Celiac disease, also referred to as nontropical sprue, gluten-sensitive enteropathy, or celiac sprue, is distinguished by symptoms that fluctuates in severity, from very gentle gastrointestinal discomfort to severe malabsorption (i.e. diarrhea, foul-smelling flatulence, bloating of the abdomen, and elevated amount of fat and undigested food particles in the bowels).

celiac disease

It is also distinguished by abnormalities in small intestine structure that go back to normal with elimination of gluten and more particularly its smaller derivative, gliadin, discovered mainly in wheat, barley, and rye grains. Side effects usually appear during the first couple years of life, after foods that contains gluten are brought into the diet. Nevertheless, a second peak occurrence comes during early adulthood. While celiac disease is frequently considered a disease diagnosed early in life, more diagnosis are made in adulthood than childhood.

The predominance of celiac disease has elevated dramatically, and this is not simply due to more detection. Until recently, celiac disease was thought to be relatively rare (it used to be 1 case in 5,000 in the U.S.), but celiac disease is now believed to influence as many as 1% of all Americans, however it remains mostly undiagnosed. Celiac disease, not detected, bears an increased risk of morbidity (disease) and early fatality, so extensive screening may be economically condoned.

Before, the actual diagnosis of celiac disease consisted of taking a small sample of the small intestine. Today there are blood tests that scope specific antibodies to gluten parts. These tests contain endomysial antibodies, anti-gliadin antibodies, and anti-tissue transglutaminase antibodies. In patients who have celiac disease, anti-gliadin antibody is an antibody created against gliadin in the diet, and endomysial and anti-tissue transglutaminase antibodies are antibodies created against the body’s own tissue as adverse side effect of the immune system’s response to gliadin.

Causes of Celiac Disease

It appears that celiac disease has a strong genetic constituent. There is an elevated recurrence of celiac disease in people with distinguishing genetic markers known as HLA-B8 and DRw3 that appear on top of cells, much the same as the genetic markers of blood type. For example, the HLA-B8 marker has been discovered in about 90 percent people with celiac disease, as compared with 25 percent of those who doesn’t have the disease.

There is a low frequency of HLA-B8 inside farming populations, as in Asia, while the frequency in northern in central Europe and the northwest part of the Indian subcontinent is much higher. Wheat farming in these high HLA-B8 areas is a relatively recent development. The predominance of celiac disease is higher in those areas than in other parts of the world. In the U.S., with its various genetic background, the prevalence rate is now 1 in 100. The previous introduction of cow’s milk and cereal grains are the basic precautionary steps that can greatly decrease the risk of developing celiac disease.

Therapeutic considerations

Celiac disease many times leads to the growth of multiple food allergies, lactose intolerance, and increased intestinal absorbance. Changing and improving your diet appears to produce compelling improvement in quality of life in people with celiac disease. Even something as simple as taking a B-complex supplement produces major benefits. In a double-blind study, 60 people with celiac disease who went on a strict gluten-free diet for several years were at random assigned to either a daily dose of 800 microgram folic acid, 500 microgram vitamin B12, and 3 milligram vitamin B6 or a placebo for seven months. Following vitamin supplementation, the levels of homocysteine decreased an average of 35 percent, and this decrease led to serious improvement in feelings of well-being, decreased anxiety, and elevated mood.

Once the diagnosis has been established, a gluten-free diet is pointed out. The diet excludes any wheat, rye, barley, triticale, or oats products. Buckwheat and millet are many times left out as well; even though buckwheat is not in the grass family and millet appears to be more closely associated with rice and corn, buckwheat and millet consist of compounds referred to as prolamins with antigenic activity very much alike that of gliadin.

Many gluten-free products are found in wholefood stores and online catalogs, but it’s crucial to read labels cautiously, because some “wheat free” products add gluten—the origin of gliadin—to improve the quality of baked goods. Grains that can be used in place of gluten-containing grains contain amaranth, quinoa, and assorted types of rice (brown, red, black, and wild). Moreover, recent evidence advises that eliminating gluten-related compounds such as hordeins and secalins may not be essential for many patients. This is also especially true of oats.

Precise studies of celiac disease patients who consumed oats have shown no evidence of immune activation. For example, in one study, 110 children who were just diagnosed with celiac disease were at random assigned to one of two groups: one group was given a typical gluten-free diet (GFD-std) while the other group was given a GFD in addition to wheat-free oat products (GFD-oats). After a year passed, there was no major difference in blood markers for celiac disease between the GFD-oats and GFD-std groups.

One thing to point out, however, is that while oat consumption may not stimulate the disease, it may increase gastrointestinal symptoms. In one study, 40 celiac disease victims were at random assigned to take either 50 gram oats-containing gluten-free products per day or to go on without oats for one year. Those taking oats suffered greatly from diarrhea, but there was a simultaneously trend towards a more extreme average constipation score. The lining of the intestine was not disrupted, but more signs of inflammation and allergy were noticed in the oats group. It appears that oats supply a substitute in the gluten-free diet, but those with celiac disease should be aware of the possible increase in intestinal symptoms. If symptoms appear or become aggravating, oats can be excluded. In the end, it depends on the sensitivity of each individual. While some people with celiac disease can eat rice and oats, others cannot.

Additionally, other food should be exchanged, and milk and milk products should be wiped out from the diet until the patient redevelops an intestinal structure and function returns to normal. For the most part with eliminating gluten, clinical improvement will be apparent within a few days or weeks. Nevertheless, 15 percent of patients respond only after two to three years of gluten avoidance. If a patient does not respond to the gluten-free diet, either he/she was misdiagnosed or there may be some obstacle to a cure such as zinc deficiency. The seriousness of a multivitamin and mineral supplement in celiac disease cannot be stressed enough. In addition to treating any underlying deficiency, supplementation supplies the essential cofactors for growth and repair.

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