Celiac disease: symptoms of gluten intolerance,complications, diet, diagnosis

Update: December 2018

See also: List of gluten-containing products

Celiac Disease – this is what celiac disease is called, in which
the intestine does not perceive foods containing gluten. Celiac disease
are considered a congenital inheritable disease, however
the final mechanisms of its development have not been clarified.

In celiac disease, gluten is not completely broken down, forming toxic
substances that damage the inner surface of the intestine. In children
celiac disease manifests itself from the beginning of the introduction of complementary foods. Mom can
understand it by the foamy stool, vomiting, abdominal distension, deterioration in
weight gain.

Symptoms of celiac disease in adults disguise as chronic
diseases of the stomach and intestines. A person can treat for years
flatulence, unstable stool and other dyspeptic manifestations, but
without success.

It is for this reason that official prevalence data
celiac disease say that in our country only 1 out of 1000 is sick of it. And
Are you sick? Already today, celiac disease is not called a disease, but an image
life that requires adherence to a certain diet. No contact
with gluten, the onset of celiac disease is impossible. The most toxic part
gluten – alcohol soluble fraction – gliadin.

Interesting facts about celiac disease

  • this disease has been known for several millennia: exactly since
    as long as people started growing wheat, rye and other cereals
  • celiac disease is much more common in women and almost never
    observed in the Chinese, Japanese and Africans. Most likely, the case
    either in special genetic status or in particular
    power supply
  • even now in some regions of Russia doctors are forbidden
    diagnose “celiac disease” because they do not recognize this
    pathology
  • Some foreign scientists view celiac disease as
    precancerous condition that increases the risk of developing small bowel
    lymphomas, intestinal bleeding, cancer of different parts of the digestive system
    systems
  • if parents have celiac disease, the risk of having the same child –
    one to ten.

The reasons

So why does gluten intolerance occur? As already been
stated above, the exact reasons are not known. But there are suggestions
expressed in the form of theories. The most common ones are
enzymatic and immunological, with the second scientists trust
most.

  • Enzymatic

in the small intestine there is no enzyme responsible for cleavage
gluten free. This reason is likely, but not fully proven, since
dieting the intestinal enzymatic function is completely
is being restored.

  • Immunological

antibodies to gluten and autoimmune are detected in the blood
antibodies to intestinal cell structures. With celiac disease increased
the number of intraepithelial lymphocytes with other receptors. Exactly
these cells see gluten as an enemy and damage the walls
intestine.

  • Unusual viral theory

studies have shown that 90% of patients with celiac disease are elevated
the amount of antibodies to adenovirus of a certain type. Not worth it
believe if one day the doctor says that celiac disease originated from
adenovirus. It has nothing to do with a congenital disease:
just adenovirus and gluten have amazing antigenic
similarity.

  • Pathoceptor

Considers that the composition of proteins on the intestinal surface is disturbed,
because of which the small intestine is hypersensitive to
gluten free.

Scientists have concluded that it is worth uniting all theories into one
complex, then we get the intended picture of development
gluten intolerance: no enzyme – gluten does not split,
accumulates, has a toxic effect on the intestines, which
reacts with cells with special receptors. These cells at
an attempt to “destroy” gluten damage the intestinal epithelium, is broken
digestion and absorption of food. Adenovirus was assigned the role of the possible
initiator of immune response to gluten.

Symptoms

The textbooks distinguish three clinical forms of celiac disease. On the very same
its manifestations are much more diverse: symptoms of celiac disease
маскируются под разные заболевания пищеварительной systems,
hypovitaminosis, dermatological pathology and many others. Exactly
therefore, a diagnosis of “celiac disease” is made to a limited number
patients, the rest are endlessly treated for her
manifestations.

On the other hand, there are many clinical cases where all
manifestations of one form of celiac disease are evident, even
blood test. But biopsy of the small intestine does not confirm
the assumptions of doctors.

In 1991, celiac disease was presented as an iceberg: on top
then there is a small amount of confirmed options flowing
with bright clinical signs. Under the water – a huge amount
of those not diagnosed, “masked” cases. And in
the basis of the iceberg – people who have a genetic
predisposition to celiac disease, but the disease develops only when
exposure to precipitating factors (stress, reduced immunity,
eating a lot of foods with gluten and so
Further).

The earlier and in large quantities gluten is introduced into food.
(for example, allna’s favorite cereal porridge), the faster
arises celiac disease and the harder it proceeds.

Symptoms у детей

�”Iceberg” celiac disease: click to enlarge

A typical form has three prominent symptoms:

  • frequent stools (up to 5 times a day and more): there is a lot of it,
    mushy consistency, glistens due to the presence of fat, bad
    it smells, can be frothy, of different colors, it is difficult to wash off
  • bulging belly: the doctor will say that this is due to rickets in a child,
    parents will think the baby just eats well
  • lag in height and weight: especially noticeable in the first two years
    (in weight), and in growth – after 2 years. Insufficient weight gain
    it is alarming after the introduction of complementary foods, and up to this point
    the child gains weight well and grows normally and
    develops.

Other symptoms of celiac disease in children are associated with deficiency.
nutrients, vitamins and trace elements, so each
baby they may be different:

  • fatigue, lethargy or, conversely, tearfulness,
    aggressive behavior, irritability
  • poor condition of the skin and hair: dryness, weakness, peeling
    skin, atopic dermatitis in a child
  • frequent fractures even with a minor injury – despite the fact
    that children have fractures really rare, their bones
    elastic
  • bad posture
  • hypotension – insufficient muscle tone
  • manifestations in the mouth: bleeding gums, stomatitis
    children, caries, enamel crumbles
  • anemia (see iron for anemia)
  • the child looks miserable
  • a child with celiac disease is compared with a spider due to
    the presence of a large belly and slender arms and legs

В дальнейшем у детей нарушается работа половой systems: у
girls do not come monthly, in boys – sexual
dysfunction.

Symptoms у взрослых

Symptoms целиакии у взрослых характеризуют атипичную и латентную
forms. Atypical form appears only on the third or fourth
decades of human life. She is one of the three
symptoms of a typical form and two or three related. But in general
extraintestinal manifestations of celiac disease predominate:

  • neurological: migraine, depression and so on
  • dermatological: herpetiformis or atopic dermatitis
  • dental: aphthous stomatitis, atrophic glossitis,
    enamel hypoplasia
  • renal: nephropathy
  • articular: arthritis, joint pain of unexplained cause
  • Incomprehensible changes in the biochemical blood test: reduction
    cholesterol, increase in alkaline phosphatase, transaminases,
    albumin
  • reproductive: infertility

In clinical studies in 4-8% of women, unsuccessfully
treated for infertility, celiac disease was discovered. They all managed
become happy moms after the appointment of gluten-free diet.

Hidden form may not manifest itself at all, only occasionally
harassing small intestinal disturbances either
внешними проявлениями (дерматит и так Further). Celiac disease
found only by random examination.

Gluten intolerance complications

With a long course of latent form of celiac disease increases the risk
development of serious diseases:

  • oncology of the gastrointestinal tract
  • autoimmune thyroiditis, autoimmune hepatitis
  • type 1 diabetes
  • rheumatoid arthritis
  • myasthenia, scleroderma
  • recurrent pericarditis and others.

Diagnostics

Most often, celiac disease is detected when they diagnose everything.
organism about one of the above diseases.
Purposeful diagnosis of celiac disease consists of three stages.

  • Stage 1 – immunological blood tests. Determine
    the level of antigliadin antibodies, the presence of autoimmune antibodies to
    reticulin, tissue transaglutaminase, endomysium.
  • Stage 2 – with positive immunological tests carried out
    biopsy of the mucous membrane of the small intestine, while determining
    the state of her villi, the presence of inflammation and lymphocyte cells with
    modified receptors (they were mentioned above). Second phase –
    most important for making an accurate diagnosis.
  • Stage 3 – the appointment of a gluten-free diet and monitoring
    by the patient for six months. If there is an improvement in overall
    condition, reverse development of symptoms of the disease, diagnosis of “celiac”
    put finally.

The third stage of diagnosis is carried out with positive
immunological tests and questionable and even negative
biopsy results. If after six months the patient’s condition
will improve, the diagnosis of “celiac disease” is made. This form of celiac disease
called the potential.

A year later, repeat immunological examination is prescribed. It
should reveal a positive trend. And after a year or two
do repeated biopsy: villi of the small intestine during this time
must fully recover.

Differential diagnostics

Doctors usually take the time to diagnose celiac disease and especially
prescribe a procedure like a gut biopsy done under
anesthesia. Celiac disease отличают от пищевой аллергии, иммунодефицитов,
intestinal infections and other non-hereditary diseases
intestine.

Celiac disease от этих патологий можно отличить по отсутствию слизи в
feces and blood in feces, good effect of gluten-free diet,
positive immunological examination of the above
antibodies.

Treatment

Lifetime Gluten Free Eating products (list)
– This is the only effective salvation. Diet for celiac disease
involves the exclusion of bread, pasta, confectionery,
some cereals (oatmeal, semolina, pearl barley), sauces, store
cutlets, cheap sausages, sausages. Hidden gluten can be contained in
mayonnaise, ketchup, cheese curds, canned yogurt and curds,
ice cream, canned food, coffee, cocoa, kvass, beer, dyes,
malt extract.

Critical is the content in 100 grams of product more than 1
миллиграмма gluten free.

What then can you eat?

  • legumes
  • eggs, natural dairy products
  • vegetables fruits
  • buckwheat, corn, millet
  • meat fish
  • from sweets – chocolate, marmalade

Children under 1 year old are prescribed a mixture based on casein hydrolyzate.
or soy (see the list in the article milk allergy in children). For
complementary foods sold special gluten-free cereal.

After diagnosis, symptomatic treatment is performed.
therapy:

  • Correction of intestinal microflora: intestinal antiseptics
    (Enterofuril), probiotics (Bifiform, Linex, Actimel, see list
    probiotics), prebiotics (Hilak Forte)
  • Treatment вздутия живота: Эспумизан, Плантекс (см. список в
    article colic in infants)
  • Improving digestion: pancreatic enzymes (Creon,
    Pancreatin)
  • Treatment диареи: отвар коры дуба, Смекта, Имодиум
  • Treatment гипотрофии: коррекция power supply, увеличение калорийности
    of food
  • Therapy of hypovitaminosis: multivitamins inside, with severe
    able to inject intravenously nicotinic acid, vitamins of the group
    A, B, E, D, K
  • Treatment аутоиммунных заболеваний: глюкокортикостероиды
  • Correction of water and electrolyte balance: Panangin, gluconate
    calcium
  • Elimination of protein deficiency: a mixture of amino acids,
    albumen.

At the same time, the patient is treated and monitored
concomitant disease (for example, diabetes mellitus and
others).

Attention! Do not use those medicines (tablets and
pills), the composition of the shell which includes gluten (for example,
Complivit, Mezim Forte, Festal, etc. list of drugs with gluten).
Some liquid preparations contain malt (for example, Novo-Passit),
который противопоказан при непереносимости gluten free.

Celiac disease не приговор

Many children with a diagnosis of “celiac disease” are given
disability. But in fact, with strict adherence to a diet forecast
extremely favorable. After a couple of weeks go intestinal
symptoms of celiac disease recover during the first two months
vitamin-mineral, water-electrolyte, protein balance.

Children over the year catch up with their peers in weight, growth and development.
However, the diet must be strictly adhered to for life, otherwise there are
high risk of return of all pathological phenomena and the possibility
development of cancer of the digestive tract.

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