Celiacs: Symptoms, Diagnosis, Treatment and more. In the second century BC Arateus of Cappadocia speaks for first time about patients that need to remove grains from their diet to “cure themselves.” In 1980, Samuel Gee wrote the treaty of “celiac disease” which accurately defines and describes the disease. However, it wasn’t until 1950 that Dutch Dike discovered that gluten is the causative agent of this disease.
Definition and Symptoms of Celiac disease
Celiac disease is permanent intolerance to gluten proteins that occurs in genetically predisposed individuals and that is accompanied by a severe atrophy of the upper small intestine mucosa, which leads to a malabsorption of nutrients. Establishing a strict gluten-free diet makes clinical symptoms disappear and normalizes the intestinal mucosa. Chronic intestinal disease is more prevalent, an estimated 1 per 100 live births will suffer from this throughout their life. The female-male ratio is 2:1. The disease is underdiagnosed due to unfamiliarity with the variety of signs and symptoms that can occur clinically.
- Clinical symptoms varies in small children depending on when gluten was introduced into his/her diet. The most common symptoms are chronic diarrhea, abdominal distension, vomiting, poor appetite, irritability, lassitude, stagnated weight gain and growth.
- Older children and adolescents may not have digestive symptoms and the disease occurs as an untreatable oral ferrotherapy oral, constipation, short stature and delayed menarche.
- In adults the disease can progress with classic gastrointestinal manifestations.
It is most common for patients to be consulted for refractory anemia, dyspepsia, constipation, irritable bowel, bone and joint aches, paresthesia, infertility, recurrent miscarriages, malnutrition, and so on.
A detailed history of the patient coupled with a careful physical examination can establish a diagnosis in patients experiencing conventional symptoms. In these cases it is advisable to determine if tissue anti-transglutaminase antibodies are present. When this serologic marker is increased this means that an intestinal biopsy at the duodenal-jejunal will be necessary to confirm Celiac disease diagnosis.
The only effective treatment for celiac disease is a strict gluten-free diet for life. This means that wheat, barley, rye and all its derivatives including starches must be excluded from one’s diet. For a gluten-free diet one must use the best natural foods: meats, eggs, milk, fish, legumes, fruits, vegetables and grains such as corn gluten or rice. It is not easy to foloow a gluten-free diet in Western countries where wheat is the most commonly consumed grain and is used to produce manufactured goods. 70% of supermarket products contain gluten.
Gluten is used in the food industry as additives, excipients, preserving the moisture barrier against grease, excipients, flavorings, to prevent the oxidation process, and so on.
Early diagnosis campaigns, as most celiacs are undiagnosed. This requires increased suspicion of celiac disease by physicians. Statistics estimate the number of celiacs in Spain is approximately 300,000, only about 30,000 are diagnosed.
Campaigns spreading awareness of celiac disease and gluten-free diet. This disease is largely unknown. On the one hand, the general public should know about it which would help increase the number of diagnoses and, secondly, it help Celiaca to solve many of the problems confronting it.
Administrative controls of products sold on the market labeled gluten-free because they are not always gluten-free, which carries a risk to celiac health.
Facilities for Celiac students to use in cafeterias just like the rest of their friends. There are many obstacles in this regard, thus preventing Celiac children from integrating normally in schools. The same problem exists in the university.
Similarly, when celiac patients are hospitalized for any reason there are a lot of difficulties. The hospital should offer them a gluten-free menu, which in most cases is an arduous task, because of the ignorance surrounding the gluten-free diet.
The same problem is presented to the patients in Andalusia when travelling and going to hotels and restaurants.
Financial assistance to buy gluten-free products, which are very expensive in relation to ordinary consumer products. In most EU countries celiacs receive aid for purchasing these products:
Communion is another obstacle to celiacs, because the Church only gives Communion to celiacs with specific wine and does not accept forms of corn as suitable for consecration.
Clasification of foods
Foods that contain gluten
- Bread, wheat, barley, rye and oats.
- Buns, cakes, pies.
- Biscuits, cakes and products pastries.
- Pasta (spaghetti, macaroni, noodles)
- Malted beverages.
- Drinks distilled from fermented grains
- beer, whiskey, water, barley, some liqueurs.
- Products manufactured with any of the flours mentioned, in any of its forms: starch, meal, protein, and so on.
Foods that may contain gluten
- Sausages: CHOP, bologna, sausage, blood sausage, etc..
- Cheese, spreads and special pizzas.
- Yogurts flavored with pieces of fruit or jam.
- Various pates, burgers and marinated.
- Canned meat.
- Canned fish in sauce.
- Candies and sweets.
- Coffee and other machine drinks.
- Nuts roasted or fried with or without salt.
- Some types of ice cream.
- Sauces, condiments and food colorants.
Food that does not contain gluten
- Milk products: cheese, curd, cream, natural yoghurt and curd.
- All kinds of meat and offal, fresh, frozen and canned tomato puree, cured meat, serrano ham cooked extra quality.
- Fresh and frozen fish without breading, fresh seafood and seafood puree or canned in oil.
- Fresh eggs, powdered, dehydrated and fluids.
- Vegetables, vegetables and tubers.
- Rice, corn and tapioca and their derivatives.
- All kinds of vegetables.
- Sugar and honey.
- Oils, butters .
- Coffee beans or grounds, tea and soft drinks.
- All kinds of sparkling wines and beverages.
- Natural Nuts (with or without salt).
- Salt, wine vinegar , raw spices and grains and all natural.
As a general guideline, Celiacs should avoid all bulk products and those made by artisans that are not labeled and which the can’t check the ingredient list.
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