celiac disease


Celiac disease is a disease caused by an abnormal response by the body's immune system to a substance called gluten found in grains such as wheat, barley, and rye. Generally, after the age of 1, the first symptoms appear with the consumption of gluten-containing foods. Initially, symptoms such as nausea, vomiting, diarrhea, and weakness appear. In the following periods, different symptoms such as anemia and skin rashes are added. Although it is a chronic disease, its treatment is possible, and treatment consists of removing gluten-containing foods from the diet.

What is celiac disease?

Celiac disease is a common disease with an increasing incidence. In most countries around the world, one in every 70 to 200 people has celiac disease. The disease, also called gluten-sensitive enteropathy, occurs for reasons associated with the body's immune system. It is triggered by a misdirected immune response to the protein called gluten found in many grains. Some patients also have an immune response to the enzyme that breaks down gluten. Celiac disease gives symptoms as a result of inflammation in the small intestine. The immune system initiates the inflammatory process by giving an abnormal response to gluten.

The intestinal mucosa normally contains small protrusions in the form of a glove finger, called the villi, which provide nutrient absorption. Villi increase the intestinal absorption surface and facilitate the passage of nutrients into the blood. As a result of the inflammatory process that develops in celiac disease, the body creates antibodies that damage their own tissues. These autoantibodies eliminate these protrusions on the lining of the small intestine and the villi are flattened. No matter how much patients eat when these are damaged, it is not possible to get enough nutrients into the body since there is no full absorption.

Experts continue to investigate whether celiac disease is an allergic or autoimmune disease. According to the latest data, the disease is thought to contain both allergic and autoimmune elements. Allergy is an excessive reaction of the immune system to substances that are actually harmless to the body. This is also the case with celiac disease because the immune system responds to harmless gluten with an excessive immune response. On the other hand, the immune system also creates antibodies against the body's own enzyme, tissue transglutaminase.

Celiac disease causes.

The exact causes that can cause intolerance to gluten are still unknown. But possibly a combination of genetic predisposition and environmental factors triggers celiac disease.

According to recent research findings, partially digested gluten molecules that reach the small intestine wall in susceptible individuals lead to an excessive reaction in the immune system. Genetic factors are the most important factor in the development of the disease. Often, first-degree relatives of celiac patients, such as parents, siblings or children, also suffer from discomfort. The person's diet, gastrointestinal infections, and intestinal bacteria can contribute to the development of the celiac disease.

It is found in cereals such as gluten, wheat, rye, oats, barley and is triggered by consuming all kinds of food made from them. In contrast, rice, corn, soy or potatoes can be easily consumed by patients as they do not contain gluten.

Celiac disease symptoms.

Celiac patients experience some typical symptoms when they eat gluten-containing foods. The most common of these are abdominal pain, bloating and oily diarrhea. These short-term symptoms are followed by chronic complaints. In celiac disease, the mucous membrane in the intestine is damaged by inflammation, and the absorption of all food components is disturbed. As a result, major health problems develop, such as iron deficiency. One of the important symptoms in the long term is weight loss.

Gluten-sensitive enteropathy causes symptoms that are not directly related to gut function, such as skin problems in some patients. In such cases, where the disease progresses with atypical symptoms, the diagnosis is often delayed. Among the typical symptoms of celiac disease are;

Itchy and red skin rashes (Dermatitis herpetiformis)
Symptoms of anemia such as burning or weakness in the tongue (This anemia, which is seen due to iron deficiency, does not respond to iron treatment due to absorption disorder.)
Calcium deficiency due to calcium deficiency, muscle weakness, bone pain
Hemorrhages due to vitamin K deficiency
Night blindness (due to vitamin A deficiency)
Symptoms of depression
Epileptic seizures
Dizziness and balance problems
Imbalance in hormone levels
Joint problems
Aphthae in the mouth
Attention disorder can be counted.
Dermatitis herpetiformis is an itchy and blistering rash skin disease caused by intestinal gluten intolerance. The rash is more common in the elbows, knees, trunk, scalp, and hips. Dermatitis herpetiformis is often associated with bowel changes similar to celiac disease; however, some patients may not have obvious digestive system symptoms. Dermatitis herpetiformis is considered the skin manifestation of celiac disease today.

Symptoms of celiac disease in children

Symptoms of the disease in babies appear when they take the first grain products after starting additional foods. After a few weeks to months, classic symptoms such as nausea, vomiting, diarrhea associated with the digestive system begin to appear. Symptoms of celiac disease in children under 2 years of age;

Chronic diarrhea
Swelling in the abdomen
Developmental retardation
Muscular dystrophy
In children older than 2 years;

Weight loss
Delay in puberty
Neurological symptoms such as attention-deficit / hyperactivity, learning difficulties, headache, lack of muscle coordination and seizures may be seen.
Celiac disease; after surgery, pregnancy, childbirth, viral infection or severe emotional stress, it may give symptoms for the first time or existing symptoms may be triggered.

How is celiac disease diagnosed?

Researchers estimate that only 20 percent of children and adults with celiac disease can be diagnosed. For the diagnosis, a detailed history is taken from the patient and a physical examination is performed first. Your doctor may order different tests to diagnose celiac disease.

Antibodies in the blood are investigated with the serology test. As a result of the test, elevated levels of certain antibody proteins indicate an immune reaction to gluten. Genetic tests for human leukocyte antigens named HLA-DQ2 and HLA-DQ8 can be used to diagnose celiac disease.

If the results of the tests support celiac disease, your doctor will examine your small intestine with a small cannula called an endoscope with a camera on the end. It may also take a small tissue sample (biopsy) to analyze villi damage if needed during the procedure.

These tests need to be done before starting a gluten-free diet to get the correct result. Removing gluten from your diet can change blood test results and the results may be normal.

How is celiac disease treated?

The only option in the treatment of celiac disease is the complete removal of gluten-containing foods from the diet. For this, foods containing gluten must be known. Wheat, barley, rye and all kinds of foods such as bulgur, semolina, pasta, noodles, cake, pies, etc., contain gluten.

Your doctor will refer you to a dietician who can help you plan a healthy gluten-free diet. When you remove gluten-containing foods from your diet, inflammation in your small intestine usually begins to decrease within a few weeks. You can start feeling better in a few days. It can take from several months to several years for full healing and re-growth of intestinal villi. The healing process in the small intestine tends to occur faster in children than in adults.

If you accidentally eat gluten-containing food, you may experience symptoms such as abdominal pain, nausea, and diarrhea. Some people experience no symptoms after eating gluten; however, this does not mean that gluten does not harm them. Even a small amount of gluten in your diet can be harmful, regardless of signs or symptoms. If a serious nutritional disorder has occurred, your doctor may recommend vitamin and mineral supplements. Generally, calcium, folic acid, iron, zinc, vitamin b12, vitamin D and vitamin K supplements are recommended.

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