Celiac disease – a disease with many faces

For many of us, celiac disease is still unknown and mysterious, affecting an increasing part of society. It is said to have different faces and can be different for each patient. Who is involved, what are the symptoms, and can it be cured? This is worth knowing because most cases go undiagnosed, and sufferers suffer without knowing the source of their problems.
Celiac disease – what is this disease?
The celiac disease belongs to the group of autoimmune diseases, i.e., those in which our immune system attacks its tissues and organs. The appearance of celiac disease symptoms in patients is caused by gluten – a protein found in some grains such as wheat, rye, and barley. Eating gluten causes the immune system to destroy the intestinal villi on the surface of the small intestine, which are responsible for the absorption of nutrients from the food you digest – proteins, fats, and sugars.
Their damage or destruction causes the absorption process to be disturbed and consequently leads to nutritional deficiencies and the destruction of the organism. The leading causes of celiac disease include genetic factors. This means that specific genes with which we are born are responsible for the emergence of the disease, and the risk of developing the disease is further increased if close relatives have celiac disease.
According to European diagnostic recommendations for celiac disease, the genetic variants associated with the disease are HLA-DQ2, specifically the HLA-DQ2.5 subtype, and HLA-DQ8 (Husby et al. J.Pediatr.Gastroenterol.Nutr .: 2012 Jan; 54 (1): 136-60). However, other publications indicate that the HLA-DQ2.2 subtype may also be associated with celiac disease, characterized by a milder course of the disease. Therefore, genetic testing for celiac disease should detect three gene variants: HLA-DQ2.5, HLA-DQ2.2, and HLA-DQ8.
Approximately 90-95% of celiac patients have the HLA-DQ2 gene (HLA-DQ2.5 or HLA-DQ2.2), while the remaining patients have HLA-DQ8. These genes may also be present in healthy people in about 20-30% of cases. The HLA-DQ2 (2.5 and 2.2) and HLA-DQ8 genes are believed to be necessary but not sufficient for developing the disease. With genes predisposing to celiac disease, the risk of developing the disease is 36-53%.
Celiac disease usually develops in early childhood but can also be much later. It occurs in both sexes, but twice as often in women as in men.

Celiac disease symptoms and diagnosis
Symptoms of the disease can be very diverse and non-specific, making it difficult to diagnose. In some cases, celiac disease appears suddenly. In others, the symptoms increase gradually, and sometimes they do not occur. Ailments that may suggest an illness include:
chronic diarrhea
flatulence and abdominal pain
losing weight
The atypical symptoms of celiac disease include:
skin changes
changes in tooth enamel
neurological disorders
The diagnosis of celiac disease requires specific laboratory tests. Blood tests for the presence of specific antibodies and a biopsy of a fragment of the small intestine are recommended. One of the essential tests is also a genetic test to detect the presence of genes related to the predisposition to develop celiac disease.

Treatment of celiac disease
It is impossible to cure celiac disease completely, and the only treatment is to follow a gluten-free diet. It requires eliminating cereals containing gluten from the menu and replacing them with gluten-free products. This type of nutrition requires careful meal planning, enabling patients to recover and be active fully. You must follow a gluten-free diet all your life because stopping it will result in a recurrence of disease symptoms. The untreated celiac disease carries severe threats to health and even life. It is comforting that nowadays, applying such a diet is not complex and requires only awareness and mindfulness when choosing food products. Shops offer a wide selection of gluten-free foods,

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