Modern society pays more and more attention to nutrition. The gluten-free diet has become a popular dietary trend, But for many people, avoiding gluten is not just a fashion trend, but a vital necessity.
Celiac disease: what is this disease?
Celiac disease is a condition that requires the complete abolition of gluten in the diet. The disease seriously affects a person's quality of life by affecting the intestinal mucosa and disrupting the absorption of nutrients. This condition can cause a lack of vitamins and minerals, as well as lead to the development of various complications: anemia, dermatitis, stomatitis, growth retardation in children and infertility in women. According to the World Health Organization, mortality among patients with celiac disease is above average.
What is celiac disease? This is a chronic autoimmune disease in which the immune system reacts to gluten, a protein found in some grains. The pathogenesis of celiac disease is that the reaction to gluten causes inflammation and damage to the lining of the small intestine, leading to a number of health problems. However, many people are unaware of their condition because the symptoms of gluten intolerance may be hidden or similar to those of another disease.
Manifestations of celiac disease
The symptoms of celiac disease occur at any age and differ between children and adults. It is worth remembering that the presence of any of the following signs of gluten intolerance may indicate a disease of the small intestine, but only a doctor can make a final diagnosis. Symptoms of celiac disease, both in children and adults, require additional diagnosis and treatment.
How does gluten intolerance manifest itself in children?
With celiac enteropathy in children, the onset of symptoms is noted 1.5-2 months after the start of complementary foods, especially after the introduction of flour products and multi-cereal cereals. How does gluten intolerance manifest itself?
The most common manifestations of gluten intolerance in childhood include:
- Loss of appetite, until the complete refusal of food.
- Bouts of vomiting.
- Profuse, frothy, greasy and fetid stools.
- Delayed physical development.
- Increased irritability.
- Sleep problems.
- Decreased activity and interest in the outside world.
- Muscle weakness.
Also, one of the pronounced signs is the appearance of a food allergy, for example, to cow's milk proteins, or lactose deficiency. It is accompanied by nausea and vomiting, urticaria, impaired stool.
Celiac disease: symptoms in adults
Symptoms of gluten intolerance in adults, as well as manifestations of celiac disease in adolescents, affect more than just the gastrointestinal tract, which can complicate the diagnosis. They usually experience the following symptoms:
- Pain in the abdomen, often localized in the umbilical region.
- Delay in physical development.
- Infertility
- Apathy, hypotension and other neurological disorders.
In rare cases, T-cell lymphoma of the small intestine develops, which may require an oncologist.
Common manifestations
Some symptoms of celiac disease occur in both children and adults. These include:
- Abdominal pain not associated with surgical pathology.
- Changing the nature of the chair.
- Vomiting up to daily
- Abdominal augmentation
Especial care should be taken if symptoms in patients appear or worsen after infections, such as rotavirus infection or respiratory diseases. With celiac disease, the immune system does not work properly: being activated to fight viruses, it simultaneously harms the mucous membrane of the small intestine.
What causes celiac disease?
In celiac disease, the immune system, instead of fighting external threats, attacks the body's own cells. When eating food containing gluten, the body perceives it as a hostile substance, which causes inflammation and damage to the small intestine, disrupting the absorption of nutrients.
The reasons for the development of gluten intolerance in different people are not fully understood. Genetic predisposition plays an important role: most people with celiac disease have genetic markers (HLA-DQ2 or HLA-DQ8).
There are also a number of conditions and diseases that can contribute to the development of celiac disease:
- Dermatitis herpetiformis.
- Type 1 diabetes mellitus.
- Autoimmune thyroiditis.
- Microscopic colitis (lymphocytic or collagenous).
- Addison's disease.
Celiac disease is often diagnosed in several members of the same family. If one of the next of kin has this pathology, it is recommended to undergo a medical examination. This also applies to individuals with risk factors for celiac disease, including type 1 diabetes.
Diagnosis of celiac disease
In order to identify gluten intolerance, it is necessary to undergo a comprehensive examination. This includes blood tests, biopsies and genetic tests. For an accurate diagnosis of this condition, the patient may need to eat some gluten before the tests, in order for their body to produce antibodies, which doctors will analyze during the study.
- Anti-antibody to tissue transglutaminase Ig can be detected in the blood of 90% of patients with celiac disease.
- Deaminated gliadin peptide IgA and IgG are commonly detected in the patient's blood, especially in children under 2 years of age.
- Endomysial IgA helps clarify the diagnosis of gluten intolerance when other test results are in doubt. This test is highly specific, but may be negative in some patients with celiac disease.
- Total serum IgA eliminates IgA deficiency, which is common in people with celiac disease and can lead to false negative results in other tests.
If testing for celiac disease indicates the presence of the disease, genetic testing may be the next step. Its task is to detect leukocyte antigens (HLA-DQ2, DQ7 and DQ8). Their absence in the blood rules out celiac disease as a possible diagnosis.
If the results of the blood test and genetic testing confirm the presence of celiac disease, the doctor will issue a referral for a biopsy. During the procedure, a small amount of tissue is taken from the small intestine for further histological analysis. In combination with a biopsy, endoscopy is often performed, which allows the doctor to visually examine the inner lining of the small intestine.
Gluten intolerance is usually diagnosed by ruling out celiac disease using the aforementioned test methods. In some cases, an IgE test for gluten allergens is performed. A high level of specific IgE indicates the presence of allergic reactions to gluten.
