Suffering from gluten allergy?
Gluten is a protein found in wheat, rye, and barley. It is responsible for the elastic texture of dough. It is what gives bread its chewy texture and pastry its flaky texture. When baking, gluten allows the bread to rise and keeps its shape.
There are two types of gluten: soluble and insoluble. Soluble gluten dissolves in water, while insoluble gluten does not. Both types of gluten are present in wheat, rye, and barley. Gluten contains two proteins: gliadin and glutenin. Gliadin is the protein that gives bread its chewy texture, while glutenin is responsible for the elastic texture of dough.
Many individuals nowadays opt for gluten-free foods as a part of their daily diet. Though some might do it strictly because of personal and dietary preferences, there are many people whose bodies cannot properly handle and digest gluten. This type of gluten intolerance is called celiac disease or celiac sprue.
Earlier this month in May, a company voluntarily recalled four lots of their sugar control capsules due to undeclared gluten. The discovery of gluten in the pills occurred during routine inspection and testing. The contaminated tablets were distributed nationwide and to the international destinations of the UK, Spain, Kenya, Trinidad, and the United Arab Emirates.
So far, there have been no reports of illnesses or adverse reactions in connection with these tarnished products.
Celiac disease is a severe autoimmune disorder where the ingestion of gluten leads to damage in the small intestine, essentially gluten intolerance. When people with celiac disease eat gluten, their body mounts an immune response that attacks the small intestine. These attacks damage the villi, which are tiny fingerlike projections that line the small intestine. Villi absorb nutrients from food, so when they are damaged, it results in nutrient malabsorption.
Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy. Celiac sprue affects children and adults alike. It is estimated to affect 1 in 100 people worldwide. Celiac sprue is hereditary, meaning it runs in families. However, only about 10% of individuals with celiac disease have a first-degree relative with the condition. Celiac disease is four times more common in women than in men.
There are a good deal of gluten allergy symptoms, and they vary from person to person. The most common symptoms are diarrhea, abdominal pain and bloating, fatigue, weight loss, and malnutrition. Celiac disease can also cause anemia, bone and joint pain, anxiety and depression, skin rashes, and migraines.
There are four types of celiac disease:
- Type 1 is the most common type, characterized by damage to the villi in the small intestine. This type of celiac disease is also known as classic celiac disease or symptomatic celiac disease.
- Type 2 is less common than type 1, characterized by Marsh 3 lesions. Marsh 3 lesions are areas of inflammation and damage in the small intestine that do not involve the villi. This type of celiac disease is also known as atypical celiac disease or silent celiac disease.
- Type 3 is non-celiac gluten sensitivity (NCGS), characterized by symptoms similar to celiac disease, but there is no damage to the small intestine.
- Type 4 is also known as latent celiac disease, characterized by a positive celiac disease antibody test but no symptoms or damage to the small intestine.
- Non-responsive celiac sprue: Characterized by persistent symptoms despite a gluten-free diet.
- Refractory celiac disease: Characterized by persistent symptoms and damage to the small intestine despite a gluten-free diet. This type of celiac disease is also known as refractory sprue, refractory celiac disease Type II, or celiac disease unresponsive to a gluten-free diet.
There are many risk factors for celiac disease, and they vary from person to person.
- Genetics: Celiac sprue is a hereditary condition, meaning it runs in families. If a person has a first-degree relative with celiac disease (parent, child, sibling), they are at an increased risk of developing the condition.
- Autoimmune Disorders: Celiac sprue is more common in people with certain autoimmune disorders, such as thyroid disease, type 1 diabetes, and rheumatoid arthritis.
- Female Gender: Celiac sprue is more common in women than in men. Pregnancy and childbirth are also risk factors for celiac disease.
- Age: Celiac sprue can develop at any age, but it is most common in adults over 50.
Symptoms and Diagnosis of Celiac Disease
The symptoms of this disease can vary from person to person, and they range from mild to severe. The most common symptoms are diarrhea, abdominal pain and bloating, fatigue, weight loss, and malnutrition. It can also cause anemia, bone and joint pain, anxiety and depression, skin rashes, and migraines. Symptoms of celiac sprue usually develop within a few weeks to a few months after exposure to gluten. However, in some cases, the symptoms may not develop for years.
Gluten allergy may also cause dermatitis herpetiformis. Dermatitis herpetiformis is a chronic, relapsing, autoimmune skin disease characterized by groups of burning, itchy blisters. The blisters typically appear on the elbows, knees, buttocks, and back. Dermatitis herpetiformis is also known as Duhring’s disease and gluten rash.
There is no single test to diagnose celiac sprue. The diagnosis of celiac sprue is made by symptoms, a family history of the condition, and blood tests. If an individual thinks they might have this disease, the first step is to see their doctor. The doctor will likely ask about the person’s medical history and family history. They will also perform a physical exam. There are two diagnostic tests for this disease: serologic tests and intestinal biopsy. Serologic tests test for the presence of antibodies in the blood that is associated with celiac sprue. An intestinal biopsy involves taking a small sample of tissue from the small intestine lining to look for damage to the villi.
The doctor may also order some blood tests. These blood tests can help rule out other conditions with similar symptoms, such as Crohn’s disease, irritable bowel syndrome (IBS), and lactose intolerance. Blood tests for celiac sprue look for antibodies in the blood produced in response to gluten. There are several different celiac disease antibodies, and the most common are tTG-IgA and EMA-IgA.
If the blood tests come back positive for celiac sprue antibodies, the doctor will likely order a biopsy of the small intestine. During a small intestine biopsy, a sample of tissue is taken from the small intestine and examined under a microscope. This procedure is the only way to confirm a diagnosis.
If a person has celiac disease, the villi in their small intestine will be damaged.
Treating and Preventing Celiac Disease
There is no cure for celiac disease, but the condition can be managed by following a gluten-free diet and eating gluten-free foods.
A gluten-free diet is the only treatment for celiac sprue. It is important to note that a gluten-free diet is different from a low-gluten or wheat-free diet. A gluten-free diet may still contain some gluten, whereas a gluten-free diet contains no gluten.
The gluten-free diet may be challenging, but many resources are available to help. There are now many food products labeled “gluten-free,” and there are also restaurants that cater to people with celiac disease.
It is important to note that a gluten-free diet must be followed strictly, as even a tiny amount of gluten can trigger symptoms and cause damage to the intestines. For this reason, it is important to read food labels and choose gluten-free foods carefully to avoid cross-contamination.
If a person has celiac sprue, it may also be good to get screened for other autoimmune conditions, such as thyroid disease, type 1 diabetes, and rheumatoid arthritis, because people with celiac sprue are at an increased risk of developing these conditions.
Celiac Disease Complications
Left untreated, celiac sprue can lead to several serious complications. These complications include malnutrition, anemia, osteoporosis, infertility, and nerve damage. Celiac sprue can also increase the risk of certain cancers, such as lymphoma and gastrointestinal cancers.
- Malnutrition: It can cause malnutrition because the damage to the intestines makes it difficult for the body to absorb nutrients from food. This malnutrition can lead to weight loss, fatigue, and several other symptoms.
- Anemia: It can also cause anemia, a condition in which the blood does not have enough healthy red blood cells. Red blood cells are responsible for carrying oxygen to the body’s tissues. Anemia can cause fatigue, shortness of breath, and other symptoms.
- Lactose intolerance: This disease can also lead to lactose intolerance, which is a condition in which the body cannot digest lactose. Lactose is a sugar found in milk and other dairy products. People with lactose intolerance may experience bloating, gas, and diarrhea after eating or drinking dairy products.
- Osteoporosis: It can also lead to osteoporosis, a condition in which the bones become weak. Osteoporosis can increase the risk of fractures.
- Infertility: Celiac sprue can also cause infertility in both men and women. In women, celiac disease can cause amenorrhea, which is the absence of menstruation. Celiac sprue can also cause problems with the production of eggs in women and low sperm count in men.
- Nerve damage: It can lead to nerve damage, which can cause numbness, tingling, and muscle weakness.
- Cancers: Celiac sprue has also been linked to an increased risk of certain cancers, such as lymphoma and gastrointestinal cancers. Lymphoma is a type of cancer that affects the lymphatic system, and gastrointestinal cancers are cancers that affect the digestive system.
- Death: Celiac sprue can also be fatal if left untreated.