What is Celiac disease ?…no, it’s not an allergy.
Celiac Disease is an autoimmune disorder that wreaks havoc on the digestive system by causing inflammation and damage to the small intestines. This damage is triggered by consuming gluten, a protein found in wheat, barley, and rye. While this disease can develop at any stage in life for those who are predisposed, it is not an allergy but a serious health condition that can serious consequences on the body.
Here’s a simple break down on what happens when people with celiac disease eat gluten. The body triggers an immune response that attacks the small intestines. This response causes inflammation of the enteric mucosa, aka the lining of the intestines, which subsequently leads to damage of the villi that line the small intestines, which are crucial for the body’s ability to absorb nutrients.
I know I just got a bit sciencey on you, so for those of you having a hard time picturing this—villi are little finger-like projections that line the wall of the small intestine. These are responsible for absorbing nutrients like carbohydrates, proteins, fats, vitamins, and minerals from the digested food and then are passed into the blood stream so they can go to the necessary places.
So what’s the big deal?
Damaged villi is a VERY big deal! If these important finger-like projections are not functioning, it makes it difficult or nearly impossible, depending on the severity of the damage, to absorb essential nutrients. Not being able to absorb these nutrients, wreaks havoc on the body as they are crucial to the nourishment of organs, tissues, cells, etc. This can cause severe malnourishment and other diseases if left untreated.
The main organ system affected by celiac disease is the digestive system due to the high amounts of inflammation in the small intestines which changes the structure of the villi. However, if left untreated celiac disease can affect almost all other organ systems such as the cardiovascular, nervous, urinary, and reproductive systems.
Symptoms in Children:
- fatigue
- abdominal bloating & pain
- vomiting
- constipation
- fatigue
- irritability & behavioural issues
- anxiety & depression
- ADHD
- Iron-deficiency anemia
Symptoms in Adults:
- bone & joint pain
- fatigue
- arthritis
- iron deficiency anemia
- depression & anxiety
- peripheral neuropathy
- seizures or migraines
- infertility
- itchy skin
- canker sores inside the mouth
Causes and Risk Factors:
Celiac disease is considered to be a multifactorial disorder, which is a fancy way of saying it can be caused by a few things.
1. Predisposing causes:
It is generally considered to be an inherited disease, however it is the susceptibility of developing the disease that can be inherited, rather than the actual disease itself. Meaning, just because you may be predisposed, it does not mean you are guaranteed to develop it. Something basically has to trigger or activate it.
The genetic markers HLA-DQ2 and DQ8 (Human Leukocyte Antigen) are strongly linked to celiac patients. Research also shows, that people related in the first degree to someone who is diagnosed with celiac disease, have a 1 in 10 risk of developing the disease themselves.
2. Contributory causes:
These genes have been proven to interact with environmental factors, such as gluten itself, to essentially trigger the disease in the person who is susceptible. Some research suggests it is because of the way wheat, barley and rye are heavily processed in certain parts of the world, which is why there are more documented cases in the western world.
There is also considered to be early childhood dietary factors in the onset of celiac disease. Research within the past few years has linked early introduction of cow’s milk and cereal grains to a child’s diet as a major causative factor in the disease. Delayed exposure to these items have been shown to greatly reduce the risk of developing this disease.
3. Specific causes:
Intestinal infections such a rotavirus and campylobacter have also been shown to increase the risk of celiac disease. This is because infections of the intestines are thought to change intestinal permeability, or also known as ‘leaky gut’.
Common Nutrient Deficiencies associated with Celiac disease:
- Iron: Celiac disease can impair the absorption of iron, leading to iron deficiency anemia. Symptoms may include fatigue, weakness, and pale skin.
- Vitamin D: Calcium absorption is closely linked to vitamin D, and deficiency can exacerbate bone health issues, leading to conditions like osteoporosis or osteomalacia.
- Folate (Vitamin B9) and Vitamin B12: Damage to the small intestine can interfere with the absorption of these B vitamins, leading to anemia, fatigue, and neurological issues.
- Magnesium: Malabsorption in celiac disease can lead to deficiencies in magnesium, which is essential for nerve function, muscle contraction, and maintaining heart health.
- Zinc: Zinc deficiency can occur due to impaired absorption, leading to skin problems, hair loss, weakened immune function, and delayed wound healing.
- Protein: Damage to the small intestine can impair protein absorption, leading to muscle wasting, weakness, and delayed growth in children.
- Omega-3 Fatty Acids: Reduced absorption may impact the intake of omega-3 fatty acids, which are essential for heart health, brain function, and reducing inflammation.
Long term management:
Managing celiac disease long-term requires a commitment to a strict gluten-free diet, which involves eliminating all sources of gluten from the diet, including wheat, barley, and rye. It’s essential to carefully read food labels, avoid processed foods with hidden sources of gluten, and be cautious when dining out. Additionally, working closely with a registered dietitian, certified nutritionist, or even Naturopathic Doctor knowledgeable about celiac disease can help ensure adequate nutrition and address any potential nutrient deficiencies. Getting routine bloodwork is also helpful in monitoring any deficiencies that may be caused by celiac disease. Bloodwork will also monitor your progress.
Regular follow-up appointments with healthcare providers, including gastroenterologists, are crucial for monitoring the condition, assessing healing, and identifying potential complications.
FDA Regulation
Please be aware that the FDA approved that manufacturers are allowed to label their product Gluten-free if it contains less than 20 parts per million (PPM) of gluten. They claim that this is because such small amounts are not harmful to people with celiac disease. As a nutritionist, I would recommend that no amount of gluten is the safest for people who suffer from celiac disease.
Products here in Canada that have the “Canadian Celiac Association” stamp are safe!
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