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Celiac Disease: Symptoms, Causes, Risk Factors, Diagnosis And Treatment

Celiac disease (CD) is a genetic [1] autoimmune disorder [2] in which the small intestine is damaged due to an immune response to gluten-based foods. In simple terms, it is a chronic digestive disorder in which if celiac- suffering individuals consume gluten-based foods like wheat, rye, and barley, they experience an immune response that leads to the inflammation of the small intestine and causes interference in the absorption of the nutrients [3] . To mention, gluten is a kind of protein that holds the food together and maintain their shape [4] .

This gluten-intolerant disease happens to 1 out of 10 people due to family history. However, it can develop at any age due to high consumption of gluten-based foods and medicines.

Symptoms Of Celiac Disease

The symptoms of CD vary from person to person and ranges from mild to severe. The symptoms are similar to other diseases and that's why it is difficult to diagnose it among others. However, the common symptoms of CD are as follows [5] :

  • Gastro issues like diarrhoea, bloating or constipation
  • Anxiety, depression, migraines or headaches.
  • Anaemia
  • Infertility [6]
  • Fatigue
  • Joint pain or thin bones
  • Discoloured teeth and mouth sores
  • Weight loss
  • Itchy skin rash or red patches on the skin
  • Persistent hunger
  • Nerve damage causing numbness or tingling [7]

Ayurvedic Treatment For Celiac Disease

Causes Of Celiac Disease

As aforementioned, CD is a genetic disorder in which the immune response to gluten foods destroys the lining of the small intestine [1] . However, there are other causes of the disease like gastrointestinal infections and infant-feeding practices. In some cases, the disease occurs late in an individual's life, mainly after surgery, pregnancy, childbirth, emotional stress and other infections.

Usually, CD takes place when the body immune system overreacts to gluten present in the food, and in the process, damages the villi (hair-like projections surrounding the small intestine), the lining of the small intestine that absorb the essential nutrients from the food [5] .

In CD, when villi are damaged, nutrients do not get absorbed by the body properly leading a person to malnutrition and other health issues like thyroid problems, cancer, and infertility, along with restriction in the growth and development of a person.

Risk Factors Of Celiac Disease

Several factors tend to increase the risk of this autoimmune gastrointestinal disorder. The risk factors of CD are as follows:

  • Family history or genetic [1]
  • Dermatitis herpetiformis, a chronic autoimmune disease identified by blisters on the skin [8] .
  • Autoimmune thyroid disorder [2]
  • Addison's disease, damage to the adrenal gland

Microscopic colitis, inflammation of the colon

Type 1 diabetes [9]

  • Turner syndrome, a chromosonal disorder in females.
  • Complications Of Celiac Disease

    If remain untreated for a longer period, CD can cause severe complications. They are as follows:

    • Malabsorption of vitamin D and calcium can lead to bone diseases like osteoporosis and rickets [10] .
    • Damage to the small intestine may develop lactose intolerance, inability to digest milk-based products.
    • As essential nutrients will not be absorbed by the small intestine, it can lead a person to malnutrition, anaemia, and weight loss.
    • It can also lead a problem to infertility due to malabsorption of vitamin D [6] .
    • Peripheral neuropathy or nervous system issues
    • The absence of essential nutrients in the body can also cause cancer.
    • Irritable bowel syndrome
    • Refractory celiac disease, a condition in which the small intestine do not heal even after shifting to a gluten-free diet [11] .

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    Diagnosis Of Celiac Disease

    Several tests help to diagnose CD and rule other similar symptoms. Firstly, it is carried out by two blood tests which are as follows:

    • Genetic testing: To detect the gene related to the CD
    • Serology testing: To check for elevated levels of antibodies that cause an immune reaction to gluten-based foods [12]

    If the above two testings are done, people usually shift to a gluten-free diet which later makes the blood tests normal. However, a few other tests are mandatory following up to the blood test. The tests are as follows:

    • Endoscopy: A test in which a long tube with an added tiny camera is inserted via mouth down to the throat to view small intestine and identify and damage to the villi [13] .
    • Capsule endoscopy: A test in which a tiny wireless camera in the form of a capsule is swallowed by the CD patient so that doctor can get a proper view of their small intestine.

    Treatment Of Celiac Disease

    As suggested by medical experts, the best way to treat CD is total prevention of gluten-based foods as there's no treatment for the disease yet, except for avoiding gluten [4] . Once a person leaves eating gluten foods, their small intestine automatically starts recovering and is healed within 6-12 months. Thus, a proper dietician is recommended the best for treating CD.

    In the case of refractory celiac disease, the doctor may suggest steroid to control inflammation and ease other symptoms of CD while the small intestine heals [11] . Also, drugs like azathioprine and budesonide are used to control intestinal inflammation.

    If a CD suffering individual gets skin rash (dermatitis herpetiformis), it is treated by a drug called dapsone [8] .

    Foods To Avoid

    A gluten-free diet is the best for people with CD disease. They should avoid the below-mentioned foods for a life long prevention. The foods are as follows [14] :

    • Foods that include wheat, rye, flour, barley, cereals, crackers, and cookies
    • Soy sauce
    • Beer or grain-based alcohol
    • Ice cream
    • Canned meat and sausages
    • Semolina
    • Pasta
    • Bread
    • Canned soups
    • Bulgar

    Also avoid over-the-counter drugs, vitamin products, few cosmetics as they are more likely to contain gluten.

    Food To Eat

    Foods that are safe for individuals with CD are as follows:

    • Cereals like corn and millet [15]
    • Rice
    • Potatoes
    • Bananas
    • Garbanzo beans
    • Fish and seafood
    • Beans and legumes
    • Chai
    • Quinoa
    View Article References
    1. [1] Dieli-Crimi, R., Cénit, M. C., & Nunez, C. (2015). The genetics of celiac disease: A comprehensive review of clinical implications. Journal of autoimmunity, 64, 26-41.
    2. [2] Bibbò, S., Pes, G. M., Usai-Satta, P., Salis, R., Soro, S., Quarta Colosso, B. M., & Dore, M. P. (2017). Chronic autoimmune disorders are increased in coeliac disease: A case-control study. Medicine, 96(47), e8562. doi:10.1097/MD.0000000000008562
    3. [3] Gujral, N., Freeman, H. J., & Thomson, A. B. (2012). Celiac disease: prevalence, diagnosis, pathogenesis and treatment. World journal of gastroenterology, 18(42), 6036–6059. doi:10.3748/wjg.v18.i42.6036
    4. [4] Niland, B., & Cash, B. D. (2018). Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients. Gastroenterology & hepatology, 14(2), 82–91.
    5. [5] Parzanese, I., Qehajaj, D., Patrinicola, F., Aralica, M., Chiriva-Internati, M., Stifter, S., … Grizzi, F. (2017). Celiac disease: From pathophysiology to treatment. World journal of gastrointestinal pathophysiology, 8(2), 27–38. doi:10.4291/wjgp.v8.i2.27
    6. [6] Freeman H. J. (2010). Reproductive changes associated with celiac disease. World journal of gastroenterology, 16(46), 5810–5814. doi:10.3748/wjg.v16.i46.5810
    7. [7] Nikpour S. (2012). Neurological manifestations, diagnosis, and treatment of celiac disease: A comprehensive review. Iranian journal of neurology, 11(2), 59–64.
    8. [8] Clarindo, M. V., Possebon, A. T., Soligo, E. M., Uyeda, H., Ruaro, R. T., & Empinotti, J. C. (2014). Dermatitis herpetiformis: pathophysiology, clinical presentation, diagnosis and treatment. Anais brasileiros de dermatologia, 89(6), 865–877. doi:10.1590/abd1806-4841.20142966
    9. [9] Cohn, A., Sofia, A. M., & Kupfer, S. S. (2014). Type 1 diabetes and celiac disease: clinical overlap and new insights into disease pathogenesis. Current diabetes reports, 14(8), 517. doi:10.1007/s11892-014-0517-x
    10. [10] Stazi, A. V., Trecca, A., & Trinti, B. (2008). Osteoporosis in celiac disease and in endocrine and reproductive disorders. World journal of gastroenterology, 14(4), 498–505. doi:10.3748/wjg.14.498
    11. [11] Rubio-Tapia, A., & Murray, J. A. (2010). Classification and management of refractory coeliac disease. Gut, 59(4), 547–557. doi:10.1136/gut.2009.195131
    12. [12] Rashid, M., & Lee, J. (2016). Serologic testing in celiac disease: Practical guide for clinicians. Canadian family physician Medecin de famille canadien, 62(1), 38–43.
    13. [13] Luján-Sanchis, M., Pérez-Cuadrado-Robles, E., García-Lledó, J., Juanmartiñena Fernández, J. F., Elli, L., Jiménez-García, V. A., … Sempere-García-Argüelles, J. (2017). Role of capsule endoscopy in suspected celiac disease: A European multi-centre study. World journal of gastroenterology, 23(4), 703–711. doi:10.3748/wjg.v23.i4.703
    14. [14] Itzlinger, A., Branchi, F., Elli, L., & Schumann, M. (2018). Gluten-Free Diet in Celiac Disease-Forever and for All?. Nutrients, 10(11), 1796. doi:10.3390/nu10111796
    15. [15] Valitutti, F., Iorfida, D., Anania, C., Trovato, C. M., Montuori, M., Cucchiara, S., & Catassi, C. (2017). Cereal Consumption among Subjects with Celiac Disease: A Snapshot for Nutritional Considerations. Nutrients, 9(4), 396. doi:10.3390/nu9040396

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