Published: 03/07/2013 - Updated: 11/05/2018
Celiac disease: the importance of a good diagnosis. It is already known that permanent gluten intolerance is caused by celiac disease. It is also a fact that this is one of the most common chronic intestinal diseases in the world, it produces an atrophy of the villi of the intestine which leads to malabsorption of nutrients (protein, fats, carbohydrates, minerals and vitamins ).
Good diagnosis in celiac disease
What not well known is the way forward to reach the clear and definitive diagnosis of the disease. In fact, a recent press release states that, for example, is that in Aragon there are 1,300 recognized celiacs, but recent studies indicate that in Spain almost 2 percent of the population has a gluten intolerance, and 9 out of 10 affected have not been diagnosed.
The situation in Aragon: early screening program
The conference presentation“Celiac disease. Keys to diagnosis”, held at the Aragonese Celiac Association to bring healthcare professionals the latest developments related to the subject emphasized the lack of proper and timely diagnosis.
“Celiac disease is more common than we think, it is very difficult to diagnose because symptoms can be masked or resemble those of other common ailments, including” irritable bowel syndrome, “said the president of Aragonese Association, Carmen Tricasa in a news conference.
Thus, according Tricas, the doctor has to propose “looking for it”, performing all the tests outlined in the protocols. This is the only way that all patients remaining at the “tip of the iceberg” without a diagnosis, will be revealed.
For his part, Dr. Miguel Ángel Montoro, scientific director of the conference, explained that “oftentimes, these patients have been diagnosed with a functional digestive disorder, and in many cases, end up being referred to the psychologist or psychiatrist, attributing their symptoms to the effects of stress or anxiety.
According to Montoro, secretary of the Spanish Association of Gastroenterology and specialist in Gastroenterology and Hepatology Unit, Hospital San Jorge, celiac disease occurs in genetically predisposed individuals when in contact with gluten, a protein contained in certain grains such as wheat , barley and rye.
“The contact of this element with the intestinal mucosa is able to promote a response from our defensive system that leads to an inflammatory lesion of the intestinal mucosa, leading to, in serious cases, intestial atrophy of the villi, leading to serious state deficiency, “he said.
Some people with iron deficiency anemia, osteoporosis or changes in mood, with a range of other gastrointestinal manifestations such as vomiting, diarrhea or constipation, suffer from the disease that may go undetected for years, “added Montoro.
In this sense, the president of celiacs in Aragon also highlights the importance that those affected be diagnosed in childhood for correct imposition of a gluten free diet.
“The work of the pediatrician is paramount, not only to identify cases with a typical presentation pattern in the form of severe diarrhea with malnutrition and progressive weight loss, but other forms with a more insidious clinical expression, including nonspecific gastrointestinal symptoms, delayed growth, irritability and anorexia, “he added.
Montoro has explained that since the launch of the “Decalogue of recommendations to improve the clinical index of suspicion”, promoted by the Spanish Association of Gastroenterology and sponsored by the Ministry of Health and Consumption, “the number of new cases of adults with gluten sensitive enteropathy is growing exponentially in Aragon.”
Good diagnosis: To keep in mind
- Gluten is a protein found in wheat, barley, rye, oats and some other grains.
- It affects 1 in 150 live births.
- Celiac Disease sufferers are genetically predisposed individuals.
- Its genetic basis explains why there may be more than one celiac patient within the same family.
- It can affect both children and adults.
- The most common symptoms are loss of appetite and weight loss, chronic diarrhea, abdominal distension, abnormal character and growth retardation in children. However, in both children and adults these symptoms may be atypical or absent, hampering diagnosis.
- The good diagnosis is made by intestinal biopsy. One should never remove gluten from a person’s diet without previous intestinal biopsy suggestion. Treatment consists of monitoring a strict gluten-free diet throughout life.
- The celiac should base their diet on natural foods: vegetables, meats, fish, eggs, fruits, vegetables and grains made without gluten, rice and corn.
- Ingestion of small amounts of gluten, on an ongoing basis, can cause major and undesirable disruptions.
- A delay in diagnosis and/or lack of proper treatment can lead to complications such as malnutrition, psychiatric disorders, male and female infertility, abortions and increased risk of certain cancers.
- Celiac disease may be associated with other chronic diseases like diabetes, epilepsy, dermatitis herpetiformis, etc..
- Kowalski, K., Mulak, A., Jasinska, M., & Paradowski, L. (2017). Diagnostic challenges in celiac disease. Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University, 26(4), 729–737.
- Byrne, G., & Feighery, C. F. (2015). Celiac Disease: Diagnosis. Methods in Molecular Biology (Clifton, N.J.), 1326, 15–22.
- Ediger, T. R., & Hill, I. D. (2014). Celiac disease. Pediatrics in Review, 35(10), 409–15; quiz 416.
- Pelkowski, T. D., & Viera, A. J. (2014). Celiac disease: diagnosis and management. American Family Physician, 89(2), 99–105.
- Kelly, C. P., Bai, J. C., Liu, E., & Leffler, D. A. (2015). Advances in diagnosis and management of celiac disease. Gastroenterology, 148(6), 1175–1186.
- Gibson, P. R., Shepherd, S. J., & Tye-Din, J. A. (2012, August). For celiac disease, diagnosis is not enough. Clinical Gastroenterology and Hepatology : The Official Clinical Practice Journal of the American Gastroenterological Association. United States.