Wheat Allergy – Symptoms of Celiac Disease and Foods That Help Treat Gluten Intolerance
Six to eight million people in India suffer from Celiac disease, as per All India Institute of Medical Sciences (AIIMS). Recent studies suggest that 1 in 100 people in the northern part of India suffer from this condition. Looking at the fact that this disease is not uncommon, it becomes important on our part to learn about this disorder.
Celiac disease is an abnormal immune reaction to gluten, a protein found in foods such as wheat, barley, and rye. This protein can also found in a variety of other things including some medicines, vitamins and even lipsticks. Celiac disease is also known as with the terms sprue, coeliac and gluten-sensitive enteropathy.
What causes celiac disease?
Celiac disease is an immune disorder that occurs from interaction of between genes, environmental factors, and foods with gluten. In some cases, celiac disease can be triggered or made active for the first time such as after childbirth, surgery, viral infection or stress.
When the immune system of the body overreacts to the gluten present in food, this reaction damages the small finger-like protrusion known as villi. The job of villi is to absorb vitamins, minerals and other essential nutrients from the food. If this part of the digestive system gets damaged, it would be difficult to get enough nutrients irrespective of how much a person eats.
Is celiac disease different from gluten intolerance?
It is often a controversial topic and without proper diagnosis, one may not be able to tell the difference. Gluten intolerance or gluten sensitivity is the body’s inability to digest or break down gluten protein. Celiac disease is an autoimmune response to gluten which affects the lining of the small intestine. This means gluten doesn’t cause the damage itself directly.
People with gluten intolerance will experience mild sensitivity while some others would have celiac disease. On the flipside, not all the physicians agree that gluten intolerance exists, they consider both the condition as same. And there are conflicting studies on the same topic. This is also because both the condition shares nearly identical symptoms.
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Risk factors – Who gets celiac disease?
Though celiac disease can affect anyone, it is common in people who are suffering from below conditions:
- Family history
- Autoimmune thyroid disease
- Rheumatoid arthritis
- Type 1 diabetes
- Down syndrome
- Turner syndrome
- Addison's disease
- Microscopic colitis
Do you have celiac disease? Check for these symptoms
Symptoms vary from person to person and involve a lot of factors. Some may not have any symptoms; this is known as silent celiac disease. People with celiac disease usually experience problems with the intestines and the digestive system. However, other body parts can also be affected. Children have different symptoms from that of adults. These are briefly pointed below:
Symptoms of celiac disease in children
Children suffering from celiac disease often feel irritable and tired. They are also shorter in height as compared to their non-celiac peers. Girls may experience delayed puberty. Some other common symptoms are:
- Weight loss
- Poor appetite
- Neurological symptoms such as seizures, lack of muscle coordination and ADHD
- Pale and foul-smelling stools
- Bloating and abdominal pain
Symptoms of celiac disease in adults
Adults can experience diverse signs including various digestive symptoms. These include:
- Acid reflux and heartburn
- Gas and bloating
- Nausea and vomiting
- Anemia occurring from iron deficiency
- Skin disorders
- Loss of bone density or weakness in bones
- Loss of tooth enamel or tooth discoloration
- Headache and fatigue
- Pale sore or ulcer inside the mouth
- Joint pain and stiffness
- Irregular periods
- Symptoms related to the nervous system including tingling sensation in hands and feet, numbness and balancing problems
Another symptom of celiac disease is dermatitis herpetiformis (DH). It is characterized by bumps, blisters and intensely itchy rashes on the skin. The condition may also develop in other parts including elbows, knees, and buttocks. Dermatitis herpetiformis affects about 15-20 percent of people with celiac disease. However, the good part is that people, who develop DH, usually don’t experience digestive symptoms.
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Complications of celiac disease – Don’t leave it untreated
In this condition, the immune system reaction to gluten produces toxins that damage the villi. If celiac disease is left untreated, it can cause:
- Infertility and miscarriage
- Loss of calcium and bone density
- Lactose intolerance
- Intestinal cancer
Diagnosis of celiac disease – Blood tests and biopsy
Mostly, people with celiac disease don’t know they have it. It is estimated that only 20 percent will get a proper diagnosis. The doctor will begin diagnostic process by checking physical symptoms followed by questions on medical history. Then you would be ordered to undergo various tests to confirm the diagnosis. These include:
- Blood tests – People with celiac disease develop high levels of antibodies namely antiendomysium (EMA) and anti-tissue transglutaminase (tTGA). Other blood tests that can be suggested include complete blood count, cholesterol test, liver function tests, serum albumin test and alkaline phosphatase level test.
- Genetic testing – Presence of human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can indicate celiac disease.
- Biopsy – This is considered as the most accurate test for diagnosing celiac disease. For this, the doctor uses endoscopy to extract sample tissue from the intestine.
It’s very important to get tested before going for gluten-free diet as it may alter the test results.
Treatment of celiac disease – Is gluten-free diet the only cure?
Since it’s an immune disorder, no drug can treat celiac disease. The one and only way to treat this condition is to go for strict and lifelong gluten-free diet. This will let the intestinal villi to heal on its own and begin absorbing nutrients. Symptoms will begin improving within days of eliminating gluten from the diet.
The doctor or dietician will tell you how to manage the condition properly. In addition to wheat and barley, there are other foods that contain gluten.
Foods to avoid
Following foods must be avoided:
- Graham flour
Foods to eat
While the list of gluten-based foods is less, you can have following gluten-free foods which are regular staple of many people in India. Also, don’t touch the food unless the label says “gluten-free”.
- Millet (jowar, bajra)
- Healthy fats
- Tapioca (sabudana)
- Flour made from corn, rice, soy, beans and potatoes
- Fresh meat, fish or poultry
- Most dairy products
- Vegetables especially the starchy ones including peas and sweet potatoes
- Rice, beans and lentils
- Soups and stews
- Herbs and spices
There is a possibility of the presence of hidden gluten in over the counter medications, vitamin and mineral supplements, toothpaste and mouthwash, herbal supplements, lipstick product and food preservatives. Talk to your doctor for more information. He may refer you to a dietician who will better guide in diet management.
Once the gluten is removed from the diet, you will start feeling better within a few days. Going gluten-free is not foolproof treatment. Several treatments are currently under research and there are good chances that would be better treatments available in future.
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2. Green P, et al.(2015, May). Celiac disease read more
3. Celiac disease (2016, June). National Institute of Diabetes and Digestive and Kidney Diseases read more
4. What is celiac disease?(n.d.) Celiac Disease Foundation read more
5. Wolfgang Holtmeier and Wolfgang F Caspary (2006, March 1). Celiac disease read more