Dealing With Celiac Disease

The term ‘Celiac Disease’ refers to a small-intestine damaging autoimmune disorder in which the immune system targets ingested gluten. Since the repercussions of untreated celiac disease include migraines at best and a possible cancer or neural condition diagnosis at worst, learning to recognize the signs and adhering to the gluten-free regime is highly imperative.

Treatment:

1- Go Gluten-Free

Although research on alternative treatment is underway, adopting a strict, lifelong gluten-free diet is currently the only effective treatment for the condition. After complete gluten removal, the villi begin to regrow, and patients may be able to observe symptom reduction within a few days. However, complete healing may take anywhere between several months to years, with children recovering faster than adults. For this purpose, patients are often referred to a dietitian.

2- Avoid Cheating and Accidental Ingestion: 

Some patients experience no symptoms upon eating small amounts of gluten-containing foods, giving them reason to cheat on their diet after following it for some time. However, the absence of visible symptoms does not mean there is no internal damage, which is why even trace amounts of gluten must be avoided to prevent future complications. That said, here are a few common glutenous foods:

• Pasta
• Cereals
• Candies
• Seafood
• Baked goods
• Luncheon meats
• Salad dressings and sauces
• Oats (while not symptom-inducing, even pure oats are sometimes contaminated with wheat, and must be consumed with care)

Of all the above packaged foods, only those labelled ‘gluten-free’ should be consumed.

Moreover, gluten may also be hidden in the following products, and therefore must be used after the doctor’s approval:

• Lipsticks
• Play-Doh
• Envelope and stamp glue
• Toothpaste and mouthwash
• Modified food starch and preservatives
• Certain prescription and OTC medications
• Vitamin, mineral, herbal and nutritional supplements

2- Supplements: 

Patients with severe nutritional deficiencies, mostly due to a late diagnosis and/or a gluten-packed diet, and risk of bone damage may be prescribed one or more of the following gluten-free vitamin and mineral supplements in pill form or as injections:

• Iron
• Zinc
• Folate
• Calcium
• Vitamin B-12
• Vitamin D and K

3- Medication: 

• A severely damaged and inflamed small intestine may warrant an oral steroid prescription alongside a gluten-free diet.
• For Dermatitis Herpetiformis (a blistering skin rash often accompanying celiac disease), topical ointment Dapsone may be prescribed. However, the rash may be recurring and requires months or even years to fully heal, with regular blood tests to confirm any of the medication’s side-effects.

Related Conditions:

1- Non-responsive Celiac Disease: 

Due to accompanying conditions like bacterial overgrowth in the small intestine, reduced pancreatic function, glucose and/or fructose intolerance, and irritable bowel syndrome, some patients might be either under-responsive or be unable to maintain a gluten-free diet. Nonresponsive celiac disease may also be due to continually ingesting gluten, either accidentally or intentionally.

2- Refractory Celiac Disease: 

Despite following a strict, gluten-free diet, damage to the small intestine and malabsorption (reduced ability of the intestine to absorb nutrients) may still persist in some individuals. However, the condition is quite rare.

3- Dermatitis Herpetiformis: 

Commonly occurring on the scalp, elbows, torso, buttocks and knees, this itchy, blistery rash forms as a reaction to villi (small finger-like projections responsible for nutrient absorption) destruction in the small intestine. The condition is usually temporary, although it may recur after long intervals in some individuals.

4- Non-Celiac Gluten Sensitivity: 

Often confused with celiac disease, ingesting gluten results in physical symptoms similar to celiac disease, minus the immune system reaction and intestinal damage. Non-celiac gluten sensitivity is different from gluten intolerance. Unlike intolerance, gluten sensitivity is a permanent condition and is usually treated via a gluten-free diet, as the patient cannot tolerate gluten, even in small amounts.

Note: Patients must attend medical follow-ups every 6 months for further blood tests to ensure their positive response to the diet and detect the presence of other celiac-induced medical conditions, if any.

If symptoms do not recede 6 months-1 year after starting the diet, report to the doctor immediately. You may require further testing, steroids, or even immunosuppressants along with following the gluten-free diet. You can also book an appointment with a top Gastroenterologist in Karachi, Multan and Islamabad through oladoc.com, or call our helpline at 042-3890-0939  for assistance to find the RIGHT Doctor for your gastric concerns.