Symptoms and co-occuring diseases of Celiac Diseases:
Celiac Disease presents in so many different ways, that is has become known as the "chameleon of the gastroenterology". Due to the nonspecific symptoms, Celiac Disease is often diagnosed late or sometimes not even considered.
The symptoms of classical Celiac Disease usually begin between the first and third years of life.
Signs of disease in children and adults include:
- Bloated belly (for small children, this presents with thin arms and legs, as well as wrinkles around the buttocks)
- Diarrhea or fat (large, clay-colored) stool
- Stomach pain
- Loss of appetite
- Weight loss
- Muscle weakness
- Behavior changes (for children, especially whininess and tearfulness)
For children, in particular, a strikingly serious iron deficiency often indicates Celiac Disease, as well as a failure to thrive.
Meanwhile, the presentation of Celiac Disease has changed. The typical form in small children is no longer the one most frequently observed by doctors. More often, they describe:
- Stomach pain
- Changes in stool
- Changes in tooth enamel
- Unpleasant tingling in hands or feet, strange and painful sensations or numbness
Sometimes, abnormal blood work, such as slightly elevated transaminase levels or some dysfunction in the thyroid, provides the only indication of Celiac Disease. The number of patients for whom Celiac Disease is diagnosed as a result of digestive tract complaints is decreasing. The number of patients whose Celiac Disease is detected by screenings of risk groups, however, is increasing. These risk groups include patients with other autoimmune diseases such as Diabetes or Thyroid Gland Disorders, as well as relatives of individuals with Celiac Disease.
Celiac Disease (also: Gluten Intolerance) has a strong genetic component
If a family member has diagnosed Celiac Disease, at least the first-degree relatives (parents, children), and possibly second-degree relatives (siblings, grandparents, grandchildren) should have a blood test for transglutaminase antibodies. In such family screenings, physicians constantly discover symptom-free celiac patients.
Even in these cases, patients should adhere strictly to a gluten-free diet, because Celiac Disease always involves an increased risk of other diseases, for example:
- Lactose Intolerance
- Fructose Malabsorption
- Histamine Intolerance
- Food allergies
- Disordered bacterial colonization of the small intestine
- Irritable bowel syndrome
- Inflammation of the colon
- Autoimmune diseases such as Type 1 Diabetes, Basedow's Disease (Hyperthyroidism), Hashimoto's Thyroiditis (Hypothyroidism), Crohn's Disease (a chronic inflammatory disease).
Strict avoidance of gluten minimizes the risk of co-morbidity and complications.
In most cases, the small intestine of individuals with Celiac Disease is severely damaged at the time of diagnosis. This can lead, temporarily, to further intolerances. The most common are Lactose Intolerance and Fructose Malabsorption. These temporary intolerances have two causes. Firstly, the damaged intestinal wall is not able to produce the necessary enzymes and transport molecules to a sufficient degree. Secondly, the reduced intestinal surface plays a role: in the healthy state, the small intestine has an enormously large surface. So-called intestinal villi protrude like fingers into it. The villi, in turn, are occupied by so-called microvilli, protuberances of the cell membrane, which further enlarges the surface of the intestine. Nutrients from the intestine enter the blood stream via this large surface. When the intestines are inflamed, the microvilli, or (in the worst cases) even the villi, recede - the surface of the small intestine is thus drastically reduced. Over the smaller area, the body can absorb fewer substances via the intestinal wall.
Chances of recovery with Celiac Disease (Gluten Intolerance)
In the vast majority of cases, affected individuals only need to avoid lactose and fructose in the early days. When the intestines have had time to regenerate, most patients tolerate dairy products and fructose-containing foods again. The Gluten Intolerance, however, will remain forever: Celiac Disease is an incurable autoimmune disease.
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