Health Facts

Celiac Disease

What is Celiac Disease?

Celiac disease, also known as Celiac sprue or gluten sensitive enteropathy, is an immunological reaction (your body’s reaction to foreign substance like virus, fungus or bacteria) to gluten (protein present in wheat, rye and other grains).

When you eat gluten, your immune system targets your own tissues. This reaction destroys the lining of your small intestine over time, preventing it from absorbing certain nutrients. This intestinal damage can lead to serious complications.

Up to six to eight million people in India are affected by Celiac disease. As per the Celiac Society of India (CSI), 90 per cent Indians are unaware of celiac disease. It is seen more often in northern India as compared to the south or north-eastern areas, where cereal consumption patterns are very different between north and south India. Rice being more staple among south Indians compared to North Indian, however, this scenario is changing because of lifestyle changes and metabolic disorders.

Symptoms of Celiac Disease:

The signs and symptoms of celiac disease differ in children and adults. Most of the adults with celiac disease have symptoms unrelated to digestive system. For example:

Anaemia (iron deficiency)

Osteoporosis
(loss of bone density)

Mouth ulcers

Itchy skin rash

Numbness and tingling
in hands and feet

Digestive symptoms in adults and children include:

Fatigue

Diarrhoea

Nausea and vomiting

Constipation

Abdominal pain

Gas and Bloating

Pale, foul smelling stools

Swollen belly

Weight loss

Types of celiac disease:

Based on the kind of symptoms, celiac disease is divided into five types:
  1. Classic: Occurs in children between 6 to 24 months of age. It is characterised by symptoms of malabsorption.
  2. Non-classic: Includes variety of symptoms and is more common than classic celiac disease.
  3. Silent: Silent celiac disease has no symptoms.
  4. Potential: It has a normal small bowel biopsy and positive serum markers.
  5. Refractory sprue: This condition is divided into 2 groups:
    1. primary – when you do not have good response to gluten free diet
    2. secondary – when you have good response to gluten free diet.

Testing and diagnosis:

Many celiac disease patients are unaware of their condition. It can be diagnosed using two blood tests: serology and gene testing.

Your doctor will recommend either endoscopy or capsule endoscopy, if the blood test results indicate celiac disease. This helps to analyse for damage to inner lining of the intestine by viewing your digestive tract.

Treatment for celiac disease:

Following a strict gluten free diet heals lining of your small intestine and cause symptoms to resolve. Gluten free diet can also help prevent future complications and malignancies. A dietician will help you follow healthy gluten free diet. Consuming even small amount of gluten can damage your intestine.

FAQ's :

Celiac disease is a genetic disorder; HLA (human leukocyte antigen) genes are associated with the disease. HLA-DQ2 or HLA-DQ8 genes can lead to development of celiac disease. Genes along with environmental triggers like stress, illness, surgery, pregnancy, etc., can cause the disease.

Celiac disease is more common in people who have a family history. This means that if you have a family member (blood relation) who has celiac disease, you are more likely to get it. Up to 10% of family relatives of celiac disease patients develop this autoimmune disorder.

Yes, genetic testing is available and is beneficial for family members and relatives of people diagnosed with celiac disease. This test examines your DNA and can tell the changes (mutations) in the disease-causing genes.

Foods that contain gluten include: Wheat, Barley, Rye, Semolina, Soy sauce, Malt, Pasta, cereals, Processed food or preservatives, Modified food starch, etc.

References:

  1. Celiac disease. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/celiac-disease/diagnosis-treatment/drc-20352225 Accessed on 25-03-2022.
  2. The genetics of celiac disease: A comprehensive review of clinical implications. PubMed. https://pubmed.ncbi.nlm.nih.gov/26194613/ Accessed on 25-03-2022.
  3. MAGI2 Gene Region and Celiac Disease. Frontiers in Nutrition. https://www.frontiersin.org/articles/10.3389/fnut.2019.00187/full#h5 Accessed on 25-03-2022.
  4. Coeliac UK. https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/causes/genetics/ Accessed on 25-03-2022.
  5. Celiac disease. Medline Plus. https://medlineplus.gov/genetics/condition/celiac-disease/#inheritance Accessed on 25-03-2022.
  6. Celiac disease. National Institute of Diabetes and Digestive and Kidney Disease. https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/symptoms-causes Accessed on 25-03-2022.
  7. What is Celiac Disease. Beyond Celiac. https://www.beyondceliac.org/celiac-disease/facts-and-figures/ Accessed on 25-03-2022.

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