Wheats End for Celiacs

Many of the foods we find on grocery store shelves are there because they’re catering to various lifestyle choices. People are exploring new and old ways to stay healthy and others are trying to cure chronic diseases. Chronic diseases usually require an overhaul of eating and exercise habits because these help to reduce inflammation in the body. Whether it’s diabetes, asthma, or celiac disease, lowering inflammation means better outcomes. You can use a variety of anti-inflammatory diets to accomplish this and for celiac patients it must revolve around being strictly gluten-free. 

What is celiac disease?

Celiac disease is a serious, incurable, autoimmune disease in which once diagnosed you can never ever ever eat anything with gluten in it again. It occurs in genetically predisposed individuals who after eating gluten will have inflammation and damage in the small intestines. Over time the villi (responsible for absorbing nutrients) become shortened and damaged and do not absorb nutrition properly. 

It occurs in people who have gene variants called DQ2 and DQ8. People without these variants are unlikely to develop the disease and only 3 percent of people with these genes will actually develop celiac disease itself. It is an underdiagnosed condition, with an estimated 2 million Americans having it and 1 percent of the world population having it. Diagnosis can be challenging because many of its symptoms mimic other conditions. Due to the lack of familiarity of physicians to celiac symptoms, many patients have a delay in diagnosis. Tools used for diagnosis are: 

  • Blood tests which check for antibodies (Tissue Transglutaminase IgA antibody (tTG-IgA) and IgA antibody)
  • Biopsy for confirmation 

Causes of celiac disease include:

  • Genes
  • Stress
  • Infections
  • Surgery
  • Pregnancy
  • Eating gluten

Some signs and symptoms of include: 

  • Digestive issues (gas, bloating, diarrhea, constipation, nausea, vomiting)
  • Lactose intolerance
  • Puberty delay, infertility
  • Abdominal pain
  • Abnormal stools
  • Damage to teeth enamel
  • Failure to thrive, short stature, low weight
  • Depression or anxiety
  • Rash 
  • Chronic fatigue
  • Joint or bone pain
  • Nervous system problems
  • Symptoms involving the mouth

These symptoms vary greatly from person to person and while some patients present with a variety of them, others may not have any symptoms (silent celiacs). Digestive problems are more common in children than adults. Symptoms typically improve with a strict gluten free diet. 

Gluten is a protein found in wheat, barley, and rye and is a staple food in most of the world’s diet. It is responsible for giving bread the chewy texture we are so accustomed to. It’s found hidden in many packaged foods and is often used as a filler or stabilizer. Which is why the journey towards health for a celiac patient can be a true challenge. A small amount, the size of a crumb, can be enough to cause a reaction. 

Gluten-free heroes who achieve remission do so by being cautious, making the right choice all of the time, and by being creative. Their support systems matter. Friends who go out of their way to buy a gluten free cake, just for them, matter. Restaurants who are careful to prevent food allergen cross-contamination matter.

Disease burden for celiac patients is similar to other chronic conditions and it is understandable that although a gluten-free diet can lead to healing, it’s not ideal to spend the rest of your life avoiding a slice of pizza. For you I say, hope is on the horizon – The New York Times recently published an article discussing a variety of trials researching a cure for celiac disease. At this moment, there are a few drugs in phase 3 (which is a pretty big deal) and 24 potential therapies at various stages of development.

Treatments will focus targeting on different pathways of the disease:

  • Using enzymes to improve the digestion and breakdown of gluten. Hopefully making it less inflammatory.
  • Healing the lining of the small intestine.
  • Suppressing the immune system to prevent inflammation in response to gluten

I’ve said it before and I’ll say it again – research is critical. While an FDA approved treatment will likely take a few years before release, you can do your part by keeping up with research information and participate in trials when possible. Also, Trader Joe’s has some pretty mean muffins on their ever growing gluten-free rapport. 


By Nadia Bhatti

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