Gluten-free living isn’t always a choice – for some, it’s a necessity. Purchasing gluten free waffles and swapping cauliflower for regular pizza crust goes beyond the popular health trend for those suffering from Celiac disease.
An estimated 3 million people suffer from celiac disease in the U.S. alone, with 97% undiagnosed, according to the University of Chicago Medicine. An inherited Immune disorder, celiac disease can develop at any time and averages four years to be diagnosed in patients showing symptoms.
Celiac disease, also known as sprue or coeliac, damages the lining of the small intestine after ingesting gluten. The body’s immune system will over-react to the gluten, causing issues to properly absorb vitamins, minerals, and other nutrients for the body and leading to symptoms and long-term complications. Symptoms triggered by gluten vary from minor day-to-day annoyances to full-fledged health problems, with over 200 possible signs, according to the Celiac Disease Foundation.
Symptoms
Symptoms of Celiac Disease present themselves in various ways, ranging from textbook signs to non-existent. Classical celiac disease demonstrates clear signs of malabsorption, including abdomen pains and weight loss. Non-classical celiac disease symptoms are far more diverse; symptoms range anywhere from mild gastrointestinal issues, to numbness in hands or feet, to dental enamel defects. Finally, silent celiac disease still damages the small intestine without presenting any symptoms in patients, according to Mayo Clinic.
It is important to know the warning signs of Celiac Disease, as the majority of people in the United States go undiagnosed.
Vomiting and Diarrhea
Among the most common symptoms of Celiac disease for children and adults are vomiting and diarrhea, according to the University of Chicago Medicine. However, these two signs alone do not immediately raise concerns for the patient due to the number of issues they accompany. If there are no immediately clear reasons for these symptoms, patients should be tested for Celiac disease.
Gastrointestinal Issues
Bloating, gas, and serious abdominal pain are further common symptoms of Celiac disease in both children and adults, according to Mayo Clinic. For children under the age of two, these issues can be accompanied by a swollen belly. Gastrointestinal issues may appear in both classical and non-classical cases.
Psychiatric Disorders
Less common issues among adults are psychiatric disorders, including anxiety and depression, which often go overlooked. In children, symptoms present themselves as irritability and attention-deficit/hyperactivity disorder (ADHD), according to the Celiac Disease Foundation. Fatigue and headaches can develop from these symptoms as well, furthering the extent of Celiac Disease’s affect on the body.
Bone or Joint Pain
Unrelated to the digestive system, bone issues and joint pain can arise from the malabsorption caused by Celiac Disease, according to the Celiac Disease Foundation. More common in adults, these symptoms can lead to serious issues if the disease remains unchecked.
Dermatitis Herpetiformis
Ten percent of Celiac patients experience dermatitis herpetiformis, an itchy blustery skin rash. The rash usually appears on the elbows, knees, or back, and stems from intestinal gluten intolerance accompanying Celiac Disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD).
Anemia
One of the more common signs of Celiac disease in adults, anemia is caused by the inability of the small intestine to absorb the much-needed iron. The deficiency caused by the disease does not respond to iron therapy, according to the University of Chicago Medicine.
Unexplainable miscarriages
Malabsorption of nutrients can lead to the inability to carry to term, according to the University of Chicago Medicine. Individuals who experience miscarriages or infertility that do not have clear medical reasons should be tested for Celiac disease.
Note there is a distinct difference between Celiac disease and gluten intolerance. While they share similar symptoms, the gluten intolerance, also known as non-celiac gluten sensitivity (NCGS), does not cause damage to the small intestine. Gluten intolerance is still being studied and has not been found to be linked to Celiac disease thus far.
While the exact cause of Celiac disease is still unknown, there are suggested contributing factors and triggers which could lead to activation. Immediate family members of those with Celiac disease are at risk due to a possible genetic predisposition, according to Mayo Clinic.
Environmental changes and nutrition can also lead to development of the disease, including gastrointestinal infections and eating foods containing gluten. Triggers activating Celiac disease may also include major body changes, such as pregnancy, childbirth, or severe emotional distress, according to Mayo Clinic.
Further studies have been made to at-risk patients, and some overlapping disorders have emerged as a result. Although the disease affects people throughout the world, NIDDKD reports that the disorder is more likely to occur in Caucasians and females. Celiac disease affects a reported 12 percent of patients with Down Syndrome and six percent of patients with Type 1 Diabetes, according to the University of Chicago Medicine.
Complications
Unchecked, serious complications can arise from the impacts of Celiac Disease. The malabsorption of nutrients causes long-term health problems in some patients, affecting both adults and children in growth and development.
Malnutrition
When the body is unable to absorb enough nutrients and minerals, weight loss becomes an issue for patients. Other complications can also develop, including iron-deficiency anemia, according to Mayo Clinic. Children are affected heavily by malnutrition, as they may hit puberty late as well as experience slow growth, short stature, or dental enamel defects.
Loss of Calcium
Lack of calcium and vitamin D to the bones can result in accelerated osteoporosis or osteomalacia, also known as bone softening, according to the NIDDKD. Further, the risk of fracturing increases as bones become thinner and more brittle when patients grow older. This inability to absorb calcium can also contribute to reproductive issues such as infertility and miscarriage.
Lactose Intolerance
Damage to the small intestine can cause issues processing lactose products, despite the fact there may be no gluten present, according to Mayo Clinic. Once the lining has healed, patients are able to eat and process dairy again, however extensive damage may not heal, leading to prolonged intolerance. This can also happen if a patient has refractory celiac disease, where nutrients are unable to be absorbed despite careful management of a gluten-free diet.
Cancer
Rare complications can include intestinal cancer and lymphoma, which affects the immune system. This often stems from the inability to stick to a gluten-free diet, thus furthering the damage to the small intestines. While not guaranteed to develop, patients who don’t maintain the proper diet do have a greater risk of developing these cancers.
Neurological problems
Some patients experience neurological problems that develop due to Celiac disease. Common problems include seizures and peripheral neuropathy, which causes tingles and numbness in the hands or feet. In some cases, the lack of Vitamin B, Vitamin B12, and Niacin can lead to the development of dementia later on, according to the Canadian Journal of Gastroenterology.
Rarely, patients will be diagnosed with refractory celiac disease. Despite following strict gluten-free diet plans, damage to the small intestine will persist, as well malabsorption. Patients who remain gluten-free for over six months may have refractory celiac disease, but often dieticians will find over-looked gluten in food or contamination, according to the Mayo Clinic.
Treatment
The only treatment for celiac disease is to follow a strict gluten-free lifestyle. If symptoms persist, patients may be given vitamin supplements and/or steroids to help alleviate symptoms as prescribed by their doctors.
It is important to avoid all gluten, as even trace amounts can be damaging. In addition to wheat, gluten is also present in barley, Farina, Graham flour, malt, rye, semolina, and spelt. Gluten can also be present in vitamin and mineral supplements, food preservatives, and over-the-counter prescriptions, so reading the labels for anything that can be ingested is paramount in managing celiac disease, according to the Celiac Disease Foundation. Gluten can be found in common products such as lipstick, toothpaste, envelope glue, and Play-Doh.
Avoiding cross-contamination with gluten foods is extremely important. Cross contamination can be caused by cooking with uncleaned dishware that contained gluten foods, using toasters, or preparing anything in an area where flour had been used, as those particles remain airborne hours after use.
However, these restrictions do not mean living without pizza or cake.
As of 2005, more than 2,000 gluten-free food items were in circulation among U.S. food stores, demonstrating a rising trend in awareness of gluten products, according to the University of Chicago Medicine. In 2004, the Food Allergen Labeling and Consumer Protection Act was passed, allowing consumers to quickly look at food labels and determine what common allergies and components were used in the product. Now there are more gluten-free products being produced than before, as well as resources available for living a gluten-free life.
Being tested for celiac disease regularly is one of the best ways of catching and managing the disorder, as it can develop at any time in life. Immediate family members should be tested regularly, as well as those with already existing autoimmune disorders and children younger than three who exhibit symptoms. Reducing gluten intake before testing will affect results, so it is important not to change diet patterns before testing for celiac disease.
Please SHARE this with your friends and family.
