In recent years, we have heard more and more about gluten intolerance. More and more people are avoiding foods containing gluten because they have the feeling that they feel better without it – but without having carried out a diagnosis of possible gluten intolerance – also known as celiac disease. What is celiac disease and how does it manifest itself? How is it diagnosed? What are the therapeutic options?
That says the pediatrician Dr. medical Nadine McGowan
Celiac disease is an autoimmune disease caused by an intolerance to gluten protein. Gluten is found in many grains: wheat, rye, barley and spelled. The numbers on how common celiac disease is varies widely. About 0.5 to 1 percent of the population is probably affected.
What is gluten and why does it damage the gut for some?
The intolerance triggers an immunological reaction in the intestine whenever non-gluten-free foods are consumed. Briefly, in these patients, gluten triggers an autoimmune response against tissue transglutaminase, an enzyme in the wall of the small intestine. This leads to the mucous membrane of the small intestine is severely damaged. It usually has a lot of villi (they are only visible under a microscope and look like little fingers protruding into the intestinal lumen). This increases the resorption area – that is the area available for absorbing nutrients, liquids, etc. – to approx. 180m2 in adults.
Gluten intolerance – symptoms in children and adults
Gluten intolerance causes a constant inflammatory reaction in the intestine, which destroys the intestinal villi. This, in turn, results in indigestion, chronic diarrhea, which is often sticky and greasy, smelly (because there is also a fat absorption disorder), and sometimes constipation.
Gluten intolerance in small children is usually first noticed by a constantly very bloated stomach and then by a failure to thrive. In adults, there can also be other symptoms that you might not initially associate with digestive problems: chronic fatigue, mood swings, depression, or even anemia (low blood count).
The severity of symptoms in celiac disease varies greatly – some patients already get the most severe symptoms from a little gluten, while others can also consume larger amounts of gluten-containing foods and still have little or no symptoms.
Gluten Intolerance Test
Celiac disease can be diagnosed relatively easily with blood tests that detect antibodies (e.g. against tissue transglutaminase). If this examination is positive, the stomach and small intestine are examined, in which the changes caused by the constant inflammation are sometimes already visible to the naked eye. At the latest in the biopsy (tissue sample) you can see exactly the damage to the villi of the small intestine and thus definitely secure the diagnosis.
Unfortunately, there is currently no causal therapy for celiac disease. Lifelong adherence to a gluten-free diet is required. Since gluten can not only be found in cereals but also in various products through admixture, the list of ingredients must be read carefully. With a valid diagnosis of celiac disease, it makes a lot of sense to seek nutritional advice anyway. Then all important points can be discussed and thus nutritional errors can be minimized.
After a period without gluten, the mucous membrane in the small intestine recovers, the villi look normal again and the symptoms disappear. The affected children often make up for the reduced growth and develop completely normally – provided they follow a gluten-free diet.