Celiac disease is a disease that leads to impaired digestion and absorption of nutrients in the intestines. people with celiac disease; They are sensitive to ‘gluten’, a protein also found in wheat, barley, rye and to a lesser extent oats.
When these people are fed with gluten-containing foods, they cause inflammation and damage to the cells as a result of immunological reactions in their small intestines. Since digestion and absorption of nutrients will be impaired after this damage, diarrhea and a deficiency of some substances in the body occur over time.
Celiac disease is a genetic disease, and up to 10 percent of patients have a family history of celiac disease. While it is seen in 30 percent of fraternal twins, the rate of incidence in identical twins is 70 percent.
Some viral infections and stress situations can cause the disease to occur. Although it can occur at any age, it is more common in children aged 8-12 months and between the ages of 30-40. It can also occur in older ages. “Latent” or “silent celiac” disease, on the other hand, is a term used for patients who do not have typical findings of this disease, but who have a hereditary predisposition. In these patients, celiac disease settles over time.
What are the symptoms?
Celiac disease manifests itself with different symptoms in children and adults, depending on the degree of absorption and digestive disorders. Developmental and growth retardation in children may be an early sign of celiac disease. Abdominal pain, nausea, vomiting, diarrhea, moodiness, sleepiness, behavioral disorders and failure in school are other symptoms that can be seen. It can take years for symptoms to appear and become severe. Although celiac disease usually occurs around the age of 30-40 in adults, it can also be seen in older ages. Symptoms manifest themselves in two ways in people with the disease:
Those due to malabsorption
Those due to nutrient, mineral and vitamin deficiencies.
The main food sources in patients; Protein, carbohydrate and fat absorption is impaired and the most severely impaired absorption is fat. Diarrhea and bloating may occur in patients as a result of impaired fat absorption. As a result of carbohydrate malabsorption, patients develop lactose intolerance, which may cause complaints such as abdominal pain and bloating after milky foods.
Due to malnutrition, vitamin and mineral deficiency in patients;
Weakness and edema
Anemia (iron and vitamin B12 deficiency)
Bone resorption (osteoporosis)
Easy decay (vitamin K deficiency)
Nerve damage = peripheral neuropathy ( Vitamin B12 and B1 deficiency)
Infertility (menstrual disorder, miscarriages)
Muscle weakness (potassium, magnesium deficiency)
Hair loss
Loss of appetite.
Diagnosis and treatment
When celiac disease is suspected, some blood and stool tests are ordered after a thorough examination. In addition to measuring the blood levels of certain substances that may be deficient in this disease, such as calcium, magnesium, potassium, protein, cholesterol, vitamin B12, vitamin A, folic acid and iron, performing a complete blood count and controlling inflammation markers; Some tests used to diagnose celiac disease also need to be done. Another examination that must be done in the diagnosis of celiac disease is small intestinal mucosal biopsy. Especially in patients with significant weight loss, abdominal pain, anemia, night sweats and bleeding, these examinations may be required and other imaging methods such as computed tomography of the abdomen may be required when necessary. If not diagnosed early, celiac disease can lead to serious problems. Those with complaints similar to the findings described above or with a family history of celiac disease should consult an internist or gastroenterology specialist. In up to 10 percent of those with celiac disease; The same disease can be seen in mothers, fathers, siblings or children. Women with severe anemia during pregnancy should be investigated for celiac disease.
A strict gluten-free diet is the basis of treatment in celiac disease. For this purpose, foodstuffs made using gluten-containing grain products (wheat, barley and rye) should never be eaten. Products made from rice, corn, potato and soy flour are edible. There is no harm in eating fruits, vegetables, eggs and meat products.
Following a gluten-free diet can be more expensive, difficult and tedious than a normal diet. Therefore, it is not recommended to follow such a diet without a definitive diagnosis. Since these patients may also have lactose deficiency (lactose intolerance), it is recommended not to take milk and dairy foods at first.
Days after starting a gluten-free diet, complaints begin to decrease. Although the symptoms disappear completely, it may take up to 2 years for the intestinal mucosa to heal completely, but the healing of the intestinal mucosa usually takes place within 3-6 months.
There is no drug treatment for celiac disease
The disease usually progresses well in patients who follow a strict gluten-free diet. Among the serious diseases that can occur in the long term (20-30 years) in untreated cases; small intestinal lymphoma, small intestinal ulcers, and collagenous celiac disease. Transformation into cancer can be prevented with a strict diet.
