Coeliac Disease (or celiac) disease is a disease of small intestines. This is a disease of the immune system that affects the absorption of essential nutrients from the small intestines. The small intestines abnormally react to gluten (a certain type of proteins) and produce the symptoms. Gluten is a protein that may potentially lead to problems such as Coeliac disease, dermatitis, autism, IBS, eczema, etc.
It is a disorder of small intestine in which a person has an immune reaction to eating Gluten. The delicate linings of the small intestines get damaged in response to the reaction of gluten, which leads to the symptoms.
Gluten is a protein found mainly in wheat, barley, oat, and rye. Gluten is found in any food prepared from such cereals, including pasta, cakes, cereals, most types of bread, biscuits and certain types of sauces. It may be noted that wheat allergy and Coeliac disease (due to gluten hypersensitive) are two different conditions.
Most beers, which are made from barley, so they contain gluten.
Since the linings of the small intestines get damages in response to gluten allergy, the inflamed intestines produce symptoms such as diarrhea, bloating of the abdomen. Also, there is lack of absorption of essential components such as vitamins, minerals, which leads to loss of weight, lethargic feeling, and other related symptoms.
Some babies may show skin rash due to gluten sensitivity. Many times, some patients may not have any symptoms. The symptoms may disappear once patient omits gluten in the diet, by following gluten-free diet. Infants Soon after introducing solid food containing gluten, the baby may fail to grow or gain weight. As food is not absorbed properly, the stools may be pale, bulky and offensive smell.
The abdomen may be swollen and the baby may have repeated vomiting. The symptoms of coeliac disease in children may be similar to those in infants. In addition, poor absorption of vitamins, minerals, and other nutrients results in anemia and poor growth in children.
Anemia (low hemoglobin) in spite of eating well should make a doctor think of Coeliac disease. Adults: The signs and symptoms of coeliac disease in adults vary from person to person. Generally, the most common symptoms observed are diarrhea and weight loss. However, some people diagnosed with coeliac disease may have constipation and are found to be obese.
Patients may present with symptoms of indigestion, bloating of abdomen, mild abdominal pain and loss of appetite. In addition to these digestive symptoms, other symptoms include Anemia, headache, fatigue, itchy blisters on the skin (often called as dermatitis herpetiformis), numbness and tingling in feet and hands, osteoporosis, osteomalacia, damage to dental enamel, joint pain and acid reflux or heartburn.
Causes of Coeliac disease
Coeliac disease is an auto-immune disorder, where the immune system mistakes one of the substances that make up gluten, called gliadin as a threat to the body; and starts fighting against it. In this process, the body produces antibodies against the gluten and the small intestines get inflamed on the surface.
The surface of the intestine is usually covered with millions of tiny tube-shaped growths called villi. Villi increase the surface area of the gut and help it to digest food more effectively. However, in coeliac disease, the damage and inflammation to the lining of the small intestine flatten the villi, which reduces their ability to help with digestion.
One has to have a genetic predisposition to get affected by the Coeliac disease. It often runs in families. Some of the genes found to be associated with the coeliac disease are HLA DQ2 and HLA DQ8. Either one or both of these genes are present in every person with the coeliac disease.
But merely having these gene mutations doesn’t mean you’ll get the coeliac disease, other factors must be involved. Sometimes the coeliac disease is triggered or becomes active for the first time after surgery, pregnancy, childbirth, viral infection or severe emotional stress.
Some environmental factors like the previous infection of the digestive tract or improper diet also play a role in triggering coeliac disease in infancy, childhood or adults. People with auto-immune disorders like diabetes type-1, ulcerative colitis, rheumatoid arthritis, thyroid disorders or some neurological disorder like epilepsy are at a higher risk of getting the coeliac disease.
There are several serology (blood) tests available that screen coeliac disease antibodies. The most commonly used test is called tTG-IgA. If the test result is positive, then a biopsy of the small intestine is carried out. If the biopsy report shows underlying damage to the surface of the intestine, the diagnosis gets confirmed.
It is very important to include gluten-containing products in the diet at least for 6 weeks before undergoing these tests. The tests may show negative if you are on a gluten-free diet. If blood and biopsy results seem unclear to diagnose coeliac disease, the gene (HLA) testing can be useful.
People affected by the coeliac disease have HLA DQ2, HLA DQ8, or parts of these genes. But only 1 in 30 people having these genes will develop coeliac disease. This test is helpful in people who have already commenced gluten-free diet, as the gene test is not dependent on gluten intake. People who are gluten sensitive experience symptoms similar to the coeliac disease, but will not have intestinal damage and will test negative for coeliac disease antibodies.