Celiac disease is a chronic, autoimmune eating disorder that develops when gluten is taken and triggers an immune reaction in those who are genetically predisposed. Over time, this reaction produces an inflammation that damages the walls of the small intestine and the villi, thus preventing the absorption of food and nutrients.
We talked about this disorder with Dr. Paoletta Preatoni, of the Humanitas Clinical Gastroenterology Unit.
Symptoms
The symptoms of celiac disease can vary greatly and do not always manifest themselves, especially in adults: among the most frequent are diarrhea, abdominal swelling and meteorism, abdominal cramps, weight loss and asthenia. One of the most frequent alterations of blood tests is represented by anemia caused mainly by malabsorption of iron and vitamins due to atrophy of the intestinal villi; for the same reason often those suffering from celiac disease also have symptoms related to osteroporosis, because our body can not absorb the calcium necessary for the health of our bones.
So when should we be alarmed? “The presence of an abdominal symptomatology, even non-specific, should always be correctly evaluated by a specialist, especially if there are even minimal changes in blood tests that cannot be justified by other causes,” clarified the doctor.
Causes
Celiac disease is a multifactorial disease: genetic , immunological , environmental
“Gluten is the triggering agent of the immune reaction in the genetically predisposed patient”, but the “precipitating environmental factors that determine the triggering of the autoimmune response may be multiple and some of them physiological such as pregnancy or gastroenteric infections”. Celiac disease is also often associated with other autoimmune diseases including thyroiditis, type 1 diabetes mellitus, rheumatoid arthritis or thyroiditis and genetic syndromes (Down, Turner).
Celiac disease, gluten intolerance and allergy: not to be confused
In addition to celiac disease, gluten allergy is a type of manifestation of gluten-related disorders, along with ‘gluten sensitivity’. “The difference between the two types of manifestation is immunological and clinical – explained the doctor -: gluten allergy is mediated by IGE class antibodies (while the antibodies involved in celiac disease are IgA and IgG), is not characterized by duodenal mucous damage and can lead to all the different symptoms typical of allergic reactions from skin reactions, to respiratory difficulties up to the intestines.
The cure
At the moment there is no pharmacological therapy to treat celiac disease. The only cure that can preserve the villi and intestines is the diet: “You must follow a scrupulous gluten-free diet. This not only helps to manage and reduce symptoms, but allows the intestine and mucous membrane to regain its original function,” explained the gastroenterologist. But what are the risks that you run if you do not follow a diet buttocks free? The coeliac patient who does not follow the diet keeps the inflammatory process of the duodenal mucosa constantly active, preventing the reconstruction of the absorbent surface of the intestine and this puts him at risk, even if asymptomatic, of developing important nutritional deficiencies that in the long run will compromise the well-being of the body. In addition, failure to adhere to the diet entails a greater risk of developing gastroenteric tract neoplasms, particularly intestinal lymphoma”.
How far has the research progressed?
“Studies have been moving for years on various fronts, including the search for a vaccine and the production of drugs capable of inactivating or disguising the toxic fractions of gluten, which are responsible for activating the inflammatory mechanism,” explained Preatoni. “Some progress has been made, but at present the only codified treatment for the disease remains the gluten-free diet”.
