Did you know that four (4) out of five (5) people who have Celiac disease are either misdiagnosed or undiagnosed or even show no celiac disease symptoms at all?
Celiac disease which was thought to show up in mostly children and stunted their growth has recently been discovered to show up at any age, and for some people, there are NO CELIAC DISEASE SYMPTOMS at all.
So today, you are going to learn all you need to know about the Celiac disease, celiac disease symptoms, how to fight it and the best celiac disease diet practices to keep the disease far away from both you and your household.
What is Celiac Disease?
Well, Celiac disease is an autoimmune infection that gets triggered when people who are genetically predisposed (someone who is likely to encounter a particular disease due to his or her inherited genes) eat the gluten protein.
Gluten which is found in most of the foods we eat like barley, rye, and wheat; it is also found in a lot of common snacks and foods like bread, pizzas, cookies, pasta and even cakes.
Something that may seem really unusual is that the gluten protein is found in some unexpected places like in lipsticks for women, lip balms, hair and skin products, some nutrition supplements and even in our daily toothpaste.
So you see, it is really difficult to avoid this kind of protein in our daily living.
This disease which has been understood as an immune-mediated disorder when the gluten in foods triggers the immune system of the body to attack the cells in the small intestine.
Well, let’s take a brief moment to analyze a wheat seed.
Taking a look at a wheat seed for an example, inside a wheat kernel (endosperm), there are a bunch of nutrients (mostly proteins, starch, and some vitamins) for the seed’s embryo. The type of protein found in the endosperm of a wheat seed is gluten
So what happens when someone with celiac disease eats gluten?
At least one (1) in every hundred (100) North Americans are diagnosed with the celiac disease and about one (1) million people in the United States have the disease.
So when someone who has been diagnosed with Celiac disease comes across a wheat-based cake, the cake is broken down in the stomach, but the gliadin which is in the gluten protein, which as well is in the wheat used to bake the cake resists being broken down by enzymes in the stomach. When the gliadin gets into the small intestine, it bonds with the SECRETORY IgA (Immunoglobulin A – an antibiotic that helps protect the enterocytefrom toxins and pathogens) in the mucosal membrane.
Typically, things bond to the secretory IgA (immunoglobulin A) are up for immune cell destruction, but for individuals with the celiac disease, this gliadin IgA (immunoglobulin A) complex for some reason bonds to a transferrin receptor (TFR) which usually is used to absorb Iron. Once bond to the TFR, it moves across the cell into the lamina properia (a thin layer that lines the walls of the gut).
When the gliadin gets to the lamina properia, an enzyme known as tissue transglutaminase (TTG) cuts out an amide group from the protein. Deamidated gliadins are then formed which are eaten up by macrophages and served upon its MHC II ( Major Histocompatibility Complex II) molecules.
Note that, macrophages in the gut help to grab proteins from the foods we eat and samples it to the immune cells to make sure that there are no pathogenic parasites loitering in the gut. There are a lot of MHC II – serving platters which are encoded by the HLA (human leukocyte antigen) genes which help to determine which things the MHC II – molecules serve up.
Researchers have discovered that patients diagnosed with the celiac disease usually have specific deamidated gliadin serving platters, such as HLA – DQ2 or HLA- DQ8.
The macrophages then serve up the HLA – DQ2 or HLA -DQ8 genes from the gliadin. The T-Helper cells from the immune system then release inflammatory cytokines which then damages the epithelial cells.
So in summary, when someone with celiac disease comes across a food with gluten in it, the immune system is stimulated and epithelial cells are destroyed.
It is very important to note that the two major anti-gliadin antibodies related with the celiac disease are the IgA (Immunoglobulin A) and the IgG (Immunoglobulin G).
For someone without the celiac disease, the immunoglobulins locate and nullifies the effect of foreign bodies like the gliadin in gluten, but in patients with the celiac disease, the immunoglobulins attacks, and damages the tissues of the small intestine instead of protecting them.
At the early stages, the damage may be so minor and not so noticeable, but with time, the villi become more damaged, flattened and start losing its ability to absorb nutrients.Now I know that the question that would be in most people’s mind would be…
How Do I Know if I Have Celiac Disease?
Scientists and researchers have been studying the celiac disease for more than seventy (70) years now, and some important discoveries have come to light to help us understand the celiac disease much better.
Like I said earlier, the celiac disease has no age limit, it happens to both the old and young.
Celiac Disease Symptoms in Children
Children with the disease are often presented with celiac disease symptoms like
- Chronic diarrhea
- Failure to thrive
- Abdominal distension (bloating and pains in
the the abdominalregion)
- Weight loss
- Pale, foul-smelling, fatty stools
- Slow growth and puberty
- Defects in the enamel of the permanent teeth
- Inattention increase
- Hyperactivity increase (fidgeting)
- Increased impulsivity (taking hasty actions without first thinking about them).
Celiac Disease Symptoms in Adults
Adults with this disease are often presented with celiac disease symptoms like
- Chronic diarrhea
- Abdominal distension (bloating and pains in the abdominal region)
- Anemia (iron-deficiency)
- Anxiety and depression
- Bone or joint aches
- Damage to dental enamel
- Peripheral neuropathy (numbness, tingling or pains in the hand and feet)
- Bone loss (Osteoporosis/osteopenia)
- Infertility and miscarriages in women
- Migraines and seizures
- Cognitive impairment
- Problems with balance
- Heartburn and acid reflux
- Cankerous sores inside the mouth
- Unusual menstrual cycles in women
- Biliary tract disorders (primary sclerosing cholangitis, fatty liver, transaminitis, etc)
All these symptoms vary widely in adults. Adults diagnosed with the celiac disease may frequently have dermatitis herpetiformis as a complication, which has nothing to do with the herpes virus.
Dermatitis herpetiformis is an itchy skin rash infection that pops up from circulating IgA (Immunoglobulin A) antibodies in the blood, where they accidentally bond with the transglutaminase (TTG) in the dermal papillae of the epidermis.
Once bonding takes place, neutrophils start up an inflammatory reaction that’s noticed on the skin of the infected as a skin rash known as the dermatitis herpetiformis.
So, back to the topic, “celiac disease”; certain signs and symptoms have made researchers and scientists come up with the conclusion that there is no one type of celiac disease.
Types of Celiac Diseases
According to the World Gastroenterology Organization, celiac disease may be divided into two types;
- Classical celiac disease
- Non-classical celiac disease
In recent times, an additional type of celiac disease has been added to the list known as the silent celiac disease (asymptomatic celiac disease). Each type of celiac has different signs and symptoms attached to it.
For example, patients suffering from the classical celiac disease experience signs and symptoms like malabsorption, including steatorrhea (pale, foul-smelling, fatty stools), diarrhea and weight loss or growth failure in children; all these likely to be experienced by young infants or children.
For patients suffering from the non-classical celiac disease, they experience signs and symptoms like abdominal distension and pains, mild gastrointestinal symptoms without clear signs of malabsorption, anemia (iron-deficiency), chronic migraine, chronic fatigue, peripheral neuropathy (tingling, numbness or pain in hands and feet), elevated liver enzymes(chronic hypertransaminasemia), late menarche/early menopause and unexplained infertility, decrease in bone mass and fractures, vitamin deficiency (folic acid and B12), dental enamel defects, anxiety and depression, dermatitis herpetiformis (itchy skin rash), etc; all these which are common in adults.
Finally, for patients having the silent celiac disease (asymptomatic celiac disease), they do not observe any symptoms but experience some villous atrophy damage to their small intestine.
With all these said, it is advisable that both parents, siblings, and children should always be screened for the celiac disease, whether or not they experience any symptoms.
The number of ways in which the celiac disease affect patients, combined with a lack of training in medical schools and primary care residency programs, contributes to the poor diagnosis rate worldwide.
According to the Celiac Disease Center at Columbia University Medical Center, “anyone who suffers from an unexplained, stubborn illness for several months, should consider celiac disease a possible cause and be properly screened for it.”
Some signs and symptoms of the celiac disease could be experienced by noninfected persons. This has been termed “non-celiac gluten sensitivity” (NCGS) and “non-celiac wheat sensitivity” (NCWS).
Is Gluten Bad For Me and my Celiac Disease Diet?
Well, gluten has been seen to be quite controversial these days. Most believe that it is safe for everyone excluding those with the celiac disease, while others claim that gluten is harmful to most people.
Interestingly, the name “gluten (glu-ten)” is gotten from the glue-like property of wet dough when flour is mixed with water.
This glue-like property is what makes wet dough elastic, and gives foods like bread and cakes the ability to rise when baked. It also provides their chewy and satisfying texture.
Generally speaking, gluten has its advantages and disadvantages.
For most people, avoiding gluten is redundant.
People suffering from the celiac disease, removing gluten from the diet can play a major role, and it is always best to avoid the gluten in diet; but this seems quite impossible considering that at some point they may come across food they did not prepare themselves.
It is also important to note that, there is no nutrient in foods containing gluten that cannot be gotten from other foods.
Best Celiac Disease Diet & Nutrition.
The best cost-effective and healthy manner to follow in order to ensure a gluten-free diet is to look out for naturally gluten-free food groups. The best celiac disease diet includes:
- Fruits and vegetables
- Meat and poultry
- Fish and seafood
- Beans, legumes and nuts
Pure barley grass and wheat grass as part of the celiac disease diet are also free from gluten, but it is also important to note that little amount of gluten can also be present in the seeds of these grasses, so there is a risk of gluten contamination if they are not harvested or processed properly.
It is also important to note that not all grains and foods containing starch are bad for our celiac disease diet, some examples of foods containing starch and grains that are naturally a gluten-free celiac disease diet include:
- Maize (corn)
- Buckwheat groats (also known as kasha)
- Nut flours, nuts and legumes
- Gluten-free oats
It is advised not to purchase grains from bulk bins due to the possibility of cross-contact with gluten. Research shows that some naturally gluten-free grains may contain gluten as a result of cross-contact with gluten-containing grains during harvesting and processing.
If you are worried about the safety of a grain, you should purchase only grains that have been tested for the presence of gluten and contain less than 20 ppm.
Many will not know this, but soups and sauces are one of the major sources of hidden gluten, as many restaurants use wheat as a thickener.
Most beverages such as juices, sports drinks, sodas and alcoholic drinks such as hard and distilled liquors, wines and hard ciders are gluten-free.
However, beverages such as malt beverages, ales, lagers, beers and malt vinegar are made from gluten-containing grains and are not distilled and therefore are not free from gluten.
List of Foods to Avoid in Order to Maintain a Good Celiac Disease Diet
Apart from wheat-grains, rye and barley, gluten is also present in many of our everyday foods; some of which are:
- Triticale (a crossbreed of rye and wheat)
- Wheat labeled by different names like Kamut, faro, durum, semolina, bulgar, spelled.
- Sauces and marinades
- Brewer’s yeast
- Packaged foods not labeled gluten-free like pasta, cookies, cereals, and breadcrumbs.
- Dextrin (starch)
Like I said earlier, gluten can be found in some non-food substances like lipsticks and lip balms, vitamin and mineral supplements, herbal supplements and medications, etc.
In ensuring a gluten-free celiac disease diet, it is very important to read the label of canned soups and sauces and any pre-prepared food. For example, potatoes naturally are gluten-free, but packages of frozen potatoes are not always a gluten-free celiac disease diet.
It is also recommended you talk to your doctor about the best medications if you are not so sure of the best celiac disease diet to adopt.