What is celiac disease?
Celiac disease is a chronic, autoimmune intestinal disease caused by a food antigen, gluten gliadin. It leads to villositary atrophy (destruction of the villi in the small intestine). The consequences of this pathology are varied; sometimes without symptoms, the disease can sometimes lead to a serious state of malnutrition.
The different types of celiac disease
The infant and young child form is the most common clinical form. It is most frequently characterised by the presence of body growth retardation. This form is often associated with chronic diarrhea, severe fatigue and negative impact on the child's mood.
The form in adults is often associated with diarrhoea and significant weight loss, but clinical manifestations vary, particularly in terms of the number and intensity of symptoms from one person to another.
Causes of celiac disease
Although the origin of celiac disease is not fully established, a hereditary component has been identified. Indeed, the presence of one or two specific genes (HLA-DQ2 and/or HLA-DQ8) seems to predispose patients to develop this pathology. More than 95% of patients with celiac disease express at least one of these two genes. It is also observed that when a family member is affected, his or her relatives are more likely to develop the disease as well.
In addition, it would appear that environmental factors such as trauma, intestinal infections or even stress may be triggering factors for the disease.
Symptoms of celiac disease
The most common symptoms are abdominal pain, chronic diarrhea, bloating, weight loss, anemia or severe fatigue.
Diagnosis of celiac disease
The diagnosis of this pathology is made using a combination of clinical, serological and histological arguments. In the presence of clinical symptoms, antibodies produced during the disease will be tested by blood tests.
Several blood tests for different antibodies exist, including anti-reticulin, anti-gliadin, anti-endomysium and anti-transglutaminase antibodies. According to the High Authority of Health, only the search for anti-endomysium antibodies and anti-transglutaminase antibodies has its place in the diagnosis of celiac disease.
Most often, when blood tests are positive and reveal the presence of these antibodies, a biopsy of the small intestine is performed.
A small bowel biopsy is essential to confirm the diagnosis and start the gluten-free diet. The diagnosis of celiac disease will thus be definitively made when there is a regression of lesions present in the intestinal villi and/or the disappearance of clinical symptoms following a gluten-free diet.
Treatments for celiac disease
There is no drug treatment available to treat celiac disease. Due to gluten intolerance, the only treatment is a total elimination of gluten by adopting a strict gluten-free diet forever.
This prevents the onset of symptoms associated with the disease. The total stop of gluten can be tricky because gluten is found in a large number of foods.
Here are some examples:
Bread made from wheat flour, barley, spelt, rye...
Viennese pastries or pastries
Sauces made with wheat flour (béchamel, roux, custard, custard...)
Gluten can be replaced by rice, corn, potatoes or buckwheat.
Due to the complexity of stopping all forms of gluten, consider seeking advice from your doctor. You can also consult a dietician who will help you better understand what foods you can eat and which ones are not recommended.
Published 16 Jul 2018