Celiac disease — an immune reaction to eating gluten
CELIAC disease — also called sprue or coeliac — refers to the body’s intolerance of dietary gluten, leading to small intestine disease with inflammation.
Internist Dr Samantha Nicholson Spence is quick to note, however, that Celiac disease is not the same as ‘gluten sensitivity’. Gluten sensitivity, she said, seems to be a fad these days, as many people claim not being able to take gluten because of symptoms such as rash, bloating, constipation and diarrhoea.
“Real celiac disease poses multiple medical problems,” said Dr Nicholson Spence.
Gluten is a family of proteins found in some grains. Celiac disease causes an immune reaction to gluten in the small intestines, which over time damages the lining of the intestines, and hinders the absorption of some nutrients by the body.
“Symptoms of celiac disease include diarrhoea, flatulence, anaemia, weight loss, brittle bones, fatigue, anxiety, epilepsy, and ataxia,” Dr Nicholson Spence said.
“They also suffer from vitamin deficiencies which result in brittle bones, hair loss, rash, feeling numb or weak, and having difficulty walking or impaired gait.”
The condition manifests itself in children with these symptoms as well, but because the disease interferes with how well the body absorbs nutrients necessary for growth, these children often suffer from stunted growth and tend to be shorter in stature. These physical signs are normally accompanied by behavioural changes including irritability, depression and poor academic performance.
Adults with the disease have an increased risk of cancer and cardiovascular events such as heart attack and stroke. They may also develop a rash (dermatitis herpetiformis) and liver disease, ranging from mild inflammation to cirrhosis, which requires a transplant. Women are at an increased risk of early menopause, infertility, miscarriage, and stillbirth.
Celiac disease is not known to be prevalent in Jamaica and is more common among people of European descent. However, you are more likely to develop celiac disease if there is a history of it in your family, or if you suffer from another autoimmune disease such as thyroid disease or Type 1 diabetes, said Dr Nicholson Spence.
“Many cases have not been identified in Jamaica because there is a low index of suspicion,” she said. “It is more prevalent in predominantly Caucasian, affluent populations, and its diagnosis requires relatively expensive testing where antibodies have to be sent to the United States. If these return positive, then a duodenal biopsy will need to be done.”
There is no cure for Celiac disease and patients have to maintain a strict gluten-free diet in order to avoid the symptoms.
“In severe disease, or when the body does not respond to dietary changes, it may require steroids or even chemotherapy drugs,” Dr Nicholson Spence explained.
Gluten is found in grains such as wheat, barley, rye and malt. Some common foods that are derivatives are noodles, baked goods, pastas, cereals, granola, sauces, dips, gravies, and beer. It is advised, however, to check the label of even the most unsuspecting products, as gluten is found in some candy bars, nutritional supplements, communion wafers, and even lipstick.
