Gluten is a valuable nutritious vegetable protein found in cereal grains. Recently, high-gluten wheat flour has become popular in food processing, the flour of which can be formed into tasty pasta without the participation of eggs that contain cholesterol.
What is gluten for a healthy body?
In the alimentary canal of a healthy person, gluten does not cause any damage and is absorbed,
as a nutritionally nourishing food. However, in those with an inborn gluten intolerance, the protein irritates the intestines and causes their inflammation that causes diarrhea, vomiting, abdominal pain and other symptoms.
When is the disease most commonly manifested?
Celiac disease usually manifests itself in infants - between 9 and 24 months of age, depending on the age in which
for gluten diet.
Typical symptoms of food intolerance to gluten:
• incorrect bowel movements (abundant, semi-liquid stools with a high content of fats and mucus);
• inhibition of growth (body weight and height);
• lack of appetite;
• change of temper (irritability).
Warning! Sometimes, the "silent" form of celiac disease is recognized too late
In too late diagnosed cases, the so-called "Silent" figure.
It concerns patients with atrophy of the intestinal mucosa in the absence of symptoms or atypical or very scanty occurrence. The most important symptoms of this "silent" form of the disease are: growth deficiency, anemia, rickets, abdominal pain, delayed sexual maturation, aphthous mouth, enamel lesions, fatigability, apathy.
Intolerance, or maybe allergy - or other causes of symptoms?
Finally, let us remind you that sometimes we can not initially distinguish the symptoms of food intolerance from allergies or infections of the infectious gastrointestinal tract. The symptoms can be quite similar. Vomiting, diarrhea, abdominal pain also causes sensitization to any product or its component and infection with pathogenic microorganisms (bacterial or viral), parasitic infections, or even a psychological disgust to a given food. A competent medical examination is therefore necessary - as discussed later in the text
The diagnosis of celiac disease in children is based on:
1) demonstrating that the occurrence of disease symptoms is related to the introduction of products containing gluten into the child's diet;
2) finding a "flat" intestinal mucosa (in a small intestine biopsy);
3) demonstration of the presence of specific antibodies - antendomiseal or anti-anastimic.
Determinants of diagnostic tests
However, it should be remembered that celiac-specific antibodies only appear when using a diet with gluten! If a blood test is performed after a gluten-free diet, the chances of their detection decrease. In doubtful situations, for example in children who have had a gluten-free diet incorrectly prior to bowel biopsy, a provocation test with gluten-containing diet will sometimes be necessary. The finding of the normal mucosa of the small intestine after 2 years of provocation excludes celiac disease.
The diagnosis of celiac disease in adults
Celiac disease in adults can be diagnosed based on an intestinal biopsy followed by another biopsy to document the recovery of atrophic villi after 3-6 months of a gluten-free diet. It is advisable to confirm the diagnosis by performing simultaneous serological tests to detect anti-endogenous antibodies in the blood serum.
Long-term effects of an untreated disease
Celiac disease is a disease characterized by persistent gluten intolerance. In this chronic disease under the influence of gluten, the intestinal mucosa disappears and, as a result, digestive disorders and the absorption of many nutrients.
Celiacal silhouette of the child's body
With a longer duration of illness, the "celiac" silhouette of the body appears: a large belly, arched over the chest, hung on the skinny limbs, as well as anemia and tetany from deficiency of poorly absorbed nutrients and vitamins. However, these extreme symptoms of celiac disease are not common nowadays.
Why are we sick?
Celiac disease is one of the most common genetically determined diseases. It occurs with a frequency of 1: 300 births. Currently, it is estimated that there are nearly 20-30 people with diagnosed celiac disease with unrecognized, latent celiac disease. It is hypothesized that gluten toxicity to the intestinal mucosa results from an immune defect - T lymphocyte abnormalities.
A disease mechanism that facilitates treatment
A characteristic feature of celiac disease is gluten dependence. It means the resolution of changes under the influence of a gluten-free diet and the conversion of symptoms when this diet is discontinued. The treatment of this disease is based on this mechanism.
ed. Edward Ozga Michalski, MA
consultation by dr n. med. Janusz Ciok - gastroenterologist