Celiac disease is an intestinal disorder that is quite widespread in our population. The disease can be classified as autoimmune disorder of the intestines together with Crohn's disease and ulcerative colitis. However, celiac disease differs significantly from both above mentioned conditions.
Unlike Crohn's disease and ulcerative colitis, we know more about mechanism of celiac disease development. It is caused by a crossed immune reaction against gluten. Gluten is protein substance present in cereals and their products. In some people with a genetic predisposition, the gluten presence triggers an immune reaction and the affected immune system attacks intestinal cells causing a chronic inflammation.
Small intestine is usually affected to a certain extent. Symptoms are variable and sometimes there are no visible signs at all. The fact that many people are unaware of their disease is the reason why celiac disease is considered rare. Possible symptoms include chronic diarrhea, abdominal pain, weight loss, blood in stool, flatulence, fatigue and impaired absorption of nutrients. In some people there is a visible skin rash on the face, elbows and knees. It is caused by a crossed immune system reaction against some parts of the skin. The rash is known as dermatitis herpetiformis or Duhring’s disease.
Untreated celiac disease increases risk of some malignant diseases including some types of intestinal lymphomas. The problem is that the risk of a cancer development is not always proportional to the severity of symptoms. Other complications come with a long-lasting untreated celiac disease – it is typically a tendency to abortions and infertility in women.
Medical history and physical examination can reveal some of the above mentioned symptoms. Blood tests are of a great importance as they can show us increased sedimentation rate and CRP (signs of inflammation). Special serology blood tests can diagnose the presence of certain antibodies typical for the disease. To fully confirm the diagnosis we can perform an upper GI endoscopy with obtaining a biopsy from a distant part of the duodenum to prove the presence of inflammation and atrophy of intestinal mucosa.
Prevention and treatment
The disease can not be prevented but after diagnostic we can prevent further symptoms and chronic complications by a strict gluten-free diet. Gluten-free food products are usually more expensive but harder to get but they really represent the best way of therapy. The diet must be, of course, lifelong. More severe bouts can be treated by a short-time administration of anti-inflammatory drugs (e.g. corticosteroids). Really severe forms irresponsible to diet need special therapeutic methods.