Celiac disease

Celiac disease, better known as gluten intolerance, is an autoimmune disease. It manifests as chronic digestive disorders after ingesting foods containing gluten. The phenomenon of gluten intolerance affects the functioning of the small intestine by damaging the intestinal villi, whose role is to absorb nutrients. This results in a chronic deficiency of essential nutrients for the proper functioning of the body. Celiac disease can also manifest as the appearance of dermatitis herpetiformis (a form of dermatosis), and currently, there is no treatment other than adopting a gluten-free diet.

Causes of Celiac Disease

Celiac disease is a disease that can be classified as a genetic disorder. Indeed, all affected individuals carry certain class II HLA genes. However, conversely, not all carriers of these genes necessarily have the disease. Emotional stress, physical trauma, surgery, viral infection, and pregnancy are some of the factors involved in the onset of this disease. Celiac disease is the most common genetic disease in Europe, where it affects 1 in 100 people with some variations (1 in 250 in Italy, 1 in 300 in Ireland). It is a disease that preferably affects the Caucasian population. Indeed, it is very rarely diagnosed in Asia and Africa.

Symptoms of Celiac Disease

The term "coeliac" comes from Greek and means "related to the abdominal cavity." Indeed, the symptoms of celiac disease are related to gastrointestinal dysfunction, although symptoms may vary depending on the severity of the disease and the individual's overall health. Some people may not even have any symptoms while experiencing intestinal damage.

The main recognized symptoms of celiac disease are: diarrhea, bloating, intestinal gas, greasy and voluminous stools, fatigue, lack of energy, joint pain, depression, irritability, dental enamel defects, vitamin B9 deficiency, osteoporosis, fertility problems in women, growth retardation in children, vomiting, weight loss, appearance of dermatitis herpetiformis. Without knowing the cause-and-effect relationships, gluten-intolerant individuals have been noted to have a number of diseases, which could be triggers or risk factors:

• Kidney and liver diseases, diabetes, thyroid diseases,
• Systemic lupus erythematosus, rheumatoid arthritis,
• Selective IgA deficiency (immune deficiency), lactose intolerance,
• Some rare diseases such as chronic active hepatitis, scleroderma, myasthenia gravis, etc...
• Diagnosis

The definitive diagnosis of celiac disease is hindered by the similarity of most symptoms to other conditions. However, it can be established through blood tests combined with a biopsy of the small intestine to examine the state of the intestinal villi. The doctor will perform several biopsies, before and after adopting a strict gluten-free diet, to observe the evolution and effectiveness of this exclusion diet. The complete diagnosis can take some time as the healing of the villi can take months or even years. Despite the difficulty of diagnosing celiac disease, early recognition of the disease can reduce the risk of developing intestinal lymphomas, as well as severe bone loss due to the malabsorption of vitamins and minerals.

Gluten and Celiac Disease

Gluten is defined as the mixture of many protein fragments (called peptide chains or polypeptides) present in cereals (wheat, rye, barley, and sometimes oats when this cereal may have been contaminated by other cereals during storage or processing). Wheat is the only cereal containing true "gluten." The peptides that predominate in wheat gluten are gliadin and glutenin. Gliadin is believed to be the peptide chain that triggers the toxic immune response leading to intestinal damage. However, other protein fragments in rye, barley, and oats could be toxic. These are respectively secalin, hordein, and avenin. Although some studies suggest that avenin is not toxic, most people with celiac disease avoid consuming oats. Indeed, minute amounts of any of these protein fragments can cause intestinal damage.

Celiac Disease, a Note on Compatible Foods

Rice and corn can be safely consumed by people with celiac disease. In addition, millet, sorghum, teff, with a genetic heritage close to corn, are also compatible. Other cereals or cereal-like grains could be safe for celiacs (buckwheat, amaranth, quinoa, etc.).

Direct Sources of Gluten

Wheat (including durum wheat semolina, spelt, triticale, and Kamut), rye, barley, oats (due to contamination by other cereals).

And indirect or hidden sources

The ingredients of certain foods or preparations must be examined to determine the presence of gluten. For example, modified food starch from corn is acceptable, as long as there is no wheat starch included. Apple cider vinegar is acceptable, but distilled vinegars may contain gluten. Buckwheat flour or buckwheat is acceptable provided it has not been contaminated or mixed with wheat flour, etc...

Quick Reminder List of Gluten-Containing Items

Binders, blue cheese, brown rice syrup (if barley malt enzyme is used), caramel coloring (made from brewery barley enzymes), glazes, colorings, dispersing agents containing dextrin, emulsifiers, excipients (added to many drugs), extracts and flavors (based on cereal alcohol), flours, breads, breakfast cereals, crackers, wheat pasta, sauces and condiments containing gluten-containing cereals, cereals (malted beers, whiskey, vodka, etc...), homeopathic remedies, hydrolyzed vegetable and plant proteins, malt or malt flavoring (barley), modified starch (if obtained from wheat), mono and di-glycerides (made using wheat starch support), oils (wheat germ oil and gluten-containing oil additives), preservatives, soy sauce (using fermented wheat), spices (if they contain anti-caking agents), starch (composed of the cereals listed previously), vegetable proteins, vinegars (distilled), etc...

Gluten Contamination

When gluten-free cereals are ground or processed, they can be contaminated by other cereals processed on the same machines. Gluten contamination can occur through molds, utensils, cutting boards, toasters, frying oils, when foods are cooked or processed.

Also,

Several over-the-counter and prescription medications may contain gluten. Pills can be dusted with flour during manufacturing, and capsules may contain gluten. Some non-food products such as toothpaste, lipstick, day cream, which may contain gluten, can be accidentally ingested when fingers come into contact with the mouth. People with celiac disease must be constantly vigilant.