Celiac Disease (aka Coeliac Disease)
Celiac disease is not really an allergy, although people do refer to it as a gluten allergy it's actually an auto-immune disorder.
It was first recognised in the 2nd Century AD by the Greeks. The Greeks called it "koiliakos" (aptly meaning "suffering in the bowels") and from which "coeliac" is derived from.
It's also sometimes referred to as celiac sprue (coeliac sprue), although this term is not so widely used as celiac disease.
What is gluten?
Gluten is a protein occurring naturally in wheat, barley, rye and oats (although some debate is held on the gluten levels of oats). When these grains are milled the gluten is released and it's this that gives grain flours their strength and elasticity, something that is noticeably missing from gluten free breads.
What is celiac disease?
People with healthy digestive systems can eat gluten without any problems, the food is broken down in the stomach and passes through the small intestine where projections called villi absorb nutrients. These villi provide a large surface area (20-40 metres squared), which is used for the absorption of the nutrients from the food.
When a celiac eats gluten in foods their intestine thinks it's under attack from a foreign body and creates an immune response to the invader. The lining of the intestine becomes inflamed and the villi flatten. The flattening of the villi means that their surface area is reduced and the nutrients vital to health therefore aren't absorbed, which over time leads to weight loss, wasting and malnutrition.
Celiac disease symptoms:
- Chronic tiredness
- Dermatitis herpetiformis
- Diarrhea (aka diarrhoea)
- Irritable bowel
- Mouth ulcers
- Psychological issues (stress, nerves, depression etc)
- Severe weight loss
The above list of symptoms associated with celiac disease or gluten intolerance is by no means exhaustive, other symptoms may present themselves in different people.
These symptoms can also be indicative of many other medical conditions, and therefore professional medical advice should always be sought when trying to determine a cause.
Is celiac disease common?
It's thought that celiac disease affects 1 in 133 people which means that in the US alone 3 million people have celiac disease. More adults than children have this condition, and many cases go undetected.
How do I know if I'm a celiac?
Diagnosis is done by biopsy, the most successful way to diagnose coeliac disease. Skin, hair, electromagnetic or other non-invasive tests cannot 100% confirm coeliac disease. Blood tests can be used to pinpoint the possibility of celiac disease, but final diagnosis is usually made by biopsy.
In a biopsy the gastroenterologist will remove a small piece of villi from the small intestine. Microscopic examination will confirm whether or not celiac disease is present.
An important thing to remember before undergoing a biopsy is that if you have been avoiding all forms of gluten for any period before the biopsy you may get a false negative result. This is not something that you are usually warned about before the biopsy, so you must tell the gastroenterologist when you last ate gluten in advance of the day you undergo the procedure. If you don't you may get the wrong result.
Once diagnosis is confirmed the person must change to a gluten free diet, and in the short term may be prescribed vitamin and mineral supplements to restock the body's vital reserves to help it return to optimum health now that the food irritant is removed from the diet.
How can I get cured of celiac disease?
Unfortunately there is no cure for celiac disease, people are born with it, and while it may take some time to manifest or be recognised, once diagnosed a gluten free diet must be followed.
Precisely how or why gluten is harmful to the small intestine is not known, but the only cure once celiac disease is diagnosed is to follow a completely gluten free diet for life.
The gluten free diet
Following a gluten free diet is a tough diet to follow. It's not a decision that should be made lightly and something that you should never embark on alone without guidance.
When a person starts on a gluten free diet after diagnosis the results are often dramatic and celiacs usually feel as if an enormous weight has been lifted from their body, especially with the reduction or disappearance of the symptoms they were suffering. In many other people the improvement will be gradual though, and this is because the lining of the small intestine takes time to grow again.
But the important thing to remember is that once a person is professionally diagnosed with celiac disease then they can take control of their body, and their life again, simply by following a gluten free diet.
This page is not to be taken as medical advice:
No information on this page or website should be taken as medical advice. Before starting any food exclusion diet you must consult your General Practitioner and/or Paediatrician together with a registered Dietician.