Is celiac disease fatal. Can celiac disease affect life expectancy. What are the long-term health risks associated with untreated celiac disease. How is celiac disease diagnosed and managed. What dietary changes are necessary for individuals with celiac disease.

The Prevalence and Nature of Celiac Disease

Celiac disease is a genetic autoimmune disorder that affects approximately 1 in 133 Americans, making it more common than Crohn’s disease, ulcerative colitis, and cystic fibrosis combined. This condition is characterized by an immune response triggered by gluten, a protein found in wheat, barley, and rye.

When individuals with celiac disease consume gluten, their immune system reacts by damaging the villi in the small intestine. These finger-like projections are crucial for nutrient absorption, and their destruction can lead to various health complications.

Key Facts About Celiac Disease

• It is a lifelong condition that cannot be outgrown
• It is not a food allergy but an autoimmune disorder
• It can affect both children and adults
• It is triggered by gluten consumption

Is celiac disease hereditary. While the exact cause is not fully understood, celiac disease does have a genetic component. Individuals with a first-degree relative (parent, sibling, or child) with celiac disease have a higher risk of developing the condition themselves.

Symptoms and Manifestations of Celiac Disease

Celiac disease can manifest in various ways, affecting multiple systems in the body. The symptoms can range from mild to severe and may differ between children and adults.

Common Symptoms in Adults

• Diarrhea or constipation
• Abdominal pain and bloating
• Weight loss
• Fatigue and weakness
• Headaches
• Joint pain
• Depression and anxiety

Common Symptoms in Children

• Poor growth or weight gain
• Irritability
• Difficulty concentrating
• Diarrhea or constipation
• Bloating
• Delayed puberty

Do all individuals with celiac disease experience the same symptoms. No, the presentation of celiac disease can vary significantly between individuals. Some people may experience severe gastrointestinal symptoms, while others may have more subtle signs or even be asymptomatic.

Diagnosis of Celiac Disease

Diagnosing celiac disease involves a combination of blood tests and intestinal biopsy. It’s crucial to maintain a gluten-containing diet during the diagnostic process to ensure accurate results.

Blood Tests for Celiac Disease

1. Total IgA
2. Tissue transglutaminase-IgA (tTG-IgA)
3. Anti-endomysial antibody-IgA (EMA)
4. Anti-deamidated gliadin peptide-IgG (DGP-IgG) for patients with low total IgA levels

Can blood tests alone diagnose celiac disease. While blood tests are an essential first step in diagnosing celiac disease, they are not definitive. A positive blood test result should be followed by an intestinal biopsy to confirm the diagnosis.

Intestinal Biopsy

An endoscopy with biopsy is considered the gold standard for diagnosing celiac disease. During this procedure, a small sample of tissue is taken from the small intestine and examined for signs of damage to the villi.

Why is it important to maintain a gluten-containing diet before diagnosis. Consuming gluten before diagnostic tests ensures that the antibodies and intestinal damage associated with celiac disease are detectable. Starting a gluten-free diet before testing can lead to false-negative results.

Long-Term Health Risks of Untreated Celiac Disease

Untreated celiac disease can have serious and potentially life-threatening consequences. The chronic inflammation and malabsorption associated with the condition can affect multiple organ systems and increase the risk of various health complications.

Potential Complications of Untreated Celiac Disease

• Osteoporosis
• Tooth enamel defects
• Neurological disorders
• Pancreatic disease
• Internal hemorrhaging
• Gallbladder, liver, and spleen disorders
• Gynecological disorders
• Increased risk of certain cancers, particularly intestinal lymphoma

Can untreated celiac disease lead to cancer. Yes, studies have shown that individuals with untreated celiac disease have an increased risk of developing certain types of cancer, particularly intestinal lymphoma. This underscores the importance of early diagnosis and strict adherence to a gluten-free diet.

Treatment and Management of Celiac Disease

Currently, there is no cure for celiac disease, and no drugs are available to treat the condition directly. However, individuals with celiac disease can lead normal, healthy lives by following a strict gluten-free diet.

The Gluten-Free Diet

The primary treatment for celiac disease involves completely eliminating gluten from the diet. This means avoiding all products derived from wheat, rye, and barley. A gluten-free diet allows the intestinal villi to heal and helps prevent further damage and complications.

What foods should be avoided on a gluten-free diet. Individuals with celiac disease must avoid:

• Wheat and wheat derivatives (including spelt, durum, and semolina)
• Rye
• Barley
• Malt
• Brewer’s yeast
• Any products containing these ingredients

Is a gluten-free diet sufficient to manage celiac disease. For most individuals, a strict gluten-free diet is the cornerstone of celiac disease management. However, some people may require additional nutritional support or treatment for associated conditions.

Impact of Celiac Disease on Life Expectancy

While celiac disease itself is not typically fatal, untreated celiac disease can significantly impact life expectancy due to its associated complications and increased risk of certain cancers.

Can celiac disease directly cause death. Celiac disease itself is not usually a direct cause of death. However, the complications arising from untreated celiac disease, such as malnutrition, osteoporosis, or certain cancers, can potentially be life-threatening.

Factors Influencing Life Expectancy in Celiac Disease

• Timing of diagnosis
• Adherence to a gluten-free diet
• Presence of associated autoimmune disorders
• Development of complications
• Overall health and lifestyle factors

How does early diagnosis affect the prognosis of celiac disease. Early diagnosis and prompt initiation of a gluten-free diet can significantly improve the prognosis for individuals with celiac disease. It allows for faster intestinal healing, reduces the risk of complications, and can help prevent the development of associated conditions.

Living with Celiac Disease: Challenges and Strategies

While managing celiac disease primarily involves following a gluten-free diet, this lifestyle change can present various challenges. However, with proper education and support, individuals with celiac disease can lead healthy, fulfilling lives.

Common Challenges of Living with Celiac Disease

• Navigating social situations involving food
• Dining out safely
• Reading and understanding food labels
• Managing cross-contamination risks
• Ensuring adequate nutrition on a restricted diet
• Dealing with the emotional impact of a chronic condition

How can individuals with celiac disease ensure they’re getting proper nutrition. Working with a registered dietitian who specializes in celiac disease can be invaluable. They can help create a balanced meal plan, identify potential nutrient deficiencies, and recommend appropriate supplements if necessary.

Strategies for Successfully Managing Celiac Disease

1. Educate yourself about gluten-free foods and hidden sources of gluten
2. Learn to read food labels carefully
3. Prepare more meals at home to have better control over ingredients
4. Use separate cooking utensils and surfaces for gluten-free foods to prevent cross-contamination
5. Join support groups or online communities for individuals with celiac disease
6. Communicate openly with friends, family, and colleagues about your dietary needs
7. Stay up-to-date with celiac disease research and management techniques

Is it possible to accidentally consume gluten while following a gluten-free diet. Yes, accidental gluten exposure, often called “glutening,” can occur due to cross-contamination or hidden sources of gluten in processed foods. It’s crucial to be vigilant and educate oneself about potential sources of gluten in various products.

The Future of Celiac Disease Research and Treatment

While the gluten-free diet remains the primary treatment for celiac disease, researchers are actively exploring new therapeutic approaches and working to better understand the condition’s underlying mechanisms.

Current Areas of Research

• Developing drugs to prevent gluten-induced damage
• Exploring enzyme therapies to break down gluten in the digestive tract
• Investigating potential vaccines to induce gluten tolerance
• Studying the role of the gut microbiome in celiac disease
• Improving diagnostic techniques for earlier and more accurate detection

Will there ever be a cure for celiac disease. While a cure is not currently available, ongoing research offers hope for new treatments that could complement or potentially replace the gluten-free diet in the future. However, it’s important to note that developing effective and safe treatments for autoimmune conditions is a complex process that often takes many years.

As research in celiac disease continues to advance, individuals with the condition can look forward to potentially improved management options and a deeper understanding of this complex autoimmune disorder. In the meantime, maintaining a strict gluten-free diet and working closely with healthcare providers remains the best approach for managing celiac disease and minimizing its impact on long-term health and life expectancy.

Celiac Disease FAQ

Get answers to common questions about celiac disease.

What is celiac disease?

Celiac disease is a genetic disorder that can affect children and adults. People with celiac disease are unable to eat foods that contain gluten, which is found in wheat and other grains. In people with celiac disease, gluten sets off an autoimmune reaction that causes the destruction of the villi in the small intestine. People with celiac disease produce antibodies that attack the intestine, causing damage and illness. Finding the cause of this disease is a priority of the Center for Celiac Research.

Nearly 1 out of every 133 Americans suffer from celiac disease, according to a study by the Center for Celiac Research. The research indicates that celiac disease is twice as common as Crohn’s disease, ulcerative colitis and cystic fibrosis combined.

A blood test is now available to screen for the presence of specific antibodies. A biopsy of the intestine (before beginning a gluten free diet) is needed to make confirm and make a final diagnosis.

Untreated celiac disease can be life threatening. People with celiac disease are more likely to be afflicted with problems relating to malabsorption, including osteoporosis, tooth enamel defects, central and peripheral nervous system disease, pancreatic disease, internal hemorrhaging, organ disorders (gall bladder, liver, and spleen), and gynecological disorders. Untreated celiac disease has also been linked an increased risk of certain types of cancer, especially intestinal lymphoma.

At this time, there are no drugs to treat celiac disease and there is no cure. But patients with celiac disease can lead normal, healthy lives by following a gluten free diet. This means avoiding all products derived from wheat, rye, and barley.

Individuals with celiac disease cannot outgrow the disease since it is a lifelong autoimmune disorder like diabetes and rheumatoid arthritis.

Celiac disease is not a food allergy; rather it is an autoimmune disease. Food allergies, including wheat allergy, are conditions that people can grow out of. This is not the case with celiac disease.

What are the symptoms of celiac disease?

Symptoms of celiac disease include diarrhea, constipation, weight loss, abdominal pain, fatigue, weakness, headache, and other non-specific complaints. In children, the symptoms may include poor growth or poor weight gain, irritability, an inability to concentrate, diarrhea, constipation, and bloating. Further, people affected by celiac disease may experience extra intestinal symptoms that involve many systems and organs including bones (osteoporosis, arthritis, and joint pain), blood (anemia and bleeding), reproductive system (infertility and reoccurring abortion), nervous system (peripheral neuropathy, depression, dementia), and behavioral changes.

How common is celiac disease?

Nearly 1 out of every 133 Americans suffer from celiac disease, according to a new study by the University of Maryland Center for Celiac Research in Baltimore. The research indicates that celiac disease is twice as common as Crohn’s disease, ulcerative colitis and cystic fibrosis combined.

How is celiac diagnosed?

A blood test is now available to screen for the presence of specific antibodies. A biopsy of the intestine (before beginning a gluten free diet) is needed to make a final diagnosis. Therefore a gluten free diet should never be started before consulting with a gastroenterologist.

What are the long-term effects of celiac disease?

Untreated celiac disease can be life threatening. Patients with celiac disease are more likely to be afflicted with problems relating to malabsorption, osteoporosis, tooth enamel defects, central and peripheral nervous system disease, pancreatic disease, internal hemorrhaging, organ disorders (gall bladder, liver, and spleen), and gynecological disorders. Untreated celiac disease has also been linked an increased risk of certain types of cancer, especially intestinal lymphoma.

What is the treatment for celiac disease?

There are no drugs to treat celiac disease and there is no cure. But celiacs can lead normal, healthy lives by following a gluten free diet. This means avoiding all products derived from wheat, rye, and barley.

What are the recommended blood tests to diagnose celiac disease?

There is a particular series of blood tests that measure your immune system’s response to gluten in the food you eat. The tests we use to evaluate for celiac disease include:

• Total IGA
• tTG-IgA or tissue transglutaminase-IgA
• EMA or anti-endomysial antibody- IgA
• For patients with a low total IgA level, DGP anti-deamidated gliadin peptide- IgG is recommended

While the presence of tTG antibodies is suggestive of celiac disease meeting with a gastroenterologist and confirming the diagnosis with an endoscopy while on a gluten containing diet is necessary.

How accurate are the celiac blood tests?

The current diagnostic tests for celiac disease are very accurate, particularly when tTG and anti-endomysial antibodies are elevated.

Are the villi permanently damaged in a patient with celiac disease and how long does it take for the villi to return to normal?

The villi are not permanently damaged. The intestine is an organ, which renews itself every three days. Therefore, if the damage is exclusively due to celiac disease, the villi will be begin to heal once on a gluten-free diet. The time for the villa to return to normal varies among individuals. Answering this question and understanding the underlying mechanism is part of our ongoing research program.

What is the meaning of HLA DQ2/DQ8?

As an autoimmune disease, celiac disease is the consequence of the interplay between genes, gluten, and the environment. We don’t know all the necessary genes to develop celiac disease; however, HLA DQ2 and/or DQ8 are absolutely necessary to develop the disease. Since up  to 40% of the general population also have these genes, the presence of DQ2 or DQ8 does not imply that the person will develop celiac disease, rather, that they have a genetic compatibility with celiac disease. Conversely, the absence of DQ2/DQ8 almost certainly rules out celiac disease.

Is it necessary to have an intestinal biopsy to confirm the diagnosis of celiac disease?

The intestinal biopsy is the gold standard for the diagnosis of celiac disease, and therefore is considered essential.

Is it necessary to have an intestinal biopsy to confirm the diagnosis of dermatitis herpetiformis (DH)?

A skin biopsy is sufficient to confirm the diagnosis of DH. Dermatitis herpetiformis is the skin manifestation of celiac disease.

If a diabetic goes on a gluten-free diet, will their diabetes improve?

Not necessarily. The current literature suggests that once you develop diabetes, the course of the disease may not be changed by a gluten-free diet. However, there are some reports suggesting that a gluten-free diet can help to better control serum glucose levels.

Can a person with celiac disease on gluten-free diet give blood?

Yes, a person with celiac disease can donate blood.

Can a person with celiac disease drink wine?

Yes, wine is made from grapes. Conversely, beer is made from grains and cannot be consumed by a celiac. However, there are gluten free beers now available.

Can I outgrow celiac disease?

If you are a biopsy proven celiac, you will not outgrow the disease since celiac disease is an autoimmune disorder like diabetes and rheumatoid arthritis.

Do I need to repeat the biopsy once on a gluten-free diet?

We recommend repeating an intestinal biopsy in our adolescent and adult patients to ensure that intestinal healing has occurred.

Is celiac disease a food allergy?

No, celiac disease is not a food allergy; rather, it is an autoimmune disease. Food allergies, including wheat allergy, are conditions that people can grow out of. This is not the case with celiac disease.

Can celiac disease affect life expectancy?

Celiac disease (CD), triggered by the ingestion of gluten, occurs in people genetically predisposed to develop the chronic autoimmune condition.

During the past few decades, doctors have learned much about how the disease develops, including genetic and other risk factors. However, results from studies on whether people with CD have an increased risk of premature death linked to the condition have been mixed. A recent study shows a small but statistically significant increased mortality rate.

Celiac disease can affect the entire body

Until recently, CD was considered a mainly pediatric gastrointestinal disorder, associated with symptoms of abdominal pain, diarrhea, constipation, and bloating, and characterized by damage to the villi of the small intestine. (Villi are tiny, fingerlike projections lining the small intestine that help the body absorb nutrients.)

With the development of accurate blood tests and large-scale screenings, we have identified CD as a truly systemic disorder that can develop at any age and affect nearly any tissue or organ in the body. People with CD may experience joint pain, osteopenia or osteoporosis, bone fracture, rash, and psychiatric symptoms such as anxiety and depression.

The environmental trigger for CD — gluten — is known. When we remove gluten (a protein found in wheat, rye, and barley) from the diet of people with CD, they usually experience an improvement or resolution of symptoms. Their blood tests return to normal and their small intestine heals.

Celiac disease may affect life expectancy

Studies evaluating CD and mortality have had conflicting results, with some studies showing up to a twofold increase in mortality, and others showing no increased risk. In addition, we have not yet identified how CD may alter life expectancy. Some think that it might be partly related to chronic inflammation, leading to the development of osteopenia and bone fractures, complications from associated conditions such as type 1 diabetes, or rarely, the development of intestinal lymphoma (a type of cancer).

A recent study published in JAMA found a small but significant increased risk of mortality in people with CD. Interestingly, people with CD were at an increased risk of death in all age groups studied, but mortality was greater in those diagnosed between the ages of 18 and 39. Researchers found that the risk of death was increased in the first year after diagnosis, but this persisted even 10 years later. The increase in mortality in patients with CD was related to cardiovascular disease, cancer, respiratory disease, and other unspecified causes.

Dietary changes and routine medical care may help reduce risks

The slight increase in mortality risk does not suggest that we need to manage CD differently. However, these findings do highlight areas for patients and physicians to focus on in an effort to possibly reduce these risks.

For example, research suggests that inadequate intake of whole grains, along with insufficient fiber intake, is a leading cause of disease and death worldwide. Specifically, lower intake of whole grains is associated with increased risk of cardiovascular disease. Given the limitations of a gluten-free diet, it is possible that people with CD eat fewer whole grains than those on an unrestricted diet. Thus, individuals with CD should consume a diet rich in whole grains that do not contain gluten, such as oats, quinoa, and amaranth.

In addition, patients with CD were found to have an increased risk of death related to respiratory disease. As part of routine care after diagnosis, patients should speak with their doctor about pneumococcal vaccines, which can reduce the risk of some respiratory infections. This is not yet common in most healthcare practices, so ask your doctor about this if he or she does not bring it up.

Chronic inflammation is likely a factor in the association of CD with increased mortality. With this in mind, physicians should consider a repeat intestinal biopsy to look for ongoing inflammation, even though this study did not find an increased risk of death in people whose intestine did not heal on a gluten-free diet.

After the intestine has healed, patients should visit their physician and dietitian yearly to review their gluten-free diet, undergo evaluation for other possible autoimmune conditions, and to discuss the need for vitamin supplementation. Routine follow-up care, pneumococcal vaccination, and a diet rich in whole grains, fiber, fruits, and vegetables should also help.

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Celiac disease (gluten intolerance) – symptoms, what kind of disease it is, clinical guidelines

This disease is treated by Gastroenterologist

The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.

Article content:

• Symptoms of celiac disease
• Complications of gluten intolerance
• Causes of celiac disease
• Classification
• Diagnostics
• Treatment of celiac disease

What is celiac disease?

Celiac disease is an intolerance to gluten, a protein found in certain grains. These are wheat, rye, barley grain. Any food that contains gluten provokes reactions from the intestines with the development of an inflammatory process, damage to the walls, which disrupts the absorption of nutrients.

The second name of the pathology is gluten enteropathy, protein sensitivity is transmitted at the genetic level, from parents, and manifests itself in both children and adults. The danger of the disease is that due to damage to the intestines, the body does not receive the necessary nutrients, mineral and vitamin components, weight decreases, various unpleasant symptoms occur. Source:
Celiac disease. Problems and solutions. Mayurnikova L.A., Ashirova N.N. Food industry No. 6, 2011. pp. 60-63.

There is no single sign of gluten intolerance – the clinical picture is very diverse, variable and depends on age. Among the main signs that occur in most patients are:

• frequent occurrence of diarrhea, in which a large amount of fluid and nutrients is lost;
• steatorrhea – the appearance of fatty stools that are poorly washed from the walls of a pot or toilet bowl;
• weight loss and malabsorption syndrome;
• polyhypovitaminosis, signs of deficiency of mineral components.

In women, manifestations of celiac disease are possible at the age of about 35-45 years, in men – 10 years later, at about 45-50 years. If the disease develops in childhood, its debut falls on the period of 9-18 months. Source:
Bai J. WGO-OMGE / J. Bai, E. Zeballos, M. Fried [et al.] // Practice Guideline Celiac Disease. – 2005. – Vol. 10. – P. 1-8.:

• loose stools, recurring on the background of the introduction of gluten cereals;
• a large amount of lipids in the stool, because of which it is poorly washed off the skin, potty walls, clothes;
• weight loss of 10% or more of normal;
• stunting and slow learning of new skills.

In adulthood, the development of celiac disease can be caused by various serious stress factors – operations, past intestinal infections, pregnancy and childbirth. In people who suffer from celiac disease, there may be a decrease in efficiency, frequent drowsiness, flatulence, rumbling in the abdomen, and instability of the stool. In old age, aches and pain in the area of ​​​​bones, joints and muscles are additionally added.

Complications of gluten intolerance

People who suffer from celiac disease are at high risk for developing bowel cancer, particularly adenocarcinoma or lymphoma. This type of cancer occurs in about 6-8% of confirmed cases, especially in people over 50 years of age. It is especially important to have a complete cancer screening if symptoms of celiac disease reappear after switching and following a strict gluten-free diet.

Another likely complication of long-term celiac disease is the development of ulcerative lesions of the jejunum and ileum, accompanied by the appearance of ulcerative defects. Typical manifestations of this complication are fever and abdominal pain. In addition, there is a high risk of internal bleeding, peritonitis, perforation of the intestinal wall. In addition, iron absorption is impaired, which leads to severe anemia. Sometimes it is persistent anemia that becomes the starting point in making a diagnosis. Source:
Modern concepts of celiac disease. Kopishinskaya S.V. Kazan Medical Journal, Volume 97, No. 1, 2016. pp. 101-107.

Prolonged malabsorption syndrome can lead to reproductive disorders, protein deficiency, mineral metabolism disorder, hypovitaminosis. A decrease in bone density and osteoporosis is formed, the spleen increases in size, typically low blood pressure.

Causes of celiac disease

The pathogenesis of celiac disease is chronic progressive inflammation localized on the mucous membrane of the small intestine. The inflammatory process leads to malabsorption of nutrients from food. The key reason for these events is a genetic defect that forms an increased sensitivity of the intestinal epithelium to the cereal protein – gluten. It is found in barley, wheat and rye grains. The basis of gluten is gliadin, a compound that has a toxic effect on the mucous membranes, which leads to damage to the intestinal wall and disruption of its functions. Celiac disease is a genetically predisposed disease. When examining the relatives of a patient suffering from celiac disease, almost 15% of close relatives (the first line – parents, children, siblings) have problems with the walls of the small intestine of a similar nature Source:
Belmer S.V. Celiac disease: from pathogenesis to treatment / S.V. Belmer, T.V. Gasilina // Questions of modern pediatrics. – 2013. – V. 12. – No. 3. – S. 12-17. In the body of people suffering from celiac disease, antibodies to gliadin, endomyosin (smooth muscle protein of intestinal cells) and tissue transglutaminase are found. In addition, people with celiac disease often have other autoimmune conditions, including type 1 diabetes, Sjögren’s syndrome, autoimmune thyroiditis, and so on.

Classification

Modern clinical guidelines advise the allocation of the following forms of celiac disease:

• Typical – the disease develops in childhood, from the first year of life, with the introduction of cereal complementary foods. It is characterized by typical manifestations.
• Erased form – occurs at different age periods, it is typically dominated by extraintestinal symptoms. These can be anemia and persistent iron deficiency, osteoporosis, bleeding gums.
• Latent form – typical of the elderly, has virtually no complaints.

In addition, during celiac disease, depending on the activity of the process, several periods are distinguished:

• Latent – there are no complaints and external manifestations, although the inflammatory process in the intestine is present.
• Active – all or some of the typical symptoms of the disease are present.
• The period of incomplete remission – as the treatment progresses, some of the symptoms disappear, only minor complaints remain.
• Period of complete remission – all manifestations disappear.
• Decompensation – newly emerged manifestations of celiac disease after a period of remission.

Diagnostics

Gastroenterologists know how to diagnose celiac disease. They use a whole range of tests, instrumental tests and functional tests to confirm the diagnosis. Displayed:

1. Determination of the titer of specific antibodies to gliadin and tissue transglutaminase. This is the most sensitive and specific test.
2. Endoscopic biopsy. Determines typical for celiac disease changes in the villi of the intestine, the accumulation of lymphocytes.
3. Schilling test or D-xylose test to assess absorption in the small intestine.

Additionally, ultrasound of the abdominal cavity, CT or MRI, contrast x-ray of the intestine are prescribed. Source:
Kamalova A.A. Evolution of approaches to the diagnosis and therapy of celiac disease / A.A. Kamalova, M.O. Pirogov // Bulletin of modern clinical medicine. – 2013. – V.6. – Issue. 3. – S. 40-48 ..

Treatment of celiac disease

The basis of therapy is the complete exclusion of gluten from the diet. The doctor helps at first to determine the list of what not to eat. Wheat or rye flour, barley can be found in the most unusual products, including dairy desserts and vegetable dressings.

Any bakery products with wheat, barley, rye or multigrain flour are prohibited. Also, traditional pasta, semolina, cereals from gluten cereals are not allowed.

It is important to read the labels of sausages, sausages, preserves, desserts and sauces. Traces of gluten can be found in instant coffee, cocoa, soy products, bagged soups. Prohibited vodka, beer, whiskey, kvass Source:
Diet for celiac disease. Nurtazina I.K. Bulletin of Surgery of Kazakhstan No. 4, 2011. p.120.

There are a number of gluten-free products available in stores today to choose from for patients with celiac disease. Ordinary flour can be replaced with buckwheat, rice, oatmeal, corn. These cereals do not contain gluten.

The diet must be followed for at least six months, during which time the condition returns to normal. Additionally, you need to take supplements with vitamins, minerals, some components. Source:
Mikhalik D.S. Celiac disease: disease and lifestyle / D.S. Mikhalik [and others] // Zemsky doctor. – 2012. – No. 4. – S. 35-38 ..

If necessary, the doctor also recommends medicines that suppress intestinal inflammation.

• Bai J. WGO-OMGE / J. Bai, E. Zeballos, M. Fried [et al.] // Practice Guideline Celiac Disease. – 2005. – Vol. 10. – P. 1-8.
• Belmer S.V. Celiac disease: from pathogenesis to treatment / S.V. Belmer, T.V. Gasilina // Questions of modern pediatrics. – 2013. – T. 12. – No. 3. – S. 12-17.
• Kamalova A.A. Evolution of approaches to the diagnosis and therapy of celiac disease / A.A. Kamalova, M.O. Pirogov // Bulletin of modern clinical medicine. – 2013. – V.6. – Issue. 3. – S. 40-48.
• Michalik D.S. Celiac disease: disease and lifestyle / D.S. Mikhalik [and others] // Zemsky doctor. – 2012. – No. 4. – S. 35-38.
• Roslavtseva E.A. Celiac disease: unresolved problems of pathogenesis, diagnosis and treatment / E.A. Roslavtseva [et al.] // Questions of modern pediatrics. – 2005. – V. 4. – No. 6. – S. 48-57.
• Celiac disease in the elderly. Sabelnikova E.A., Krums L.M., Vorobieva N.N., Gudkova R.B. Experimental and clinical gastroenterology №12, 2010. p.48-53
• Surgical aspects of celiac disease. Shakirova A.R., Kamalova A.A., Yafyasov R.Ya., Nizamova R.A. Russian Bulletin of Perinatology and Pediatrics, 2018. p.188-191
• Diet for celiac disease. Nurtazina I.K. Bulletin of Surgery of Kazakhstan No. 4, 2011. p.120
• Modern understanding of celiac disease. Kopishinskaya S.V. Kazan Medical Journal, Vol. 97, No. 1, 2016. p.101-107
• Celiac disease. Problems and solutions. Mayurnikova L.A., Ashirova N.N. Food industry №6, 2011. p.60-63

Article published : 3/31/2017
Last updated : 4/20/2023

See also

Pancreatitis

Appendicitis

Acute pancreatitis

Celiac disease (gluten intolerance) – symptoms, what kind of disease it is, clinical guidelines

This disease is treated by Gastroenterologist

The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.

Article content:

• Symptoms of celiac disease
• Complications of gluten intolerance
• Causes of celiac disease
• Classification
• Diagnostics
• Treatment of celiac disease

What is celiac disease?

Celiac disease is an intolerance to gluten, a protein found in certain grains. These are wheat, rye, barley grain. Any food that contains gluten provokes reactions from the intestines with the development of an inflammatory process, damage to the walls, which disrupts the absorption of nutrients.

The second name of the pathology is gluten enteropathy, protein sensitivity is transmitted at the genetic level, from parents, and manifests itself in both children and adults. The danger of the disease is that due to damage to the intestines, the body does not receive the necessary nutrients, mineral and vitamin components, weight decreases, various unpleasant symptoms occur. Source:
Celiac disease. Problems and solutions. Mayurnikova L.A., Ashirova N.N. Food industry No. 6, 2011. pp. 60-63.

There is no single sign of gluten intolerance – the clinical picture is very diverse, variable and depends on age. Among the main signs that occur in most patients are:

• frequent occurrence of diarrhea, in which a large amount of fluid and nutrients is lost;
• steatorrhea – the appearance of fatty stools that are poorly washed from the walls of a pot or toilet bowl;
• weight loss and malabsorption syndrome;
• polyhypovitaminosis, signs of deficiency of mineral components.

In women, manifestations of celiac disease are possible at the age of about 35-45 years, in men – 10 years later, at about 45-50 years. If the disease develops in childhood, its debut falls on the period of 9-18 months. Source:
Bai J. WGO-OMGE / J. Bai, E. Zeballos, M. Fried [et al.] // Practice Guideline Celiac Disease. – 2005. – Vol. 10. – P. 1-8.:

• loose stools, recurring on the background of the introduction of gluten cereals;
• a large amount of lipids in the stool, because of which it is poorly washed off the skin, potty walls, clothes;
• weight loss of 10% or more of normal;
• stunting and slow learning of new skills.

In adulthood, the development of celiac disease can be caused by various serious stress factors – operations, past intestinal infections, pregnancy and childbirth. In people who suffer from celiac disease, there may be a decrease in efficiency, frequent drowsiness, flatulence, rumbling in the abdomen, and instability of the stool. In old age, aches and pain in the area of ​​​​bones, joints and muscles are additionally added.

Complications of gluten intolerance

People who suffer from celiac disease are at high risk for developing bowel cancer, particularly adenocarcinoma or lymphoma. This type of cancer occurs in about 6-8% of confirmed cases, especially in people over 50 years of age. It is especially important to have a complete cancer screening if symptoms of celiac disease reappear after switching and following a strict gluten-free diet.

Another likely complication of long-term celiac disease is the development of ulcerative lesions of the jejunum and ileum, accompanied by the appearance of ulcerative defects. Typical manifestations of this complication are fever and abdominal pain. In addition, there is a high risk of internal bleeding, peritonitis, perforation of the intestinal wall. In addition, iron absorption is impaired, which leads to severe anemia. Sometimes it is persistent anemia that becomes the starting point in making a diagnosis. Source:
Modern concepts of celiac disease. Kopishinskaya S.V. Kazan Medical Journal, Volume 97, No. 1, 2016. pp. 101-107.

Prolonged malabsorption syndrome can lead to reproductive disorders, protein deficiency, mineral metabolism disorder, hypovitaminosis. A decrease in bone density and osteoporosis is formed, the spleen increases in size, typically low blood pressure.

Causes of celiac disease

The pathogenesis of celiac disease is chronic progressive inflammation localized on the mucous membrane of the small intestine. The inflammatory process leads to malabsorption of nutrients from food. The key reason for these events is a genetic defect that forms an increased sensitivity of the intestinal epithelium to the cereal protein – gluten. It is found in barley, wheat and rye grains. The basis of gluten is gliadin, a compound that has a toxic effect on the mucous membranes, which leads to damage to the intestinal wall and disruption of its functions. Celiac disease is a genetically predisposed disease. When examining the relatives of a patient suffering from celiac disease, almost 15% of close relatives (the first line – parents, children, siblings) have problems with the walls of the small intestine of a similar nature Source:
Belmer S.V. Celiac disease: from pathogenesis to treatment / S.V. Belmer, T.V. Gasilina // Questions of modern pediatrics. – 2013. – V. 12. – No. 3. – S. 12-17. In the body of people suffering from celiac disease, antibodies to gliadin, endomyosin (smooth muscle protein of intestinal cells) and tissue transglutaminase are found. In addition, people with celiac disease often have other autoimmune conditions, including type 1 diabetes, Sjögren’s syndrome, autoimmune thyroiditis, and so on.

Classification

Modern clinical guidelines advise the allocation of the following forms of celiac disease:

• Typical – the disease develops in childhood, from the first year of life, with the introduction of cereal complementary foods. It is characterized by typical manifestations.
• Erased form – occurs at different age periods, it is typically dominated by extraintestinal symptoms. These can be anemia and persistent iron deficiency, osteoporosis, bleeding gums.
• Latent form – typical of the elderly, has virtually no complaints.

In addition, during celiac disease, depending on the activity of the process, several periods are distinguished:

• Latent – there are no complaints and external manifestations, although the inflammatory process in the intestine is present.
• Active – all or some of the typical symptoms of the disease are present.
• The period of incomplete remission – as the treatment progresses, some of the symptoms disappear, only minor complaints remain.
• Period of complete remission – all manifestations disappear.
• Decompensation – newly emerged manifestations of celiac disease after a period of remission.

Diagnostics

Gastroenterologists know how to diagnose celiac disease. They use a whole range of tests, instrumental tests and functional tests to confirm the diagnosis. Displayed:

1. Determination of the titer of specific antibodies to gliadin and tissue transglutaminase. This is the most sensitive and specific test.
2. Endoscopic biopsy. Determines typical for celiac disease changes in the villi of the intestine, the accumulation of lymphocytes.
3. Schilling test or D-xylose test to assess absorption in the small intestine.

Additionally, ultrasound of the abdominal cavity, CT or MRI, contrast x-ray of the intestine are prescribed. Source:
Kamalova A.A. Evolution of approaches to the diagnosis and therapy of celiac disease / A.A. Kamalova, M.O. Pirogov // Bulletin of modern clinical medicine. – 2013. – V.6. – Issue. 3. – S. 40-48 ..

Treatment of celiac disease

The basis of therapy is the complete exclusion of gluten from the diet. The doctor helps at first to determine the list of what not to eat. Wheat or rye flour, barley can be found in the most unusual products, including dairy desserts and vegetable dressings.

Any bakery products with wheat, barley, rye or multigrain flour are prohibited. Also, traditional pasta, semolina, cereals from gluten cereals are not allowed.

It is important to read the labels of sausages, sausages, preserves, desserts and sauces. Traces of gluten can be found in instant coffee, cocoa, soy products, bagged soups. Prohibited vodka, beer, whiskey, kvass Source:
Diet for celiac disease. Nurtazina I.K. Bulletin of Surgery of Kazakhstan No. 4, 2011. p.120.

There are a number of gluten-free products available in stores today to choose from for patients with celiac disease. Ordinary flour can be replaced with buckwheat, rice, oatmeal, corn. These cereals do not contain gluten.

The diet must be followed for at least six months, during which time the condition returns to normal. Additionally, you need to take supplements with vitamins, minerals, some components. Source:
Mikhalik D.S. Celiac disease: disease and lifestyle / D.S. Mikhalik [and others] // Zemsky doctor. – 2012. – No. 4. – S. 35-38 ..

If necessary, the doctor also recommends medicines that suppress intestinal inflammation.

• Bai J. WGO-OMGE / J. Bai, E. Zeballos, M. Fried [et al.] // Practice Guideline Celiac Disease. – 2005. – Vol. 10. – P. 1-8.
• Belmer S.V. Celiac disease: from pathogenesis to treatment / S.V. Belmer, T.V. Gasilina // Questions of modern pediatrics. – 2013. – T. 12. – No. 3. – S. 12-17.
• Kamalova A.A. Evolution of approaches to the diagnosis and therapy of celiac disease / A.A. Kamalova, M.O. Pirogov // Bulletin of modern clinical medicine. – 2013. – V.6. – Issue. 3. – S. 40-48.
• Michalik D.S. Celiac disease: disease and lifestyle / D.S. Mikhalik [and others] // Zemsky doctor. – 2012. – No. 4. – S. 35-38.
• Roslavtseva E.A. Celiac disease: unresolved problems of pathogenesis, diagnosis and treatment / E.A. Roslavtseva [et al.] // Questions of modern pediatrics. – 2005. – V. 4. – No. 6. – S. 48-57.
• Celiac disease in the elderly. Sabelnikova E.A., Krums L.M., Vorobieva N.N., Gudkova R.B. Experimental and clinical gastroenterology №12, 2010. p.48-53
• Surgical aspects of celiac disease. Shakirova A.R., Kamalova A.A., Yafyasov R.Ya., Nizamova R.A. Russian Bulletin of Perinatology and Pediatrics, 2018. p.188-191
• Diet for celiac disease. Nurtazina I.K. Bulletin of Surgery of Kazakhstan No.