Celiac Disease: Treatment, Symptoms, Causes, Procedure, Cost, Diet and Side Effects

Celiac disease is a hereditary and autoimmune disorder occurring in humans where usually the small intestine is affected that occurs in genetically predisposed people. When people suffering from this problem consume a protein called gluten (found in wheat, barley and rye), their body mounts an immune response to attack the small intestine. Such attacks tend to damage the villi (small finger like projections along the wall of the small intestine) that are involved in absorption of nutrients. When the villi get damaged, absorption of nutrition is hampered within the human body.

There are various symptoms of celiac disease and they include chronic diarrhoea, mal-absorption of nutrients (giving rise to nutrition deficiency problems like anaemia), loss of appetite, abnormal growth in children, late puberty, pregnancy complications, certain skin diseases, smaller and under-active spleen, abnormal liver functioning and abdominal distension. Mouth ulcers, Gastrointestinal problems, diabetes mellitus type1 and thyroiditis are also linked with celiac disease, which may occur if the problem is not treated with care or mal-handled.

Celiac disease can be diagnosed by several blood tests, endoscopy and other pathological tests. Once it is confirmed that a person is suffering from this disease, the treatment should begin. The most important treatment is prevention of further gluten into the diet. No medicines exist to prevent celiac disease completely. Therefore, the subtraction of gluten from the diet is strictly recommended. As soon as the diet is restricted, the intestine starts healing, and the problems related to the celiac disease start disappearing gradually from the body. The diet may seem to be burdensome, but this should be followed without failure till complete results are achieved.

Celiac disease is an autoimmune reaction to the protein gluten. It damages the inner lining of the small intestine. Symptoms associated with this condition vary in different individuals.

Symptoms observed in adults mainly include:

• Severe forms of diarrhea
• Fatigue and weakness
• Bloating and flatulence
• Nausea or vomiting
• Pain in the abdomen
• Constipation and weight loss

Symptoms seen in children may include:

• Iron deficiency anemia
• Bone density loss or bone softening
• Ulcers in mouth
• Headaches
• Blisters and skin rashes
• Impairment in the nervous system functioning

Summary: Celiac disease is an autoimmune condition accompanied by the immune reaction to gluten ingestion. It involves intestinal damage, thus associated with symptoms like diarrhea, fatigue, nausea, abdominal pain, weight loss, etc.

The exact cause of the celiac disease is still unknown. Gluten intolerance is considered to be the main causing factor. Some of the important factors contributing to this disease directly or indirectly include:

• Consumption of gluten-rich foods - Certain genes as a result of the combination with gluten may contribute towards developing this disease.
• Gastrointestinal infections
• Feeding practices in infants
• Severe emotional stress
• Viral infections
• Pregnancy
• Surgery

As a result of the body’s immune reaction to gluten-rich food items, villi or finger-like projections lining the small intestine gets damaged. It leads to the disturbing absorption mechanism, causing malabsorption.

Summary: The direct or exact cause of Celiac disease is unknown till the time, however, there are certain factors that contribute indirectly to it. Some of them include eating gluten-rich foods, gastrointestinal infections, emotional stress, etc.

Celiac disease is asymptomatic in most cases. Important blood tests preferred for diagnosis mainly include:

1. Serology testing: It checks for the antibodies in our blood.
2. Genetic testing: It is done for the human leukocyte antigens - HLA-DQ2 and HLA-DQ8

When these tests show positive results, they are followed by some confirmatory tests which mainly include:

1. Endoscopy: This involves taking a small tissue sample from the intestine using endoscopy.
2. Capsule endoscopy: In this test also, tissue samples are collected for biopsy.

Summary: Diagnosis of Celiac disease is an important step as most of its cases are asymptomatic. It is done through blood testing that involves serology testing and genetic testing as the preferred methods. After that, a confirmatory test through endoscopy is performed.

Celiac disease belongs to the category of autoimmune diseases, hence is incurable. But prevention is quite possible in certain ways. Important preventive measures may include the following:

• Early screening: Celiac disease is asymptomatic in most cases, hence early detection is helpful in preventing the progression of the disease as well as the related complications. It is done through Serology and Genetic testing.
• Eliminating gluten-rich foods from the diet: Gluten-rich foods may include bread, cookies, pasta, pizza, wheat, rye, barley, etc. These food items need to be avoided completely as they act as triggering agents for such conditions.

Summary: Celiac disease is incurable but can be prevented. Early screening methods and the elimination of gluten-rich diets are some of the important preventive measures.

The treatment for curing celiac disease is related to strict gluten free diet. The most important fact is that a dietician should be there to assist the affected person to know well about the nutrition contained in various food items, so that the person knows which food has gluten in it, and which doesn’t. Otherwise, the person might be unaware of the foods which he/she must avoid in order to stay healthy. It is recommended for people suffering from celiac diseases to eat gluten-free food available in the market. People are mainly advised to avoid wheat or barley and rather consume rice and oat products.

If a person is suffering from the diseases that are related to celiac disease like diabetes, gastric or ulcer and thyroid, then he/she can be treated with proper medications. If a person is suffering from diabetes mellitus type1 that can happen due to celiac disease, then the affected person has to take insulin throughout his/her lifetime. In case of thyroiditis, immediate hormone replacement should be done to treat this problem. This prevents hypothyroidism and/or prevents further growth of the size of the gland. Steroids and anti-fungal drugs can be taken to cure the mouth ulcer caused due to celiac disease. Gastric ulcer is a problem, which may arise due to celiac disease. This can be cured by proper restrictions regarding food intake, eating light meals at regular intervals, proper medication and so on.

Therefore, to prevent celiac disease, the most important form of treatment is restricting the patient’s diet as strictly as possible. In case, if the probable problems which can occur if celiac disease is neglected or untreated for a long time, are found to occur, then those diseases should be treated properly along with the treatment of celiac disease.

The celiac disease is a problem which is related to genes, i.e. it is a hereditary disease. This is a disease which is present in a person once he/she is born. Also, this disease if left unattended for a long time can increase its effect causing other problems like gastric ulcer, thyroiditis and others. Therefore, any person, irrespective of age barrier is eligible for this treatment.

A person who is not suffering from celiac disease, or whose intestine is functioning perfectly is not eligible to take this treatment.

Celiac disease is a problem which does not need a very costly treatment process, as this can alone be treated by proper diet. If the diet is maintained strictly by a victim, then he or she can be cured very soon. This treatment regarding diet does not have any side effect as such. If a person starts suffering from other complications due to the presence of celiac disease in his or her body, and the person in under the influence of steroids, then he or she can have certain side effects in the body. The side effects that can occur due to steroid intake are kidney problems, liver problems, cardiovascular diseases, high blood pressure, presence of feminine traits in men and masculine traits in women and others.

Celiac disease is aggravated by certain foods that contain gluten. Hence, it is important to eliminate those from the diet, so as to facilitate the healing process. Food items to be preferred in such conditions mainly include:

• Milk and dairy products such as cheese and butter
• Fresh fruits and vegetables
• Fishes and meat
• Potato
• Rice noodles and rice
• Gluten-free flours including corn, soy, or rice flour

Summary: Eliminating sources of gluten is the major part of recovery from Celiac disease. Hence, it is important to take gluten-free food items so that healing of the damaged intestine may take place.

Celiac disease is asymptomatic in most cases and people are unaware of having it. In some cases, it may need urgent medical care. Symptoms in such conditions include:

• In children: experiencing chronic forms of diarrhea, inflamed belly, pale skin, foul-smelling bulky stools, chronic constipation, irritability, headaches, and other neurological symptoms in children are concerning.
• In adults: Experiencing chronic diarrhea, severe headaches, mouth ulcers, blisters on the skin, joint pain, anemia, bone density loss, etc. are concerning in adults.

In case, these symptoms persist for a longer duration or more than two weeks, it becomes important to consult a doctor. Ignoring such conditions may lead to complications.

Summary: When the symptoms related to Celiac disease are in severe forms and stay for more than two weeks or even longer, consultation with a doctor becomes necessary in such cases so as to prevent related complications.

There are no such post treatment guidelines for celiac disease. Since it is a genetic disease, the person has to take care of it throughout his/her life. The person has to avoid the food items containing gluten like wheat, barley and rye and all products that are made out of these grains. So such persons can take food like rice and oat products to keep his or her intestine in good condition and to keep the body healthy so as to prevent further diseases from occurring. To be precise, there are no specific post treatment guidelines, but a check on the food intake should be strictly followed as long as the affected person lives, in order to stay healthy.

If a person is affected with this disease, a person might require 4 to 5 months to recover. But others my take more than 15 months to recover. However, the check regarding the food intake of such patients cannot be avoided.

The treatment of celiac disease involves gluten free food consumption, which can cost within Rs. 600 to Rs. 13000. Generally the gluten free food is made separately for such patients and can cost somewhat higher than normal food.

The results of treatment in case of this disease are not permanent. People who are suffering from celiac disease should keep in mind that this is a hereditary disease and therefore can come back to them in certain instances. So, regular check-ups and tests are recommended to assure the status of the disease within the body.

Recovery in the case of Celiac disease can be made easier and better with the implementation of physical activities and exercises as a part of daily routine. They help to prevent risks of developing certain neurological problems such as depression and mood disorders.

Certain forms of exercises prove to be stress-relievers and enable a person to overcome stress and anxiety.

Preferred forms of exercises in Celiac disease may include:

• Mild aerobics: These include swimming, jogging, running, cycling, etc.
• Walking: Walking effectively increases blood circulation throughout the body and brain, thus providing relaxation to one’s mind.
• Dancing: Mild forms of dancing may also play a role to destress the mind.
• Yoga and meditation: They relax our mind and body, making the body free from stress.

Summary: Physical activity and exercises play an important role in the recovery phase of Celiac disease. They energize the body and reduce levels of depression, thus preventing the risks of neurological complications.

Although diet changes and lifestyle modifications help to recover from Celiac disease, the application of certain medications is important for a better and faster recovery.

Some medicines which are usually preferred under doctor’s recommendations mainly include:

• Steroids: These help to minimize inflammation as well as ease severe symptoms of the disease during the healing process of the intestine.
• Other drugs: Azathioprine, budesonide, etc. are other medicines effective in such conditions.
• Dapsone: This is prescribed against dermatitis herpetiformis, a symptom of Celiac disease.

Summary: Diet and lifestyle changes certainly help to ease recovery in Celiac disease, but the application of medicines is important in cases that are severe and show progressive inflammation.

There are no alternatives to the treatment of this disease. The only possible treatment to keep this disease under control is to follow a strict diet. No medicines have been discovered till now to cure this disease completely.