Main points of the article:
What are the symptoms of celiac disease? Most people with the disease do not experience any symptoms at all, in such cases the disease may be detected in a routine blood test. If there are symptoms, they will usually be expressed in abdominal pain, abdominal swelling and diarrhea – the symptoms are the same in children and adults.
How is it diagnosed? The initial diagnosis is made through an antibody test in the blood. If the test is normal, the result will almost certainly rule out the disease. If it is not normal, the next step is a gastroscopy, in which a tube with a camera is inserted into the upper digestive system to take a sample from the small intestine.
How are you treated? The treatment of the disease is based on a gluten-free diet – it is important to consult with a dietitian about what is allowed and what is not allowed to be eaten and for building an appropriate menu.
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Celiac is an autoimmune intestinal disease in which the body secretes antibodies that attack healthy cells in the body, after absorbing gluten. Those antibodies affect the intestinal lining – especially the lining of the upper part of the small intestine. Following the attack of the antibodies, the body may develop inflammation in the small intestine, which causes problems with the absorption of vitamins critical to the healthy functioning of the body. The disease has a genetic component, therefore it is important that first degree family members of a patient are tested because they are at high risk of getting sick, compared to the general population.
Mechanism of celiac disease. Photo: Shutterstock
Dr. Naim Abu Friha, expert to gastroenterology At Soroka Hospital, Leumit Health Services explains about the disease:
What are the symptoms of celiac disease?
“Most people do not experience symptoms at all. In such cases, the disease may be detected in a routine blood test,” explains Dr. Abu Feriha. The symptoms are the same among children and adults, but unlike adults, children who suffer from growth problems and low weight may suffer from celiac disease, so it is important to get them checked. It is also important to know that there is no specific symptom for celiac disease, the symptoms that people present with can of course indicate other diseases as well.”
What are the ways to diagnose celiac disease?
“Usually, we will start with a comprehensive medical investigation, after discovering abnormal findings in the blood tests, which are manifested by anemia and a lack of iron or a disturbance in the liver enzymes. The initial diagnosis is made through a blood test that tests the level of antibodies in the blood. If the test is normal, the result will almost certainly rule out the disease. That is, if the test is not normal, another test must be performed – a gastroscopy test, during which a tube with a camera is inserted into the upper digestive system to take a sample from the small intestine. If results suitable for celiac disease are obtained in both the blood test and the gastroscopy test, a diagnosis will be obtained. However, sometimes the results obtained are considered borderline and in these cases a genetic blood test is performed, which can help with the diagnosis.”
What is the prevalence of the disease?
“It is a relatively common disease, it varies from country to country and from population to population, but statistically speaking, one out of a hundred people has celiac disease. At the same time, awareness of the disease has increased significantly in the last two decades both among the general population and among medical professionals. In the past, patients were diagnosed In a very advanced stage of the disease, after their bodies have already suffered advanced damage. Today this almost never happens.”
How is the disease treated?
“Since it is an autoimmune disease in which the immune system attacks the body – in the case of celiac disease after absorbing gluten – the main treatment is avoiding gluten. After the diagnosis, we refer the patients to a dietitian. Of course, they are not allowed to eat bread, pasta, certain cakes, etc. There are gluten substitutes on the market , which are a bit expensive but worth it because after all the patient will have to avoid gluten for the rest of his life. In addition, patients with the disease should be monitored by a gastroenterologist and a dietician, among other things, to check that they do not suffer from vitamin deficiencies, including iron, vitamin D, and folic acid And more. If they are balanced and everything is fine, once a year they will have to perform blood tests.”
What are the risks of the disease?
“The risks are absorption disorders, which cause a lack of iron and a lack of vitamins. A lack of vitamin D, for example, can cause bone diseases and osteoporosis (bone thinning). There are two other complications that are considered rare. The first is the development of ulcers along the small intestine, which may indicate a more serious disease. The complication The other is the development of lymphoma – cancer of the lymph cells in the small intestine. As mentioned, this is a rare complication but it exists and we are aware of it. In addition, the disease may harm fertility, so it is important that women of childbearing age be diagnosed and avoid gluten.”
What is the difference between celiac disease and gluten intolerance?
“In gluten intolerance, the antibodies that attack the immune system cannot be diagnosed, that is, it is not classic celiac disease – it is a lower level of gluten sensitivity. Also, because the intolerance cannot be diagnosed, the attending physician will rely on the patient’s story and the symptoms he is suffering from Most of the time, we ask those patients to avoid gluten for a period and check if there is an improvement in their condition.”
what did we learn Celiac is an autoimmune intestinal disease, in which the body secretes antibodies that attack healthy cells in the body when gluten is absorbed. In many cases, people with the disease will not feel any symptoms at all, but because it is a genetic disease, you should get tested even if you are asymptomatic. After the diagnosis, it is important to avoid consuming gluten and follow a proper diet for the condition.