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Debunking Myths: What is Celiac Disease?

Between 600,000 and 900,000, that's the number of people with celiac disease estimated by FACE (Federation of Coeliac Associations of Spain) in Spain in 2024. Despite its increasing visibility, there are still many myths surrounding this condition.


Panes, pastas y derivados del trigo

 

Celiac disease, also known as coeliac disease (CD), is an autoimmune disorder that affects approximately 1% of the global population.


This condition manifests when a person consumes gluten, a protein found in wheat, rye, and barley. In genetically predisposed individuals, gluten triggers an immune response that damages the lining of the small intestine, affecting its ability to absorb nutrients properly.

Unlike a simple food intolerance, celiac disease can have serious implications for overall health.


Damage to the intestinal mucosa can lead to nutritional deficiencies, growth problems in children, and a variety of long-term complications. Therefore, it's important to understand that celiac disease is a chronic condition that requires accurate diagnosis and rigorous treatment to prevent serious complications...


Risk Factors and Triggers of Celiac Disease


Celiac disease cannot be prevented, but certain risk factors increase the likelihood of developing the disease. Genetic predisposition is one of the most significant factors.

People with close relatives who have celiac disease have a higher risk of developing it themselves. Additionally, certain genes such as HLA-DQ2 and HLA-DQ8 are strongly associated with the disease.


Other risk factors include a history of other autoimmune diseases, such as type 1 diabetes and autoimmune thyroiditis.


Interestingly, events like viral infections or prolonged high levels of stress can act as triggers for the onset of celiac disease in predisposed individuals.


Although gluten is the main trigger, the disease can develop at any time in life, from childhood through old age. So forget the myth that it's a childhood illness.


Mechanism of Action: How Gluten Affects the Body


Gluten, a protein found in wheat, barley, and rye, triggers an autoimmune response in individuals with celiac disease.


When a person with celiac disease ingests gluten, their immune system responds by attacking the lining of the small intestine. This causes inflammation and damage to the villi, small projections on the intestinal mucosa that are necessary for nutrient absorption.

This damage can result in malabsorption of essential nutrients such as iron, calcium, and B vitamins, leading to a range of health issues including anemia, osteoporosis, and vitamin deficiencies. Furthermore, chronic inflammation in the intestine can have systemic effects, affecting multiple organs and systems in the body.


It's important to note that celiac disease is an autoimmune condition, not a food allergy, which means the body's immune system is involved in attacking its own tissues.


Infografía síntomas de Celiaquía

Symptoms of Celiac Disease: Beyond Digestive Issues


Celiac disease manifests in various ways, and symptoms can vary significantly from one person to another.


Traditionally associated with digestive symptoms such as chronic diarrhea, abdominal pain, bloating, and weight loss, many individuals also experience extra-intestinal symptoms or may even be asymptomatic.


Common non-digestive symptoms include:


  • Chronic fatigue

  • Iron-deficiency anemia

  • Osteoporosis

  • Dermatitis herpetiformis (an itchy skin rash)

  • Neurological problems such as migraines and peripheral neuropathy


In children, celiac disease can cause growth delay, short stature, and developmental issues.


It's important to understand that extra-intestinal manifestations of celiac disease are more common than previously thought. For example, fertility problems, liver conditions, and additional autoimmune diseases are frequent in individuals with undiagnosed or poorly managed celiac disease.


Due to the wide range of symptoms, a high level of clinical suspicion is often needed to diagnose the disease.


Dermatitis por enfermedad celíaca

Diagnosis of Celiac Disease: Tests and Procedures


Diagnosing celiac disease is complex and requires a combination of tests.


The first step usually involves a blood test to detect specific antibodies, such as tissue transglutaminase antibodies (tTG-IgA) and endomysial antibodies (EMA). These antibodies are markers of an abnormal immune response to gluten.


Additionally, it's important to consider a DNA test to detect the HLA-DQ2 and HLA-DQ8 genes, present in the vast majority of individuals with celiac disease.


Anclaje de antígenos celíacos

If blood test results are positive, the next step is a biopsy of the small intestine, performed via endoscopy. During this procedure, a small tissue sample is taken from the small intestine to examine for damage to the intestinal villi. The combination of positive blood test results and evidence of damage in the biopsy is essential for a definitive diagnosis.


It's crucial that these tests are conducted while the patient is still consuming gluten, as a gluten-free diet can reduce antibody levels and heal the intestine, potentially leading to false negative results.


For proper management and an accurate diagnosis, consult a gastroenterology specialist.

El diagnóstico de la celiaquía es complejo y requiere una combinación de pruebas.


Impact of Celiac Disease on Daily Life


Living with celiac disease involves more than just avoiding gluten. The condition can have a significant impact on daily life, from meal planning and label reading to managing the diet in social situations and during travel.


One of the biggest challenges for people with celiac disease is avoiding cross-contamination, which can occur when gluten-free foods come into contact with gluten during preparation or storage. This requires careful food preparation and often changes in the household kitchen.


Additionally, eating out can be tricky, as not all restaurants are equipped to handle gluten-free diets. It's important to clearly communicate dietary needs to restaurant staff and, whenever possible, research and select places that offer safe gluten-free options.


Etiqueta de alérgenos

Myths and Realities about Celiac Disease


There are many myths and misunderstandings about what it means to have celiac disease.

One of the most common myths is that it's simply a food intolerance. As we've seen, it's actually a serious autoimmune disease that can have significant health consequences if not properly managed.


Another myth is that celiac disease is exclusively a childhood illness. While it can be diagnosed in childhood, it can also appear at any stage of life.


Additionally, not all people with celiac disease have digestive symptoms; many experience symptoms unrelated to digestion or may even be asymptomatic.


And unfortunately, to date, the only effective way to manage the disease is to strictly adhere to a gluten-free diet. There are no medications that allow celiacs to consume gluten without suffering damage.


Celiac disease is complex, but with early diagnosis and proper treatment, it can be effectively managed. Detecting it early not only prevents complications but also significantly improves the quality of life for those affected.


Adapting to a gluten-free diet may be challenging at first, but it's crucial for long-term health maintenance. With ongoing education and guidance from healthcare professionals, the challenges of living with this disease can be managed.


And with the necessary precautions, individuals with this condition can indeed lead a full and healthy life.


Are there other foods that don't sit well with you? You might find this interesting.

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