nausea, vomiting, bloating, cramps and diarrhea. If the diet is consistently broken, even if there aren’t any symptoms, there is still the risk of more serious conditions such as anemia, osteoporosis, gut lymphoma (cancer) and problems surrounding fertility and pregnancy.

What if the difference between being a celiac and being wheat-intolerant?

If someone suspects they are wheat-intolerant, they should discuss their symptoms with their GP. The GP can take a simple blood test to identify celiac disease. The GP will then refer the person to a hospital specialist, a gastroenterologist, for a biopsy of the gut. By removing wheat from the diet before testing you could mask celiac disease without treating it. Wheat intolerance is quite rare, is more likely to affect young children and may be a temporary problem, unlike celiac disease which is permanent. Associated symptoms of wheat intolerance may include eczema and other skin irritations but it does not affect the immune system. Celiac disease, on the other hand, is known as an autoimmune disease because the presence of gluten in a celiac’s diet causes an immune reaction.

Sources: BBC, Gillians Foods

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