Celiac Disease: Diagnosis and Treatment Methods

Celiac disease is a condition that has frequently emerged in recent times due to gluten sensitivity. It can generally be defined as the body developing an intolerance to all foods containing gluten. This disease can manifest with various symptoms when foods containing gluten are consumed. Celiac disease can be treated by removing gluten-free foods from the daily diet. In this article, you can find answers to what celiac disease is, its types, diagnostic and treatment methods, and frequently asked questions about celiac disease.

What Is Celiac Disease?

Celiac disease is the intolerance of the small intestine to a substance called gluten, which is found in the structure of wheat, barley, oats, and rye. In this disease, the small intestine is sensitive to gluten. When the immune factors in the small intestine encounter the gluten protein, which they cannot tolerate, they produce antibodies. These antibodies damage the villi and microvilli, which are finger-like projections in the small intestine that enable the absorption of nutrients. Because the damaged villi and microvilli cannot fully absorb digested nutrients, vitamins and minerals, celiac disease symptoms appear.

What Are the Types of Celiac Disease?

Celiac disease has several types, classified according to its effects and symptoms. These can be described as follows:

Classic Celiac: A type of celiac disease usually seen in infants and children. In babies, it can manifest after the transition to solid foods with gluten consumption, with symptoms such as diarrhea, loss of appetite, abdominal bloating, and growth retardation. Once gluten sensitivity develops, absorption in the intestines is not completed, so vitamins and minerals such as B12, vitamin D, iron, folate, and calcium cannot be fully absorbed. This affects muscle and bone development and causes negative progression of growth and development in infants and children.

Atypical Celiac: In this type of disease, symptoms may appear outside the digestive system. Atypical symptoms can include defects in the tooth enamel, iron-deficiency anemia of unexplained cause, bone diseases such as osteoporosis, and impaired liver function.

Silent Celiac : A situation in which no sign of celiac disease is observed. In these individuals, celiac disease may be detected during screening of first-degree relatives who have celiac disease, or incidentally during investigation for another disease.

Potential Celiac : A situation in which celiac disease is identified in tests, yet small intestine biopsies are healthy. In this case, the presence of symptoms outside the gastrointestinal system, as in atypical celiac disease, should be monitored. Although it may not be a problem for the patient at first, the disease may become active over time and develop into a health problem. For this reason, regular doctor check-ups should be attended.

Non-Celiac Gluten Sensitivity : These patients have mild symptoms suggesting they cannot tolerate gluten. However, no problem is observed in blood tests or small intestine biopsy. In this case, symptoms may not appear gastrointestinally, but may include headaches, joint pain, and similar complaints. Although these patients' intestines are not affected, they should still adopt a gluten-free diet to reduce other symptoms.

What Is the Cause of Celiac Disease?

There is no definitively known cause of celiac disease. If first-degree relatives such as a mother, father, or sibling have celiac disease, celiac disease may be seen. In this respect, one of the causes of celiac disease may be a genetic predisposition. On the other hand, dietary habits, certain intestinal infections, and increased bacteria in the intestines may cause intolerance to develop in the intestines. This may create a predisposition to celiac disease.

What Are the Symptoms of Celiac Disease?

Celiac disease may have different symptoms according to age group. These symptoms may appear differently in infants, children, and adults.

In infants: nausea, vomiting, chronic diarrhea, abdominal bloating, loss of appetite, and the resulting growth and developmental retardation may be seen.

In children: chronic diarrhea or constipation, loss of appetite, weight loss, short stature, muscle and bone pain, headache, attention deficit, learning difficulties, and growth and developmental retardation may be seen.

In adults: due to irregular bowel function, diarrhea or constipation, nausea, vomiting, loss of appetite, weight loss, vitamin and mineral deficiencies in the blood such as B12 and iron, anemia, fatigue, weakness, dental enamel problems, skin rash, and anxiety may occur.

What Are the Diagnostic Methods for Celiac Disease?

If there are symptoms of celiac disease in an infant, child, or adult, a visit should first be made to a gastroenterologist in the gastroenterology department of a healthcare facility. The specialist physician will request laboratory testing for antigliadin, endomysial, and transglutaminase antibodies, which result from gluten sensitivity, to diagnose celiac disease. Then, to make a definitive diagnosis, the small intestine is usually examined by endoscopy, and a biopsy may be performed for more detailed investigation. Celiac disease can be diagnosed based on the evaluation of all these tests. Hisar Hospital Intercontinental Hospitals provide services in gastroenterology with specialist physicians and various laboratory investigations.

What Are the Treatment Methods for Celiac Disease?

Treatment of celiac disease consists of a completely gluten-free diet that must be maintained for life. Apart from this, there is currently no alternative treatment. In this dietary treatment, it is essential to completely remove products containing wheat, barley, oats, and rye from the diet. In addition, the labels of all other foods should be checked for the phrase "Gluten-free," because apart from the cereal group, many packaged foods may contain gluten. Even consuming very small amounts of gluten can cause symptoms to recur. In addition, on the advice of a dietitian, a diet targeting vitamins and minerals that are low in blood values should be adopted. With a gluten-free diet, symptoms usually begin to decrease from the first day and may return completely to normal over time.

Frequently Asked Questions About Celiac Disease

Celiac disease is a condition characterized by the immune system producing antibodies when the small intestine cannot tolerate the gluten protein, and these antibodies damaging the intestinal villi. When celiac diagnosis is delayed, or a strict gluten-free diet is not adopted in treatment, it causes other health problems at advanced stages. Deficiencies of essential vitamins and minerals such as B12, vitamin D, iron, and folate in the blood, anemia, bone diseases, infertility, commonly known as sterility, and gastrointestinal cancer may occur in advanced stages. For these reasons, the risk of stomach cancer is higher in patients with celiac disease than in those without it. Although the causes of celiac disease are not clearly known, studies show that there is a genetic predisposition. In this case, if there is celiac disease in first-degree relatives, gluten intolerance may be seen. In this respect, it can be said that celiac disease has a genetic relationship. In the treatment of celiac disease, gluten-containing foods must be removed from the diet for life. Therefore, knowing which foods contain gluten and which do not is important during the treatment process.

Foods containing gluten:

All bakery products such as bread, pasta, cake, and cookies made with wheat, barley, oats, or rye

Foods such as bulgur, vermicelli, couscous, and breadcrumb flour

Drinks containing barley and malt

Processed meat products may contain gluten.

Gluten-free foods:

Fruits and vegetables

Legumes such as chickpeas, dried beans, and lentils

Nuts such as hazelnuts, peanuts, almonds, and walnuts

Meat, chicken, fish, eggs

Rice, corn, potatoes, soybeans, starch

Buckwheat, quinoa, chia, and flaxseed are gluten-free foods.

Points to consider on a gluten-free diet:

Gluten-free foods can become risky through cross-contamination with gluten-containing products. For this reason, care should be taken not to store gluten-free products next to gluten-containing ones. Examples include storing gluten-containing bread and gluten-free bread in the same container, or cutting fruit with a knife that was used to cut wheat bread.

Some salad dressings, tomato pastes, seasonings used in meat or meal dishes, spice mixes, ketchup, mayonnaise, and many other packaged foods may contain gluten. Products labeled "Gluten-free" should be preferred.

Gluten is found not only in foods but also in cosmetic products such as creams and shampoos, and in medicines. When using these products, gluten-free options should also be preferred.

A gluten-free diet is the only treatment for celiac disease. If a gluten-free diet is not observed, symptoms may increase and lead to other health problems in later stages. For this reason, maximum care should be taken with all gluten-containing foods, medicines, and cosmetic products, in short, with everything. If there is a genetic predisposition to celiac disease, symptoms may appear in infants who start solid food after 6 months. On the other hand, it may also appear at older ages, around 5-6 years, in childhood. It can usually manifest gastrointestinally with diarrhea, nausea, vomiting, loss of appetite, weight loss, short stature, and growth and developmental retardation. In this respect, celiac disease can be seen not only in adults but also in infancy and childhood. Early diagnosis and treatment with a gluten-free diet are important so as not to cause growth and developmental retardation and other health problems. If left untreated, celiac disease can cause many serious health problems, including cancer. For this reason, if there are signs of gluten intolerance or if there is celiac disease in a first-degree relative, the nearest healthcare facility should be visited as soon as possible and regular celiac follow-up should be carried out. At Hisar Hospital Intercontinental hospitals, a specialist gastroenterologist will diagnose and treat celiac disease in the gastroenterology department, with the most comprehensive testing and laboratory investigations.