Symptoms of celiac disease

There are 600,000 Italian citizens suffering from celiac disease, but according to the Ministry of Health, of these, only 183,000 have received a diagnosis.

Worldwide, it affects about 1% of the population, a percentage that has been growing in the last twenty years, both for the improvement of diagnostic tests and for the tendency to screen people considered at risk.

What is it?

Celiac disease is an autoimmune disease of the digestive system that particularly affects the small intestine.

Those suffering from this disease are intolerant to gluten, a protein typical of wheat, which is also found in barley and rye.

When a celiac eats a food that contains gluten, his immune system puts in place a reaction similar to that which occurs in the presence of some allergies: it reacts by damaging or destroying the cells of the intestinal villi, the small finger-shaped bumps that make up the mucous membrane of the intestine.

These formations allow an effective absorption of nutrients that, through the wall of the intestine, reach the blood and then be transported throughout the body.

Due to the flattening of the intestinal villi, celiac disease sufferers do not absorb nutrients properly.

The cause of this disease is not yet certain: recent scientific evidence suggests that it is triggered by genetic and environmental factors.

That suspicious stomach ache: recognizing the symptoms of celiac disease

Signs and symptoms of this disease also include some disorders that are not related to intestinal or digestive system functioning and can vary greatly depending on the stage of life in which you are. Children and adults react differently.

Celiac disease is an underdiagnosed disease. That is, not all people who are affected receive the right diagnosis. This is because those who suffer from this disorder do not necessarily have the typical symptoms of this pathology.

In the long run, however, even in asymptomatic individuals complications may arise such as:

• malnutrition
• liver problems
• bowel tumors.

When celiac disease is seen from the skin: dermatitis herpetiformis

It is a skin disorder that, at first glance, does not seem to have anything to do with intestinal intolerance to gluten. In fact, dermatitis herpetiformis is related to celiac disease, of which it is the specific dermatological expression.

It occurs in some subjects, with the appearance of a real skin rash, with itching and redness in some areas of the body, including elbows, knees and buttocks.

Dermatitis herpetiformis is not always accompanied by intestinal symptoms but in 100% of those who suffer from it it is possible to observe, thanks to a biopsy of the intestine, alterations of the mucosa, which can be of different degrees. In addition, most patients respond effectively to a gluten-free diet.

When it is good to contact your doctor

If you have diarrhea or digestive problems that last for more than two weeks: here is a good time to go to your doctor.

In children, the alarm bell should go off in case of:

– growth retardation

– presence of foul-smelling or oily stools.

This disease is chronic and, although there is no real cure, the strategies to follow to live and eat with serenity exist. Never, however, let yourself go to DIY solutions.

If you suspect celiac disease, do not start following a gluten-free diet without first consulting your specialist. This choice, in fact, could distort the results of any subsequent tests.

Since celiac disease could be hereditary, if someone in the family already suffers from it, it may be useful to consult a doctor.

Celiac disease or other?

Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other conditions.

Often, in fact, the disorders that the patient reports can lead the doctor to suspect other diseases, such as:

• irritable bowel syndrome
• In women, iron deficiency anemia caused by menstrual cycle
• inflammation of the intestine
• diverticulitis
• intestinal infection
• chronic fatigue syndrome.

This is why many cases of celiac disease are not detected immediately and patients can remain unaware of their true pathology even for quite a long time.

The right tests for an accurate investigation

Compared to the past, doctors today are more aware of the extreme variety of symptoms related to celiac disease. In addition, more reliable diagnostic techniques are now available.

If your doctor suspects that you have this condition, he will prescribe some easily performed diagnostic tests, such as:

– blood test to detect anti-tissue transglutaminase or anti-endomysium antibodies. If the test results are negative, but celiac disease is still suspected, further analysis may be necessary

– intestinal biopsy, performed to confirm the suspicion resulting from a positive blood test. It involves taking a small portion of tissue at the level of the small intestine, to check if the villi are damaged. To obtain the sample, the surgeon performs a gastroscopy, introducing a long, thin tube (the endoscope) through the patient’s mouth and stomach to the small intestine.

Why such different symptoms for the same disease?

Researchers are working to find out more about what is still a little-known disease. There are three factors that can influence the type of symptoms and their appearance , such as:

– the duration of breastfeeding

– the age at which you started eating foods containing gluten

– the amount of foods containing this protein that are consumed regularly.

Also important is the age of the patient, on which the duration of exposure to gluten will depend and therefore the level of deterioration that the intestine has suffered.

For many adults, for example, it can take up to a decade between the onset of the disease and its diagnosis. The longer it takes before diagnosis and treatment, the greater the chances of long-term complications.

Celiac disease and diet

The only way to live with this disease is to follow a strict gluten-free diet.

According to the Italian Celiac Association (AIC), the products that do not contain this protein and can therefore be consumed by celiacs without any danger are:

• rice grains
• corn (maize) grains, steamed
• buckwheat in grains
• amaranth grains
• millet seeds
• Quinoa seeds
• tubers (potato, sweet potato, Mexican potato, cassava, Jerusalem artichoke, etc.)
• substitute products in the Register of the Ministry of Health
• oats (only as an ingredient of products in the National Register of the Ministry of Health)
• coffee, tea, wine, fruit juices
• fruits, vegetables and legumes.

The products to avoid are:

• wheat (wheat)
• spelt
• barley
• oats
• rye
• Prohibited cereal flours, starches, groats, meal meal and cereal flakes
• first courses prepared with prohibited cereals (pasta, stuffed pasta, potato gnocchi, gnocchi alla romana, pizzoccheri, crepes)
• bread and substitute bakery products, sweet and savory, prepared with prohibited cereals (breadbread, breadcrumbs, focaccia, pizza, piadine, panzerotti, breadsticks, crackers, rusks, taralli, croutons, pretzels, cracotte, biscuits, snacks, pastries, cakes)
• wheat germ
• bulgur (boulgour or burghul), couscous (from prohibited cereals), cracked wheat, frik, greis, greunkern, seitan, tabulè
• breakfast products based on prohibited cereals (puffed, flakes, muesli, porridge)
• polenta taragna (if buckwheat flour is mixed with wheat flour).

A good dietician will surely be able to suggest the most suitable combinations and the best recipes for a healthy, but tasty gluten-free cuisine.

In recent years, following this type of diet has become easier, also thanks to the fact that many companies have marketed specific products, such as pasta, bread or biscuits, from which gluten has been eliminated. However, it is good to know that only those who are celiac derive a real benefit from a “gluten-free” diet.

Why it is important to treat celiac disease

The importance of achieving a correct diagnosis for celiac disease is paramount. If not treated through adequate nutrition, in fact, it can be the cause of other disorders, including:

• neurological disorders
• Tumors
• osteoporosis
• Parkinson’s disease
• psychic and neuropsychiatric disorders (anxiety, bipolar disorder, schizophrenia)
• gastroenteritis.

Those suffering from celiac disease also have a higher risk of developing other autoimmune diseases, including:

• Type 1 diabetes
• Autoimmune thyroid diseases
• autoimmune diseases of the liver
• rheumatoid arthritis
• Addison’s disease, a disease that affects certain glands
• Sjögren’s syndrome, a disease that damages the lacrimal and salivary glands
• lactose intolerance, which occurs due to damage to the intestines.