Evidence is conflicting regarding the health benefits of a gluten-free diet for the average person; however, it is understood that those with Celiac disease necessitates these dietary restrictions. While the arguments for and against gluten information have provided little to the public about what Celiac disease is. This is unfortunate, as it affects 1 out of every 133 people, and most of them have no idea that they have it.
When Celiac received official recognition as an autoimmune disorder, it was relatively uncommon and little was known about the true nature of the disease. It was generally recognized as a childhood disorder, one that resulted in obvious signs of malnutrition, such as low body weight and stunted growth. As children grew older, symptoms often lessened, or disappeared entirely, thus the opinion was that it was a temporary ailment. Few doctors ever saw an actual patient with Celiac, and education regarding it was relegated to a few paragraphs in medical textbooks.
While Celiac disease was known to have existed for centuries, it wasn’t until the 1950s that its link with gluten was fully understood. Often incorrectly termed a “gluten allergy,” or “gluten intolerance” it is actually an autoimmune disorder. Gluten is the protein found in wheat, rye, and barley, and when someone with Celiac eats it, their immune system launches an inexplicable attack on their intestinal lining, inhibiting the absorption of nutrients, which results in malnutrition. The only treatment is a strict gluten-free diet for life.
The recent fad of eating gluten free for weight loss or perceived health benefits has resulted in an influx of specialty gluten-free products; however, the inflated price of such items can make the cost prohibitive for many people. Many foods are naturally gluten free, such as fruits, vegetables, nuts, and animal products, though care must be taken to insure that gluten has not been added as a filler or binding agent. Microscopic amounts of gluten can trigger the immune response of Celiac disease, therefore patients must scrutinize every label and prepared dishes.
Thankfully, much has been learned over the last 60 years. Celiac disease affects people of all ages and can involve a myriad of seemingly unrelated symptoms, or, at times, none at all in what is referred to as “Silent Celiac.” Classic symptoms of Celiac are diarrhea, bloating, abdominal pain, weight loss, extreme fatigue, and anemia; however, an increasing number of patients present with atypical symptoms, such as constipation, weight gain, skin conditions, neurological issues, and depression. Symptoms come and go throughout a patient’s life; however, the condition is permanent and incurable.
Celiac is no longer a rare disorder; a comparison of 10,000 perfectly preserved blood samples taken between 1948 and 1954 indicates that rates have quadrupled for reasons not yet understood. And it is genetic; the odds of first-degree relatives sharing the disease are 1 in 12.
Despite the increased prevalence, and improved understanding of the disease, it continues to be undiagnosed in the majority of sufferers. While most doctors are familiar with the recent gluten-free diet trend, few are knowledgeable regarding the rate of disease, the symptoms a patient may present with, the proper way to test for the disease, who should be tested, and how to implement the strict dietary measures needed to keep a Celiac safe. Even when presented with current facts, many professionals refuse to accept gluten-intolerance.
While a highly reliable panel of blood tests can reveal the presence of gluten-specific antibodies that identify Celiac, many physicians continue to rely on outdated, less accurate tests and fail to identify a significant number of cases. In addition, patients who have already adopted a gluten-free diet prior to testing will cause a false negative result, as the antibodies quickly dissipate in the absence of gluten. For this reason, those who suspect they may have Celiac should continue eating gluten until all testing has been completed. Patients who have prematurely removed gluten from their diet may be unable to obtain a definitive diagnosis, as damaged villi heal very quickly; those who suspect they may have Celiac should continue eating gluten until all testing has been completed.
In patients where blood tests are negative, yet Celiac is still suspected, an upper endoscopy should be ordered. But damage from Celiac disease is visible to the eye only in patients with extensive damage, so a negative diagnosis should not be made without examining multiple samples of biopsied tissue.
Untreated Celiac disease can lead to serious health complications, including lymphoma and death, therefore, increased awareness and education is imperative.
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