In this article, I will look at what celiac disease is. In addition, we will talk about the research done and the symptoms of the disease. In addition, we will discuss preventive measures, diet, and food.
Peculiarities of the disease
Celiac disease is genetically predisposed to gluten intolerance. It is also called gluten (or celiac) enteropathy, which is a form of enteropathy.
There are currently no standardized guidelines for the early detection of celiac disease.
Originally, gluten disease was a childhood disease dominated by ailments related to the digestive system.
It is a fact that only about 2-5% of the 30-35% of people with a genetic predisposition to celiac disease will conclude that there is an environmental factor that causes the disease.
Although there is evidence of a connection between gut dysbiosis and gluten disease, it is unknown whether the qualitative and quantitative disruption of the gut microbiome is a consequence of celiac disease or, conversely, a contributing factor to its activation.
Significant differences were found in the composition of microbes in the feces of healthy children or children with gluten disease but treated with a gluten-free diet.
In addition, studies by “Canov et al.” Have shown that the gut microflora can target dendritic cells or macrophages that are involved in the pathomechanism of celiac disease.
It also found that infection in the first year of life, especially intestinal infection and antibiotic therapy, are closely related to the likelihood of developing the celiac disease later.
A growing number of celiac disease studies and case studies have found that it is not the only form of the disease.
In 2013, the American College of Gastroenterology published a standard that requires an adult patient with gluten disease to be monitored by a family physician, gastroenterologist, and nutritionist.
In addition, the patient should have the opportunity for ongoing monitoring of health status, monitoring remission after introducing a gluten-free diet, and monitoring for unwanted symptoms associated with the course of celiac disease.
This research used a diagnostic survey method to assess the knowledge of patients with gluten disease about preventive measures and treatments.
For this purpose, we created our questionnaire containing 30 questions, of which 26 were closed, with single and multiple choice. The other 4 were in the form of open-ended questions. The questionnaire provided complete anonymity.
The survey lasted from August 25 to September 2. The survey involved 280 respondents. Exclusion criteria were age under 15 and incorrect completion of the questionnaire. The final analysis included 260 correctly completed questionnaires. The survey group consisted of 244 women and 16 men. The age of the respondents ranged from 15 to 69 years old.
The vast majority of respondents (n = 177) declared higher education. Sixty-nine respondents indicated secondary education. The smallest group consisted of people with vocational (n = 5) and primary (n = 9) education.
Among the respondents:
- 155 respondents were diagnosed with the classical form of celiac disease;
- 56 people reported an atypical form of celiac disease with extraintestinal symptoms;
- 40 respondents reported an asymptomatic form;
- 9 respondents said they did not know what form the disease was.
Celiac disease treatment
To stop the progression of celiac disease, start a gluten-free diet. The diet must be very strict because even minimal amounts of this protein can be harmful to the patient.
A gluten-free diet is not just about eliminating foods that contain gluten. The essence of the gluten-free diet is knowing the grains and products that are alternatives to these foods.
It is necessary to be able to integrate new foods into the menu. The diet does not have to be fancy, but it does need to be varied to provide all the necessary ingredients.
An improperly balanced diet leads to nutritional deficiencies. This effect is exacerbated by the malabsorption syndrome that accompanies the celiac disease.
In such a situation, when the intestine has a reduced suction surface, and the patient does not meet the individual needs for energy, protein, fats, carbohydrates, minerals, and vitamins in the food, not only impaired but also suppressed intestinal epithelial regeneration occurs.
This situation can lead to diseases associated with nutritional deficiencies.
Diet or selected alternative grains
A well-conceived gluten-free diet can be delicious and exciting. The restrictions caused by avoiding many common foods can encourage the patient to try new flavors, alternative grains or pseudo-grains, or previously unknown vegetables or fruits.
Common buckwheat is a common plant belonging to the pseudo-grain family. It is mainly used for the production of cereals or flour. It is characterized by a high content of exogenous amino acids – lysine and methionine.
The presence of stable starch makes it a low-energy product. It is a good source of thiamine, its binding proteins, and rutin.
Plain corn is often used in the kitchen, not only by people following a gluten-free diet. Used as starch, it is often the main ingredient in gluten-free bread or pasta.
However, this is not the best option because it easily raises blood glucose levels. Regular corn is high in carbohydrates and relatively high in fat compared to other grains.
It is used to make gluten-free cereal or corn oil. Fine-grind corn grits can replace wheat grits. Common millet is another plant grown in Russia, but flour made from this grain is not popular.
Millet is increasingly becoming an ingredient in dishes. It can be prepared as a base for dinner or as a sweet breakfast or afternoon snack.
Millet is another source of essential amino acids such as isoleucine, leucine, and methionine. It is high in easily digestible fats.
Millet is rich in polyunsaturated fatty acids, including linolenic acid, B vitamins, lecithin, and magnesium.
Amaranth is increasingly used in the cuisines of different countries. What distinguishes amaranth from gluten grains is its good amino acid composition. It has all the essential amino acids, including large amounts of tryptophan and lysine.
It is characterized by better mineral content. The presence of easily digestible iron is noteworthy. This plant enriches the food with:
- B vitamins,
- vitamin C,
- fat-soluble vitamin E.
The composition of fats in this pseudo-grain is also noteworthy. Amaranth is a source of oleic, linolenic, and linoleic acids, which are unsaturated fatty acids. In addition, it has a low glycemic index.
Almost twice the vitamin E content of rye or wheat gives it an edge over gluten grains. The seeds of this plant contain highly absorbable minerals:
- folic acid.
Because of its delicately sweet flavor, it can be used in many kitchens for both sweet and dry dishes. It is also suitable for making pasta or thickening sauces.
Diagnosing celiac disease
The celiac disease remains a disease that is not easy to diagnose, despite the advanced diagnostic tools available to doctors.
Specific symptoms and a very diverse clinical picture make it easy to miss the disease. As I wrote above – there are currently no standardized guidelines for the early detection of celiac disease.
Often, adult patients who go to the doctor are diagnosed with a completely different problem than those that might indicate celiac disease.
Such a process not only requires high treatment costs for people with chronic diseases coexisting with celiac disease, but it is also difficult for patients.
In Europe, there are no standards by which a patient with celiac disease will undergo periodic preventive examinations when diagnosing diseases that often arise with celiac disease, in the form of complications after poorly administered dietary therapy.
Preventing celiac disease
Prevention is a process aimed at preventing the occurrence or development of a disease, which is determined to have a high probability of occurring in the future, taking into account contributing factors.
In this context, 3 types of prevention can be distinguished, which differ from each other in the stage at which the corresponding procedure can be started.
Expected to cover all or most of the population. Its purpose is to prevent the occurrence of the disease or the factors that can cause it.
In the context of celiac disease, unfortunately, this type of prevention cannot be realized at this stage of research. No method has yet been found to prevent all children or adults from getting celiac disease.
Celiac disease can even appear in a child just a few months old. In this context, it is important to point out the exact causative factors of this disease, which is extremely difficult at this stage of research, since the pathomechanism of gluten disease is multifactorial and ambiguous.
It is also worth mentioning that the ESPGHAN position clearly states that breastfeeding does not protect the child from celiac disease. Moreover, the safe dose and form in which gluten should be given to the baby during the expansion of the diet to prevent the occurrence of this disease in the future are not defined.
Phase two prevention is already a more strictly defined area of activity. It performs its task among groups at risk of developing the disease.
This phase includes screening tests aimed at early detection of an increased risk of disease activation.
ESPGHAN has defined in its guidelines which patients can be included in the risk group. Atypical symptoms of celiac disease that are not indicative of its onset and course are still a barrier.
In people with autoimmune diseases, Down syndrome, Williams syndrome, Turner syndrome, iron deficiency anemia, and in a family of first-line gluten patients, your doctor may need to check you periodically for the disease.
Phase three prevention already covers the group of people with chronic diseases. Its purpose is to exclude undesirable consequences of the further development of the disease.
Celiac disease is a chronic disease in which lack of treatment is associated with a high risk of other comorbidities.
This stage of celiac disease prevention is underestimated. ESPGHAN does not specify to what extent medical care should be provided to patients diagnosed with celiac disease.