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Today, in our nutrition and health section, we would like to talk about the symptoms of celiac disease and its diagnosis. It is our way of making a small contribution to the National Day of the Celiac, held every May 27th with the goal of giving visibility and support to people with celiac disease.
Celiac disease, or gluten intolerance, is a chronic intestinal disease, which occurs in individuals who are genetically predisposed (in a high percentage). When these people ingest gluten, it causes a malabsorption of nutrients at the level of the small intestine, or small bowel (it damages the wall of the intestine, and this damage causes that malabsorption).
Gluten is a protein found in the seed of some cereals (wheat, triticales, spelt and their derivatives and hybrids, rye, barley and oats) formed by Gliadin and Glutenine and that gives consistency, elasticity and fluffiness to the flour, breads and doughs of these cereals.
Symptoms and diagnosis
The ingestion of this protein by people intolerant to gluten causes:
- intestinal discomfort, bloating,
- frequent bowel movements,
- iron anemia due to malabsorption of this latter,
- (in children) growth retardation and alteration of character,
- eczema,
- fatigue,
- constipation,
- ..
Diagnosis can be made through several tests:
- Blood tests looking for markers indicating this intolerance (anti-gliadin antibodies, anti-transglutaminase antibodies and anti-endomysial antibodies).
- Small intestine biopsy (to see the villi).
- Specific genetic tests (HLA-DQ2 or DQ8 genes). If positive, they are an indicator of celiac disease (almost 100%).
Treatment of gluten intolerance
The only way to treat celiac disease without causing any health issue is to avoid the consumption of gluten. Therefore, the consumption of the following foods must be avoided:
- All foods containing wheat, barley, rye and oats, such as bread, pasta, cookies, cakes, cereals, bread crumbs…
- Beer,
- Processed foods that contain gluten (80% of them do): cold meats, sauces, sweets, snacks, ice cream…
It is crucial to read labels carefully to know if a food contains gluten or not. Nowadays, processed foods usually mention if they are gluten-free. Besides, more and more gluten-free products are available. However, they are usually much more expensive. In addition, care must be taken with the consumption of some “gluten-free” products, since they can be unhealthy, processed foods (a gluten-free cookie is not necessarily a healthy cookie).
¿What should you eat if you are gluten intolerant?
Generally speaking, people with gluten intolerance can eat a wide range of natural products such as fruits, vegetables, fish, meat, eggs, legumes… They can also eat gluten-free cereals such as rice, corn, millet, quinoa and buckwheat (even though they are not cereals, they are included in this group), sorghum… dairy and other healthy processed foods such as canned fish. Of course, they should always check the label to make sure they only eat gluten-free dairy and healthy processed products.
Other gluten-related pathologies
In addition to celiac disease, there are other pathologies related to gluten. However, they are different:
- Sensitivity to non-celiac wheat. The symptomatology is very similar to gluten intolerance when ingesting food that contains it, but the reaction is not autoimmune (unlike celiac disease). Therefore, the diagnostic tests of celiac disease tend to be negative, and it is not a wheat allergy. Diagnosis is usually made by exclusion of the aforementioned pathologies, and its treatment also consists in removing gluten from the diet. However, some people may tolerate eating small amounts of cereals containing gluten.
- Wheat allergy. In this case, a disproportionate and potentially life-threatening response of the immune system to wheat proteins occurs. In such case, the affected person must avoid wheat (only wheat, other cereals are fine) for life.
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