Celiac disease (or celiac disease) is a common condition that affects approximately one in 100 people, being more frequent in women. A significant percentage of patients (75%) are undiagnosed, hence the need to carry out an intentional search for symptoms or symptomatic combinations that should arouse clinical suspicion.
living gluten free
Celiacs are individuals genetically predisposed to have a permanent intolerance to gluten from wheat, barley, rye and probably oats. When this intolerance occurs, it is characterized by an immune-based inflammatory reaction in the mucosa of the small intestine that hinders the absorption of macro and micronutrients.
Although, on occasion, symptoms may be atypical or absent, patients often experience weight loss, loss of appetite, fatigue, nausea, vomiting, diarrhea, bloating, loss of muscle mass, growth retardation, character changes ( irritability, apathy, introversion, sadness), abdominal pain, meteorism, iron deficiency anemia, all of them resistant to treatment.
Regarding treatment, the Federation of Celiac Associations of Spain recalls that to control the disease it is necessary to do a strict gluten-free diet for life. This leads to clinical and functional normalization, as well as repair of the villous lesion.
Celiacs should base their diet on natural food: legumes, meats, fish, eggs, fruits, vegetables, vegetables and gluten-free cereals: rice and corn. Prepared and/or packaged foods should be avoided, as far as possible, since it is more difficult to guarantee the absence of gluten in these.
When celiac disease occurs, it hinders the absorption of macro and micronutrients
The ingestion of small amounts of gluten, in a continuous way, causes the deterioration of the intestinal villi. As a consequence, a nutrient malabsorption defect (immediate principles, mineral salts and vitamins) can occur, leading to various deficiency states responsible for a wide spectrum of diseases.
From the psychological point of view, the person with celiac disease is no different from the rest of the population, but the lack of information, the difficulties to follow the diet correctly or the lack of support from society can lead some patients to feel anxious and depressed. .
Early diagnosis of celiac disease
According to the Ministry of Health guide on ‘Early diagnosis of celiac disease’, there are eight signs that may be of great interest for its early diagnosis, which we have compiled here:
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In it toddlerthe intestinal symptoms and growth retardationespecially if they are accompanied by irritability and anorexia, constitute a highly suggestive clinical picture of celiac disease.
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In it older child and adolescentthe discovery of a delayed height or pubertyas well as iron deficiency or hypertransaminasemia without any other justification, makes it necessary to rule out the existence of celiac disease.
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In the Adultsthe classic presentation of the disease in the form of chronic diarrhea with symptoms of malabsorption is unusual, with the presence of non-specific symptoms.
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4. It must be taken into account that the probability of suffering from celiac disease increases in certain risk groups. These primarily include first-degree relatives, certain autoimmune diseases (type I diabetes, hypothyroidism, etc.) and some chromosomopathies such as Down’s Syndrome.
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Often, the celiac patient has been visited by numerous physicians and subjected to various complementary examinations, being labeled a ‘functional disorder’. Experts advise special care for these patients, particularly if they also report a history of canker sores, asthenia, irritability, or depression.
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The possibility of celiac disease should also be taken into account in patients with early satiety and epigastric pain or burning (dysmotility dyspepsia or postprandial distress, especially if associated with flatulence, swelling and meteorism). In these cases, the suspicion of celiac disease in patients suffering from these symptoms should be strongly considered when the symptoms are chronic and recurrent and have not responded adequately to empirical treatment.
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Patients with chronic, intermittent watery diarrhea who have been classified as having irritable bowel syndrome (SII), must be thoroughly reviewed. The coexistence of flatulence or abdominal distension, rumbling and bowel movements mixed with abundant gas (‘explosive’) forces us to consider the possibility of celiac disease, likewise chronic constipation is not an exclusive symptom of suffering from CD.
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In addition, it should be evaluated for a diagnosis if the following situations occur without demonstrable explanation: women of childbearing age with iron deficiency, infertility and recurrent miscarriages; those who present elevation of transaminases; those who report a history of fractures from minimal trauma or osteopenia/osteoporosis detected before menopause or in a young adult male.