People with celiac disease suffer an autoimmune reaction when they consume wheat, Rye (it is not mustard seed which is used in pickles. It is a cereal which is not found in India) and Barley or any of their derivatives. They are basically intolerant to protein called gluten which is present in these cereals. Consumption of gluten causes damage to small finger like structures called villi that line our intestine. The damage occurs as shortening and flattening of villi and damage to the lining of intestine, thus leading to poor absorption of food resulting in fatigue, diarrhoea, upset stomach, bloating, gas, weight loss, malnutrition etc. and also many autoimmune diseases.
The gluten-free diet means avoiding all food products that contain wheat, rye and Barley or any of their derivatives.
Oats are gluten free by themselves but because the harvesting season for oats and wheat is same and generally they are cultivated together. So gluten may be present in preparation of oats as contamination. Hence, one must check for gluten free label before consuming any preparation of oats.
Classical symptoms are :
• Diarrhea
• Malabsorption
• Bloating and abdominal distension
• Weight loss
• Anemia
Following non classical symptoms may be seen which are now fairly common :
• Silent damage to the intestine
• Recurrent or treatment refractory Anemia.
• Bone or joint pains, Osteoporosis, recurrent fractures
• Recurrent oral ulcers
• Vitamin and mineral deficiencies
• Delayed puberty/ menstrual bleeding
• Infertility
• Short stature
• Autoimmune diseases like Hypothyroidism, diabetes mellitus.
Rarely in untreated or poorly treated patients intestinal lymphoma (cancer) may develop.
Increasing awareness, easy availability and decreasing cost of diagnostic tests and probably genetically modified wheat are some of the factors leading to increased detection of this disease.
Inheritance of this disease is polygenic. Only people who have HLA DQ2 or DQ8 can develop this disease. You will be surprised to know that 30-35% individuals in our population have these HLA yet only about 3% of them develop this disease. Though this is a genetic disease but there are many environmental factors which precipitate it and we still exactly don't know what are those factors. But about 10% of family members of a patient of celiac disease are found to be affected with this disease when investigated who might not be having classical symptoms.
It is said that about 1% of world's population is affected by this disease.
A simple blood test such as anti tissue transglutaminase (tTg) antibodies is advised for people who are suspected to have celiac disease.
Further confirmation is done by performing endoscopic biopsy of small intestine.
Blood test for celiac disease generally becomes negative after six months of gluten free diet. If diagnosis is in doubt, you will need a gluten challenge before testing.
Each patient has different sensitivity to gluten. Therefore period of gluten challenge is different for different individuals.
Cross contamination between foods in stores or at home is very common :
• Through scoops or teaspoons used for taking flour out of containers.
• Through nails while kneading gluten free flour after kneading normal flour.
• Through chakla and belan while making gluten free chapattis if made after making normal chapattis.
• Many food products may have hidden gluten for example malt (barley) in chocolates and corn flakes, wheat flour in heeng powder etc.
• Wheat bread crumbs in butter, jams, toaster or on counter etc.
• Fried restaurant food via gluten contaminated grease or oil.
• Grilled restaurant food via Gluten contaminated grill
As gluten is present in many colouring agents, flavouring agents, emulsifiers and preservatives :
• Many lotions, creams and cosmetics contain gluten.
• Tooth pastes, mouth wash and even medicines may contain gluten.
• Sauces (soya sauce, mustard and mayonnaise etc.) might have gluten.
• Many ice creams may contain gluten.
• Packed and canned soups may contain gluten.
• Dried meals and gravy mixes also may contain gluten.
Wheat, rye, barley and all their derivatives must be excluded from gluten free diet. Always check for ingredients and allergen content before trying any packed/processed food from market.
One has to be on gluten free diet lifelong to stay cured. If you start consuming gluten again the symptoms will appear again.
Earlier these two terms were used interchangeably but now we know that these two conditions are different. Celiac disease is an autoimmune disease resulting in damage to the intestine where as wheat allergy is just like dust allergy which is IgE mediated and causes urticaria (red itchy rash) and/or breathing difficulty.
Yes fat people can also have celiac disease.
It is said that exclusive breastfeeding for six months followed by gradual introduction of gluten containing food along with continued breastfeeding may help in preventing this disease. Rota virus vaccinations may also help in preventing it but till date no therapy is available which can prevent it 100%.
It can present at any age after starting gluten containing diet. Disease is commonly seen after few months or years of starting gluten diet but it may also present in adults for the first time.
Generally blood test for celiac disease becomes negative 6-12 months after starting proper gluten free diet but that does not mean that you can start eating gluten again because symptoms will come again once you start eating gluten containing diet. Test can be repeated annually to find out if some hidden gluten is present in the diet or not.
Repeated ingestion of gluten in however small amount will cause damage to a small portion of intestine and may not lead to any symptoms. But because of this damage incidence of autoimmune diseases increase a lot and this will lead to increased chances of your daughter having thyroid diseases, diabetes, infertility, menstrual problems and even intestinal cancer. You will be surprised to know that a food item should have less than 20 ppm (particle per million), meaning less than 20 particles of gluten in ten lacs of food particles, to be labelled as gluten free food and some patients may have symptoms even with this low amount of gluten.
No, you should not go for these treatments as they are not scientifically proven and it is seen that after starting gluten after these treatments, symptoms again recur and even if they do not recur, gluten can silently damage the intestine leading to increased incidence of autoimmune diseases as is seen in many untreated/undiagnosed patients.
Yes sometimes blood test (anti tTg) may be falsely negative particularly if done before 2 years of age. If repeated after 2 years of age it may come positive. Few patients of celiac disease are IgA antibody deficient, in these patients also blood test may be negative even though they are having the disease.
Yes. All first degree relatives of a patient have about 10% chances of having this disease which may be silent.
People with celiac disease suffer an autoimmune reaction when they consume wheat, Rye (it is not mustard seed which is used in pickles. It is a cereal which is not found in India) and Barley or any of their derivatives. They are basically intolerant to protein called gluten which is present in these cereals. Consumption of gluten causes damage to small finger like structures called villi that line our intestine. The damage occurs as shortening and flattening of villi and damage to the lining of intestine, thus leading to poor absorption of food resulting in fatigue, diarrhoea, upset stomach, bloating, gas, weight loss, malnutrition etc. and also many autoimmune diseases.
The gluten-free diet means avoiding all food products that contain wheat, rye and Barley or any of their derivative.
Oats are gluten free by themselves but because the harvesting season for oats and wheat is same and generally they are cultivated together. So gluten may be present in preparation of oats as contamination. Hence, one must check for gluten free label before consuming any preparation of oats.
Classical symptoms are :
• Diarrhea
• Malabsorption
• Bloating and abdominal distension
• Weight loss
• Anemia
Following non classical symptoms may be seen which are now fairly common :
• Silent damage to the intestine
• Recurrent or treatment refractory Anemia.
• Bone or joint pains, Osteoporosis, recurrent fractures
• Recurrent oral ulcers
• Vitamin and mineral deficiencies
• Delayed puberty/ menstrual bleeding
• Infertility
• Short stature
• Autoimmune diseases like Hypothyroidism, diabetes mellitus.
Rarely in untreated or poorly treated patients intestinal lymphoma (cancer) may develop.
Increasing awareness, easy availability and decreasing cost of diagnostic tests and probably genetically modified wheat are some of the factors leading to increased detection of this disease.
Inheritance of this disease is polygenic. Only people who have HLA DQ2 or DQ8 can develop this disease. You will be surprised to know that 30-35% individuals in our population have these HLA yet only about 3% of them develop this disease. Though this is a genetic disease but there are many environmental factors which precipitate it and we still exactly don't know what are those factors. But about 10% of family members of a patient of celiac disease are found to be affected with this disease when investigated who might not be having classical symptoms.
It is said that about 1% of world's population is affected by this disease.
A simple blood test such as anti tissue transglutaminase(tTg) antibodies is advised for people who are suspected to have celiac disease. Further confirmation is done by performing endoscopic biopsy of small intestine .
Blood test for celiac disease generally becomes negative after six months of gluten free diet. If diagnosis is in doubt, you will need a gluten challenge before testing.
Each patient has different sensitivity to gluten. Therefore period of gluten challenge is different for different individuals.
Cross contamination between foods in stores or at home is very common :
• Through scoops or teaspoons used for taking flour out of containers.
• Through nails while kneading gluten free flour after kneading normal flour.
• Through chakla and belan while making gluten free chapattis if made after making normal chapattis.
• Many food products may have hidden gluten for example malt (barley) in chocolates and corn flakes, wheat flour in heeng powder etc.
• Wheat bread crumbs in butter, jams, toaster or on counter etc.
• Fried restaurant food via gluten contaminated grease or oil.
• Grilled restaurant food via Gluten contaminated grill
As gluten is present in many colouring agents, flavouring agents and emulsifiers.
Wheat, rye, barley and all their derivatives must be excluded from gluten free diet. Always check for ingredients and allergen content before trying any packed/processed food from market.
One has to be on gluten free diet lifelong to stay cured. Once anyone start having gluten again the symptoms will appear again.
Earlier these two terms were used interchangeably but now we know that these two conditions are different. Celiac disease is an autoimmune disease resulting in damage to the intestine where as wheat allergy is just like dust allergy which is IgE mediated and causes urticaria and/or breathing difficulty.
Yes fat people can also have celiac disease.
It is said that exclusive breastfeeding for six months followed by gradual introduction of gluten containing food along with continued breastfeeding may help in preventing this disease. Rota virus vaccinations may also help in preventing it but till date no therapy is available which can prevent it 100%.
It can present at any age after starting gluten containing diet. Disease is commonly seen after few months or years of starting gluten diet but it may also present in adults for the first time.
Generally blood test for celiac disease becomes negative 6-12 months after starting proper gluten free diet but that does not mean that you can start eating gluten again because symptoms will come again once you start eating gluten containing diet. Test can be repeated annually to find out if some gluten is present in the diet or not.
Repeated ingestion of gluten in however small amount will cause damage to a small portion of intestine and may not lead to any symptoms. But because of this damage incidence of autoimmune diseases increase a lot and this will lead to increased chances of your daughter having thyroid diseases, diabetes, infertility, menstrual problems and even intestinal cancer. You will be surprised to know that a food item should have less than 20 ppm (particle per million), meaning less than 20 particles of gluten in ten lacs of food particles, to be labelled as gluten free food and some patients may have symptoms even with this low amount of gluten.
No, you should not go for these treatments as they are not scientifically proven and it is seen that after starting gluten after these treatments, symptoms again recur and even if they do not recur, gluten can silently damage the intestine leading to increased incidence of autoimmune diseases as is seen in many untreated/undiagnosed patients.
Yes sometimes blood test (anti tTg) may be falsely negative particularly if done before 2 years of age. If repeated after 2 years of age it may come positive. Few patients of celiac disease are IgA antibody deficient, in these patients also blood test may be negative even though they are having the disease.
Yes. All first degree relatives of a patient have about 10 % chances of having this disease which may be silent.