Celiac disease is a gluten-sensitive intestinal disease that affects people of all ages. Factors such as the introduction of gluten at childhood, infectious agents, as well as genetics contribute to the development of celiac disease.
A life-long, strict adherence to gluten-free diet is the only efficient and safe treatment and brings about a considerable impact on daily living. Around two to five percent of patients with this disorder fail to improve upon elimination of dietary gluten. Nevertheless, a diet that is free in gluten is still the recommended treatment despite the presence of other alternative therapies such as alteration of dietary components, enzymatic breakdown of gluten, suppression of intestinal permeability, and modulation of the immune response.
Celiac disease is the most prevalent type of food intolerance in the Western population. It is an ancient disease which was first described in the 1st and 2nd century AD. During the latter parts of the 19th century, Samuel Gee described common symptoms of celiac disease in children, including chronic diarrhea, failure to thrive, and irritability, among others. Since then, the understanding of the disease has undergone huge developments and a treatment in the form of a diet was suggested.
Celiac disease is a chronic autoimmune and intestinal disease that is associated with a protein called gluten. This protein triggers the body’s immune system to produce an allergic reaction. The allergic response occurs because the body considers gluten as a foreign substance and supports an immune reaction with certain antibodies. The antibodies attack the fingerlike villi lining the small intestine, which causes inflammation in the digestive tract. Because an inflamed intestine fails to absorb nutrients efficiently, anemia, vitamin and mineral deficiencies, osteoporosis, and other neurological problems occur.
Gluten is found in wheat, barley, rye, and other related food products. A gluten-free diet is enough to treat the majority of patients with celiac disease. Usually, clinical improvement becomes evident after a few weeks.
As mentioned earlier, the only available treatment for celiac disease at present is the dietary exclusion of food items that contain gluten, such as wheat, barley, and rye. Eliminating dietary gluten usually leads to fast healing of the damaged mucosa of the small intestine and improvement in the absorption of nutrients. Supportive nutrition in case of iron, calcium and vitamin deficiencies also helps improve the condition. A strict, life-long gluten-free diet is often a well-tolerated treatment that improves overall health and quality of life of the majority of patients with suffering from the condition.
This therapy, however, is difficult to manage and sustain as a result of the small amounts of gluten contamination in many food products, high costs, and minimal availability of gluten-free food alternatives. Because of this, medical experts have become more and more interested in therapeutic alternatives for use in patients with celiac disease. Implementation of these alternatives is extremely difficult because their potential adverse effects will always be hard to accept as an alternative to a safe gluten-free diet.
A dietician can help patients in terms of eating, diet, and nutrition. A licensed nutritionist can assist patients in selecting gluten-free food products by checking food labels. In general, however, celiac disease sufferers can eat the following gluten-free food items: cassava, corn, Indian rice grass, legumes, millet, nuts, potatoes, rice, sago, seeds, soy, tapioca, and wild rice. Anything that contains wheat, barley, and rye, on the other hand, must be avoided.
It was stated earlier that a small percentage (two to five percent) of patients with this condition, especially those diagnosed above the age of 50, does not respond well to a gluten-free diet. These individuals are usually observed as suffering from a condition known as refractory celiac disease (RCD). The major complication associated with refractory celiac disease is the development of enteropathy-associated T-cell lymphoma (EATL), which is the number one cause of death in this patient group. It is therefore very important to identify the presence of disease early so that early intervention can be done and complications can be prevented.
The long-term consequences of celiac disease are still subject to debate, particularly since the identification of its broad clinical spectrum. The non-adherence to a gluten-free diet and large number undiagnosed sufferers are of greatest concern, since these factors could possibly contribute to serious complications, particularly the development of malignancies. It is of utmost importance for patients to follow the prescribed diet. Celiac disease is not something to be taken lightly because it is one of those diseases that produce hundreds of uncomfortable symptoms if not managed properly.