What is Celiac Disease?

By Editor On Dec 24, 2023

What is Celiac Disease?

Celiac disease, which progresses with chronic damage to various tissues on the intestinal surface, is an immune system disease caused by both environmental and genetic factors. Consuming some grains such as barley, wheat and rye by genetically sensitive people causes a reaction in the body, and the protein called gluten contained in these grains is considered a completely toxic substance by the immune system. This disease, which was initially considered a digestive system disease, has been examined in detail in many studies conducted in recent years and has been shown to seriously affect many neurological, psychological, hormonal, rheumatological and cardiological systems. Lack of knowledge about celiac disease delays the diagnosis process of the disease, and this can lead to growth and development retardation, especially in childhood. Therefore, having accurate information about celiac disease and gluten intolerance is extremely important to support the healthy development process.

What is Celiac Disease?

The healthy intestinal surface is surrounded by protruding structures called villi. These structures facilitate the movement of consumed food within the intestine and ensure the absorption of digested food contents. In celiac disease, gluten consumption causes damage to these valuable structures in the intestinal mucosa and healthy intestinal functioning is disrupted. When a person consumes gluten-containing foods, the peptides called gliadin contained in the gluten protein combine with molecules called “Human leukocyte antigen” (HLA) class II, and this initiates the reaction chain of the immune system. Gliadin substance is considered “toxic” by the immune cells of celiac patients and a strong humoral and cytotoxic cellular immune response occurs. The molecule called gliadin is actually completely toxic. A molecular structure called “33-mer peptide” contained in it is the pioneer molecule that initiates the inflammatory response in genetically predisposed people. When this toxic molecule is taken into the body, anti-gladin (AGA), anti-endomysial (EMA), anti-tissue transglutaminase (Anti dTG), anti-reticulin (ARA) and similar antibodies are formed in the blood. The autoimmune response developed against these antibodies targets not only intestinal cells but also the tissue transglutaminase enzyme, which is found in many other organs. Therefore, celiac disease is not only a disease related to the digestive system, but a complex disease that affects the entire body system in gluten-sensitive people.

What are the Symptoms of Celiac Disease?

The first symptoms of celiac disease are usually changes in the digestive system. Loss of appetite, chronic diarrhea or chronic constipation, recurrent abdominal pain and vomiting, short stature of unknown cause, significant delay in puberty, iron deficiency anemia that does not respond to treatment and whose cause cannot be determined, and osteoporosis are the main symptoms indicating celiac disease.

What Causes Celiac Disease?

Genetic factors play an important role in the emergence of celiac disease, but environmental factors are also extremely important. Even in people with genetic sensitivity, no symptoms of the disease are seen unless gluten is consumed through diet. For this reason, celiac disease is frequently encountered in societies that consume mainly wheat and other gluten-containing grains in their diet. The duration of exposure to the gluten molecule is directly proportional to the duration of the body’s immune response and disease development. When gluten is taken into the body, toxic gliadin peptides are released and the reaction chain of the immune system is initiated.

What are the symptoms that occur with Celiac Disease?

The clinical picture in celiac disease can be extremely variable. As a result of damage to structures called villi, malabsorption develops in the small intestine, and this leads to changes in the functioning of many body systems, especially the digestive system. Common clinical symptoms associated with celiac disease can be listed as follows:

The most important symptoms of celiac disease are the oily and dull appearance of the stool and the frequent and abundant defecation.
In classical celiac disease, the majority of symptoms are related to the digestive system and are often observed between the 6th and 24th weeks of life. It occurs with additional food intake during the months. Typically, digestive system findings such as chronic diarrhea or loose stools, nausea, vomiting, loss of appetite, abdominal pain, and gas complaints are accompanied by growth and developmental delay.
Celiac disease, which presents with non-classical, non-digestive symptoms, occurs mostly in children over the age of 5-7 and in adults. Common symptoms include short stature, delayed puberty, deterioration in the tooth enamel layer, recurrent aphthous ulcers in the mouth, iron deficiency anemia that does not fully respond to treatment and whose cause cannot be determined, skeletal diseases related to osteoporosis or low bone density, heart muscle disorders such as cardiomyopathy, chronic arthritis. In addition to liver dysfunction and neurological disorders, digestive system symptoms such as recurrent abdominal pain, nausea and vomiting, feeling of bloating in the abdomen, constipation and gastroesophageal reflux are included.
Another common symptom, especially in adults, is skin rash called dermatitis herpetiformis. Maculopapular rashes occur especially on the arms and legs, buttocks, face, neck and trunk surfaces.
Depending on the immune response, various dermatological diseases such as linear IgA dermatosis, hereditary angioneurotic edema, cutaneous vasculitis, erythema nodosum, urticaria, vitiligo, and alopecia areata may be observed.
However, aphtha-like findings may occur in the oral and/or genital mucosa due to iron, zinc, folic acid and B12 deficiencies.

How to Diagnose Celiac Disease?

Celiac disease is a complex disease that continues throughout life and greatly changes a person’s eating habits, so it is extremely important to be sure of the diagnosis of the disease. In order to make a diagnosis in the presence of classical or non-classical symptoms, it is necessary to detect the presence of antibodies in the blood in the first stage. These tests, which search for antibodies developed against dietary gluten and damage to the intestinal mucosa, are considered the most valuable method for screening, but small intestine biopsy is the gold standard for diagnosis. Intestinal biopsy is preferred to eliminate suspicion, especially in non-classical celiac diseases that do not cause clear symptoms related to the digestive system.

Celiac Disease Treatment

Since celiac disease is a condition that occurs with the consumption of gluten protein in people with a genetic predisposition, the only accepted treatment option for the disease is a lifelong gluten-free diet. As long as the person does not consume foods containing gluten, no disease develops in the body and healthy intestinal functioning is maintained. People diagnosed with celiac disease should choose options such as corn and rice that do not contain toxic prolamins, instead of gluten-containing grains.

In order to properly comply with the gluten-free diet, it is important to prevent contamination with gluten during food preparation and to prepare meals in completely gluten-free environments.

How to Prevent Celiac Disease?

Since celiac disease occurs with gluten consumption, preventing the disease is only possible by maintaining a gluten-free diet. Even if a person with a genetic predisposition has been diagnosed with celiac disease as a result of screening, he or she can prevent the development of the disease by adapting to a gluten-free diet. People who avoid gluten consumption do not experience digestive system problems such as diarrhea, abdominal pain, nausea, or bloating, do not develop any damage to the intestinal surface, and do not experience absorption-related disorders. Therefore, even if a diagnosis of celiac disease, also called gluten enteropathy, is made, the disease is prevented.

What Happens If Gluten-Free Diet Is Not Followed?

Since classical celiac disease causes significant complaints about the digestive system in its initial stage, the person’s quality of life is greatly impaired and this makes diagnosis easier. However, in non-classical, atypical celiac disease, the disease symptoms are not easily noticed and the person’s treatment with a gluten-free diet is delayed. In this case, failure to comply with the gluten-free diet causes serious disorders in many systems of the body.

Celiac disease is a disease directly related to the body’s autoimmune response mechanism. Therefore, continuing the disease for a long time causes disruptions in the body’s autoantibody production mechanism and makes the person prone to other autoimmune diseases. Multiple sclerosis (MS), rheumatoid arthritis, insulin-dependent diabetes, systemic lupus erythematosus (SLE), pemphigus vulgaris and ankylosing spondylitis can be listed as common serious autoimmune diseases.
Celiac disease, which progresses with damage to the intestinal surface and malabsorption, causes nutritional deficiencies and negatively affects the functioning of many systems in the body. As the disease progresses, some endocrine disorders occur, and the risk of miscarriage increases in women who do not follow a gluten-free diet, and the complication of premature birth is frequently encountered.
If the gluten-free diet is not followed, the possibility of developing malignant tumors in the body increases. In other words, it is possible to say that people with celiac disease who refuse treatment are in the high-risk group against various cancer diseases.

For other issues you are curious about about celiac disease, you can contact health institutions and get support from specialist physicians.

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