The most common genetic autoimmune disorder in the world, celiac disease, and its symptoms can be effectively treated with a gluten-free diet.
The frequency of celiac disease has gained increasing attention over the past several years, but labeling the rise of the condition, which affects the digestive process of the small intestine, as a recent development would be telling only part of the story. It has actually been around since the time of the ancient Romans and is the worlds most common genetic autoimmune disorder, affecting an estimated 3 million Americans and nearly 1 percent of the worldwide population that have had the gene passed down to them.
And despite 2009 Mayo Clinic findings that celiac disease is four times more common today than it was 50 years ago, it remains so misunderstood that 97 percent of Americans with the disorder are undiagnosed. The disease can also mimic symptoms of many other conditions such as anemia, fatigue, joint pain and infertility, making it even more difficult to diagnose; a large number of people who are affected show no symptoms at all. However, education for both the general public and the medical profession is increasing.
The most popular theory for the increased attention toward the inherited disorder is the hygiene hypothesis, which suggests that the cultures in our guts don’t get exposed to enough bacteria early on in life in other words, were too clean nowadays. Eventually, our immune system becomes weaker and more vulnerable. In addition, foods with gluten, which is a protein found in wheat, rye and barley, have become a staple of many people’s diets. Consuming gluten, even in microscopic amounts, causes the immune system of a person with celiac disease to attack the small intestine and hamper the absorption of nutrients into the body.
For those diagnosed with celiac disease, the only effective treatment is adopting a strictly gluten-free diet.
Once symptoms become apparent, the recommended screening initially involves genetic testing, particularly for first-degree relatives of someone with the condition. Next are blood tests to determine if your system is producing antibodies, which are created by the immune system to fight off the body’s enemies, as a negative response to gluten. A definitive diagnosis should include a biopsy of the small intestine to test tissue samples in combination with results determined through a gluten-free diet. If the condition goes undiagnosed or untreated, it can result in osteoporosis, infertility, neurological conditions and even cancer in rare cases.
For those diagnosed with celiac disease, the only effective treatment is adopting a strictly gluten-free diet. A program of gluten-free foods can produce symptom improvement within weeks. Although gluten-free options in stores and restaurants are increasing, the FDA has yet to establish a gluten-free standard on nutrition labels, so its important to always carefully understand what you’re eating. The goal of finding a cure remains 10-15 years away, but with a well-planned gluten-free diet, leading a healthy lifestyle with celiac disease is attainable for all of us.
How is gluten intolerance different from celiac disease? And can you get sick from gluten even if you don’t have celiac disease?
Gluten intolerance is the umbrella term used by The University of Chicago Celiac Disease Center when referring to the entire gamut of gluten issues: celiac disease, non-celiac gluten sensitivity and wheat allergy. Celiac disease, unlike a wheat allergy or gluten intolerance, is an inherited condition. While the symptoms of intolerance can be similar, they do not cause permanent damage to the small intestine. Thus, one can test negative for celiac, but still be gluten intolerant or have a wheat allergy.
A 2012 report details the symptoms of gluten sensitivity, which can include fatigue, headache,foggy mind, numbness of the arms, fingers or legs, and joint pain, along with associated gastrointestinal symptoms. People allergic to wheat can experience wheezing, swelling of the mouth or throat, rash, and diarrhea. Currently, there is no test available for gluten intolerance, and eliminating gluten from your diet makes it more difficult to diagnose inherited celiac disease. Ruling out celiac through proper testing is recommended before adopting a gluten-free diet plan.
Dr. Stefano Guandalini, M.D., is founder and medical director of The University of Chicago Celiac Disease Center and president of the North American Society for the Study of Celiac Disease. An internationally recognized expert on celiac disease, his scientific and professional career has focused on diarrheal diseases of children. He graduated with high honors from the University of Messina, Italy, and is the past president of the Federation of International Societies for Pediatric Gastroenterology, Hepatology, and Nutrition.