Consider a situation where you are out for a family dinner but you have to order separately for your wife as she is intolerant to wheat-based products. Every time she consumes anything made with wheat, she develops abdominal pain and diarrhea. It becomes quite a task to choose foods that are not wheat-based. As an alternative, she orders rice-based foods, vegetables, and fruits. Owing to this factor, eating out becomes quite a challenge!
The above stated condition is known as celiac disease and is also called celiac sprue, non-tropical sprue, and gluten-sensitive enteropathy. It becomes imperative to bring about a change in lifestyle and follow precautions that can help you to keep up the quality of your life and have a good health.
Understanding celiac disease
Celiac disease is an example of an autoimmune disease. In this, the immune system (body’s defense system) mistakenly recognizes the intestinal enzyme, tissue transglutaminase (tTG) as harmful and attacks it, resulting in inflammation. Our intestine has villi, which are finger-like protrusions in the luminal surface that help in the absorption of the digested food. Due to the immune system attack, these villi become flattened and are not able to help in absorption. In the long-term, it leads to malnourishment because it hampers the absorption of major nutrients from the intestine into the blood.
Gluten, which is a protein found in wheat, rye, barley, and triticale, is the reason behind this problem. It triggers an immune response in patients who suffer from celiac disease. These people are also intolerant to other gluten-containing products such as lip balms and certain medicines. Celiac disease is a genetic disease, which means it runs in families from one generation to another. This condition can be detected for the first time after a surgery, pregnancy, childbirth, viral infection, or severe emotional stress. A person with celiac disease may have or may be at risk of developing other autoimmune disorders such as type 1 diabetes or thyroid disorders.
The symptoms of celiac disease may get manifested in the digestive system or other systems. The symptoms may be masked until late adulthood. Some of the common symptoms of celiac disease are diarrhea, bloating, and abdominal pain. The stools may be frothy in appearance or malodorous due to unabsorbed fats. It is very common for the affected person to become anemic and experience unexplained weight loss. Other than these, there may be skin rash, brittle bones, bone and joint pain, mouth ulcers, tingling or numbness in hands and feet, fatigue, depression, and even infertility.
Almost 15-25% of patients with celiac disease may have an itchy skin and blistering skin rash on areas such as the elbows, knees, and buttocks. This rash may be a characteristic sign of celiac disease and may not necessarily be accompanied by digestive or other complaints. Such a condition is called dermatitis herpetiformis (DH).
Babies and children who suffer from celiac disease may be unusually irritable and exhibit behavioral problems. They may seem to appear pale due to deficiency in red blood cells and anemia. They may suffer from diarrhea, abdominal pain, bloating, weight loss, delayed puberty, and stunted growth over the growing years.
Diagnosing celiac disease
For diagnosis of celiac disease, presence of certain antibodies is detected in the blood. These are special proteins produced by the hyperactive immune system. In order to get a clear view of the interiors of the intestine, an endoscopy may be done. It consists of a flexible tubing, with a camera mounted on top that is inserted into the digestive tract. A piece of the intestine is retrieved and sent to the laboratory for examination. Rarely, a gene analysis may be required. It is recommended to get your entire family also screened for celiac disease. You may be advised by your doctor to stick to a gluten unrestricted diet for a couple of days before you undergo tests so as to facilitate the diagnosis.
Living with celiac disease
Celiac disease is a serious health condition. It may lead to several deficiencies of various essential nutrients such as vitamins and minerals. You may become anemic due to deficiency of iron and may easily bruise and bleed due to deficiency of vitamin K. Celiac disease can affect various organs such as the liver, pancreas, gallbladder, heart, bones, nervous system, etc. You may face fertility issues. Lastly, you become more likely to develop cancers in the digestive tract.
One should not ignore celiac disease. Although it has no cure, the safest and best bet is to follow a gluten-free diet. During the process of healing and restoration of the intestine, both trivial and severe symptoms respond dramatically to gluten restriction. It is important to bring about a change in food habits by learning to avoid even small amounts of gluten. Before you buy a product, read the food label carefully. Beware! What is wheat-free is not gluten-free. It may contain other grains that you need to avoid, including rye, barley, triticale, einkorn, kamut, and spelt. Some of the foods to avoid include breads, broth, commercial cereals, pastas, wafers with grains, cakes, marinades, sauces and stuffings, food starch, vegetable gums, dextrin, etc.
It is advisable to avoid cross contamination with gluten products. If you use a toaster, ensure one is separate for your use. Do not use a knife that has already been used to spread butter or jam on a bread slice. Buy food from a bakery that has a separate gluten-free machinery.
Foods that you can normally eat include fruits, vegetables, eggs, corn, rice, sorghum, buckwheat, chickpeas, garbanzo beans, quinoa, teff, tapioca, potatoes, meat, chicken, fish, legumes, seeds, nuts, oils, milk and cheese.
Additionally, you may require nutritional supplements to overcome the deficiencies caused by Celiac disease. You do not need any medication. In rare cases, steroids may be needed to suppress the immune activity. A drug called dapsone may help cure dermatitis herpetiformis.
Help for people with celiac disease
Joining a support group for celiac people may be a good idea. Keep yourself updated and connect with others having the same problem. A dietician may help you chart out a diet plan.
Go gluten free
It is quite a daunting task to remain gluten-free throughout life. Learn ways to live with this multisystem disorder. Manage yourself better to improve the quality of your life.
