Find out if you are an unaware celiac: symptoms and remedies

The International Celiac Day on May 16th reminds us how essential it is to have the right attention for this chronic inflammation of the small intestine.

“About 1% of the Italian population is celiac. But currently only 230,000 patients have a diagnosis, against the expected 600,000. – he claims Alexander GraniteAssociate Professor of Internal Medicine at the University of Bologna IRCCS Policlinico di Saint Ursula – A considerable number of people who do not yet know that they have this autoimmune chronic intestinal disease. These are data confirmed by the Ministry of Health.

A difficult diagnosis, due to very different symptoms and manifestations, both intestinal and extraintestinal, also common to other pathologies. A difficult identification, which often leads to too long and unnecessary tests for some patients before receiving a correct diagnosis.

The celiac disease it is an autoimmune disease, triggered by the ingestion of gluten in genetically predisposed subjects, which mainly affects the female population.

Specifically, these are people who cannot consume cereals containing gluten such as wheat, spelt, barley and rye. To date, in fact, the only therapy with demonstrated efficacy consists in the rigorous and permanent exclusion of gluten from the diet, which represents a social and psychological burden for the subjects involved.

Symptoms

• Abdominal pain The reaction to gluten causes some typically intestinal symptoms, such as bloating, flatulence and abdominal pain. The latter can be of the colic type, with acute painful waves, cramping or continuous.
• Anemia Another characteristic symptom is a drop in the amount of hemoglobin in the blood. The celiac subject can suffer from various types of anemia, such as iron deficiency, folate deficiency, pernicious or megaloblastic anemia.
• Dysentery The body’s immune reaction to gluten can also cause diarrhea and, in the most serious cases, real dysentery, which is rarer in adults than in children.
• Depression or anxiety
• Irregular menstrual cycle
• Vomit Vomiting can also occur among the other symptoms of celiac disease.
• Sufferers of celiac disease may also feel a sense of tiredness, weakness or lack of energy. All this leads to a decrease in physical and mental capacity, easy fatigue and reduced resistance to effort.
• Asthenia
• Undernutrition Celiac disease also affects the absorption of some important nutrients, so undernutrition can take over, a physical state that characterizes the body when, for long periods, the supply of nutrients is insufficient to meet the body’s daily needs.
• Pallor Loss of normal skin color may also occur, which usually occurs gradually, even in a generalized form
• Weight loss
• Growth retardation Especially in children, celiac disease leads to growth retardation, with a consistently low weight in relation to age. All this is caused by the lack of absorption of essential nutrients for the body.
• Osteopathy Celiac subjects can sometimes also suffer from osteopenia, the reduction of bone mass, with thinner and weaker bones and joint pain.

As you can see the many symptoms of celiac disease are the same as those of other diseases. This is why it can be difficult to realize that you suffer from this disorder.

The diagnosis of celiac disease

In the presence of the symptoms listed above, specific tests can be used to diagnose celiac disease with certainty. In fact, untreated celiac disease can lead to even dramatic complications, such as intestinal lymphoma.

• A first level test for diagnosis is represented by blood tests, with which the presence and quantity of certain antibodies is identified. Test results are used to determine whether or not gastroscopy with biopsy is needed.
• Gastroscopy with biopsy is a necessary exam to confirm the diagnosis of celiac disease in adulthood (but not always necessary in childhood): this exam involves the microscopic analysis of a small fragment of intestinal mucosa to check if there are any tissue alterations typical of celiac disease.
• Finally, it is possible to carry out a genetic test in which, by means of a blood sample, the presence of one or both of the HLA-DQ2 and DQ8 genes (the predisposition haplotypes for celiac disease) is determined, the presence of which, however, only indicates that that subject is predisposed to the development of celiac disease. The diagnosis, in fact, is made by evaluating the clinical picture, the other laboratory data and the histological examination of the intestinal mucosa fragment. This test is therefore only important to exclude celiac disease: in fact, the failure to find the HLA-DQ2 and/or DQ8 haplotypes determines a very strong improbability (about 95%) that that individual will develop this disease.

It is important to keep in mind that, in order not to risk obtaining false results, all tests for the diagnosis of celiac disease must be carried out without having first eliminated gluten; for those who have already started a gluten-free diet, a new set of tests may need to be done after consuming some foods with gluten in one meal a day for 2-6 weeks.

Therapy

The only therapy available for celiac disease is a completely gluten-free diet, to be strictly followed for life. After removing gluten from the diet, intestinal damage begins to heal within weeks, while antibody levels decrease over the course of a few months.