Gluten is a protein found in grains- wheat, barley, rye, and many other processed and shelf-stable condiments, spices, foods, and even some items and “toys.” For those humans who have Celiac disease, any amount of this protein that is ingested into their body can cause permanent, irreversible damage and life-long body changes.
How much gluten protein does it take to set off a reaction for a Celiac patient? Only five mere crumbs of gluten-filled bread can trigger extreme symptoms in many Celiac sufferers.
Celiac disease is an immune system response and body reaction to being exposed to or ingesting the protein gluten (CDC/NIH). With repeated exposures, the damage can build on itself over time creating serious complications in the small intestine preventing nutrient absorption. Malnutrition is a common problem for Celiac patients, and they also deal with fatigue, weight loss, bloating, anemia, diarrhea, and in some cases- cancer. There is no cure for Celiac disease but to follow a specific, strict gluten free diet (CDC).
Signs & Symptoms of Celiac Disease
These symptoms can be difficult to pinpoint as they mimic many other medical issues and complications. Common signs are diarrhea, fatigue, and weight loss. Many adults also wind up with one or more of these symptoms:
- mouth ulcers, or open sores in the mouth.
- itchy, blistering skin rash called dermatitis herpetiformis.
- anemia from iron deficiency.
- damage to enamel of teeth with discoloration or decay.
- acid reflux and heartburn.
- a malfunctioning spleen called hyposplenism.
- joint pain with or without swelling.
- headaches and fatigue.
- nervous system injury with numbness or tingling in the feet or hands.
- equilibrium and balance can be “off” and feel different (NIH).
For children, the symptoms may follow this symptom list with or without those symptoms listed for adults:
- swollen belly
- chronic diarrhea
- poor appetite
- failure to thrive
- muscle wasting
- vomiting
- constipation
- irritability
- delayed puberty
- learning disabilities including ADHD, slow to learn functions and lack of coordination.
Why Celiac Disease?
The true cause or causes of Celiac disease are not known, although speculation from medical professionals in many fields believe that gastrointestinal infections, gut issues, certain infant and child feeding practices, and environmental issues are the common triggers. In some other cases, infection, emotional distress, pregnancy, childbirth, menopause, surgery, and hormone fluctuation have been studied for linking correlation.
When gluten is present in the body of a Celiac patient, the body begins to attack the protein, freezing the small intestinal villi that help with digestion and absorption. Without working villi, the body will struggle with nutrition and function (NIH). Celiac disease is present in roughly 1% of the USA’s population, with Caucasian humans being most predisposed & likely to be diagnosed. That said, Celiac disease is present in every ethnicity around the globe.
Increased Risks for Celiac Disease
Certain hereditary and familial medical issues have been noted to increase the overall risk for a person developing Celiac disease. These are:
- any autoimmune thyroid disease
- Addison’s disease
- Rheumatic diseases like rheumatoid arthritis
- a family member with the disease
- type 1 diabetes
- Down Syndrome or Turner Syndrome
Complications from Celiac Disease
When Celiac disease is left untreated, or the patient refuses to follow a gluten free diet, the chances of these things happening rise significantly. This information is compiled from the NIH, CDC, and Beyond Celiac (see Citations).
- Lactose intolerance. Damage to your small intestine may cause you to experience abdominal pain and diarrhea after eating lactose-containing dairy products, even though they do not contain gluten. Once your intestines have healed, you may be able to tolerate dairy products again. That said, most people choose to also avoid dairy products.
- Cancer. People with celiac disease who do not follow a gluten free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer. This is since gluten damages the intestines, causing small ulcers and even holes which leads to abnormal cell growth in the body. Celiac disease is an autoimmune disease, which enables the body to attack itself. Instead of attacking damaged cells, infection or otherwise, the body attacks normal cells, healthy organs, and the brain.
- Malnutrition. The damage to your small intestine means it cannot absorb enough nutrients. Malnutrition can lead to anemia and drastic weight loss. In children, malnutrition can cause slow growth and short stature. Severe malnutrition can be treated with feeding tubes and medications to calm the GI system.
- Loss of calcium and bone density. Malabsorption of calcium and vitamin D may lead to a softening of the bone in children and a loss of bone density or osteoporosis in adults.
- Infertility and miscarriage. Malabsorption of calcium and vitamin D can contribute to reproductive issues like infertility and miscarriage.
- Neurological problems. Some people with celiac disease may develop neurological problems such as seizures or peripheral neuropathy, which causes numbness or tingling in the extremities.
The Different Types of Celiac Disease
Nonresponsive Celiac Disease is had by nearly 30% of patients diagnosed and is the inability to maintain the gluten free diet. Patients with this type of Celiac Disease also struggle with other GI issues, like SIBO infections, microscopic colitis, poor pancreas function, IBS, IBD, or intolerance to sugar (NIH). Those patients who have nonresponsive Celiac disease may also have refractory Celiac disease.
Refractory Celiac Disease happens when the GI tract, intestines, and gut do not heal from the damage done by gluten exposure. These patients often end up on steroids to help ease the inflammation to ease the body from the autoimmune attack. In extreme cases, immunosuppressants may be prescribed. Any patient with Celiac disease needs to be monitored regularly to ensure nutrition and body homeostasis are maintained.
Diagnosing Celiac Disease
No cure exists for Celiac disease, and the treatments require much self-control and dedication. There are standardly two tests done for diagnosing Celiac disease and they are:
- Serology testing that looks for the antibodies in your blood. Elevated levels of certain antibody proteins prove an immune reaction to gluten.
- Genetic testing for leukocyte antigens, specifically HLA-DQ2 and HLA-DQ8, can be used to rule out Celiac disease.
One important aspect of testing sometimes ignored is that the patient should STILL BE EATING GLUTEN FILLED FOODS BEFORE AND WHILE your testing occurs. If the patient stops eating gluten, it could take six months or more of eating it again to have a confirmed diagnosis (CDC). In many cases, the patient has already gone gluten free to ease their own symptoms without realizing the need to continue eating those foods. They are then unwilling to begin eating gluten to cause the very problems that they have halted (Beyond Celiac). In these cases, good doctors will treat their patients as if they do indeed have Celiac disease to continue easing their symptoms.
Celiac disease treatment is both easy and difficult at the same time. Jumping on a new diet wagon immediately can be very difficult physically and mentally, and the life changes that follow can be hard to swallow. So often, people do not understand the wide variety of products and food items gluten can hide in. Here is a small list of areas to watch for gluten:
- Baked Goods
- Baking Mixes
- Barley
- Bulgur
- Condiments
- Durum
- Farina
- Graham flour
- Malt
- Processed foods and meats
- Rye
- Semolina
- Spelt, a form of wheat
- Spices
- Triticale
The Celiac diet can be very tricky to learn in the beginning. There are nutritionists, dieticians, and counselors that can help you to get a better understanding of which foods are safe, and which are not. There are numerous resources on the internet as well, including OH, Forks!™ and Beyond Celiac. Six months of the strict diet is typically the time it takes for a patient to report feeling the positive changes in their body (CDC). Complete healing could take years, or never happen. Children are often faster healers than adults, if they can have the support they need to maintain the strict diet.
Have you been Glutened?!
If you suspect that you have accidentally ingested gluten, immediately begin to drink fluids and water. This can help to dilute and push those proteins through your system and out of your body as fast as possible. Abdominal pains, headaches, body aches, diarrhea, and other symptoms may present themselves depending on how much gluten you ingested, and how sensitive your system is.
Do you think that you might have Celiac disease? Don’t worry! Just schedule an appointment with your doctor to discuss your symptoms and ailments to begin treatment and learning about the power of the gluten free diet! Celiac disease is known as a “silent killer” because so often damage is done before the patient has any idea what has even occurred. Be body aware and pay attention to your gut health!
Citations:
Beyond Celiac
National Institutes of Health and Human Services
World Health Organization
Centers for Disease Control and Prevention
American Cancer Society
OH, Forks!™ Resource