Definition
Celiac disease is a medical condition in which the absorptive surface of the small intestine is damaged by a substance called gluten. This results in an inability of the body to absorb nutrients: protein, fat, carbohydrates, vitamins and minerals, which are necessary for good health.
Although statistics are not readily available, it is estimated that 1 in 133 persons in Canada are affected by celiac disease.
A wide range of symptoms may be present. Symptoms may appear together or singularly in children or adults. In general, the symptoms of untreated celiac disease indicate the presence of malabsorption due to the damaged small intestine.
Gluten is a protein found in wheat, rye, triticale, barley. In the case of wheat, gliadin has been isolated as the toxic fraction. It is the gluten in the flour that helps bread and other baked goods bind and prevents crumbling. This feature has made gluten widely used in the production of many processed and packaged foods.
At present there is no cure, but celiac disease is readily treated by following the gluten-free diet.
Recent studies have shown that pure uncontaminated oats may be used in the gluten-free diet with care.
Symptoms
Common symptoms are anemia, chronic diarrhea, weight loss, fatigue, cramps and bloating, irritability.
Although some or all of these symptoms occur in celiac disease, some can also occur in many other diseases more common than celiac disease.
In other cases, sufferers from gluten-intolerance develop an intense burning and itching rash called dermatitis herpetiformis. The intestinal symptoms of celiac disease may or may not appear in dermatitis herpetiformis.
Diagnosis
a) Screening
Until recently physicians had to rely on clinical signs to suggest the diagnosis and to select which patients should have further investigation to prove the diagnosis. Since these signs may be vague or of varying severity this may be difficult. Now simple blood screening tests are becoming available to help this process.
b) Biopsy
A definitive diagnosis can only be made by a small bowel biopsy. The biopsy is performed by a specialist in the gastrointestinal field. The biopsy must be done before treatment is started.
Treatment
Celiac disease as yet has no known cure, but can usually be effectively treated and controlled. The treatment of celiac disease is strict adherence to a GLUTEN FREE DIET FOR LIFE. This requires knowledgeable dietetic counselling and frequent “up-dates” as commercial food contents change.
Celiacs must be alert to hidden sources of gluten such as HVP/HPP (hydrolyzed vegetable/plant protein); malt; spelt; kamut; and certain drug products.
Today’s processed and packaged foods have many hidden sources of gluten which can be unintentionally ingested. Particular care should be taken in the selection of soups, luncheon meats and sausages.
The person with celiac disease MUST READ THE LIST OF INGREDIENTS ON ALL LABELS, EVERY TIME.
There is a great variation in sensitivity to gluten among those with celiac disease, and although one may have no obvious symptoms, damage to the intestinal lining may still occur.
From The Canadian Celiac Association 2011
