Managing Celiac Disease With A Gluten-Free Diet

Celiac disease is an autoimmune disorder causing inflammation of the small intestine. The disease is prompted by ingesting gluten-containing products in susceptible people.  

Gluten is a group of alcohol-soluble proteins found in various grains, including wheat, barley, spelt, rye, and Kamut. 

Celiac disease is often brought on by environmental factors, including viral infections and an imbalance of the gut microbiome, making susceptible people more at risk. 

Due to environmental risk factors, the disease can occur at any age. It affects between 0.5%-1% of the population, with more women affected than men (a female-to-male ratio of 1.5:1). 

People with Down syndrome, type 1 diabetes, thyroid disorders, anemia, infertility, osteoporosis, and people with celiac disease in their family are (about 10–15%) more susceptible than the rest of the population. 

Two hypotheses for the rise in this disease in recent years include the possibility of a decline in the quality of grains and the production of new grain variants for better preservation during long and far exports of grains. [9-10] However, these hypotheses are unconfirmed, and gluten may not be the sole culprit in developing this disease; furthermore, the condition is still relatively rare. 

Celiac disease is detected through an intestinal biopsy or tissue antibody tests. Tissue transglutaminase is the auto-antigen for this autoimmune disease. The detection is usually sought after a child under three years has anemia, diarrhea, loss of appetite, abdominal distention, and failure to thrive. 

Older children may present symptoms of diarrhea, bloating, constipation, abdominal pain, retarded growth, or weight loss. 

Adults may have neurological symptoms such as headaches, tingling sensations, pins and needles, epilepsy, ataxia, anxiety, depression, and malabsorption syndrome. Malabsorption leads to iron, folic acid, vitamin B12, calcium, vitamin A, and D deficiencies. These deficiencies lead to recurrent mouth ulcers, tooth enamel defects, and other diseases involving these nutrient deficiencies, which are common complications in unmanaged celiac disease, especially osteoporosis. Cancer in the lymph nodes, decreased fertility, ulcerative colitis, and Crohn’s disease are other possible complications if celiac disease is left unmanaged, as well as reproductive disorders, primarily reduced fertility in both men and women. 

Even though some people have no symptoms, they may still suffer from damaged intestinal walls. [25]

Preventing Celiac Disease BEFORE Onset In Susceptible People 

Celiac disease runs in families; therefore, it is good to take precocious measures if you have a family history of the disease. 

Here is how to do this:

Innate (non-specific) immunity plays a critical role in initiating celiac disease. You want to ensure that your diet before the possible onset of the disease is full of healthy fiber-rich foods consumed regularly to support a healthy microbiome, which supports a healthy innate immune response, and helps prevent the onset of autoimmune disorders, avoiding the onset of celiac disease. Clean and simple foods are key. This can actually be done by regularly consuming whole-grain foods (free from additives and preferably organic), legumes, fruits, and vegetables and avoiding obesity. 

This way of life helps prevent microbiome imbalances. Several studies have shown a connection between celiac disease and a change in the microbiome’s composition. [1-3] 

The environmental factors known to influence the intestinal microbiome composition are also thought to play a role in the development of celiac disease. 

Breastfeeding your baby for several months after birth and avoidance of the use of antibiotics during the first year as much as possible is crucial in preventing the onset of celiac disease as this helps produce and support a varied and health-promoting microbiome in the newborn. 

Management of Celiac Disease

You should start treatment as soon as feasibly possible following the onset of the disease to prevent any complications that may be irreversible, such as growth retardation, abnormal tooth growth and health, and osteoporosis. 

Treatment of the disease involves a life-long, strict avoidance of gluten in the diet which improves symptoms and quality of life and prevents other intestinal disorders or cancer. The loss of intestinal barrier function, pro-inflammatory innate immune response, inappropriate adaptive immune response, and an imbalanced gut microbiome are all fundamental features of celiac disease. Avoiding gluten helps in the regrowth of intestinal villi, repairs any mucosal damage, and rebalances the gut microbiome. Tiredness, some neurological symptoms, and functional digestive symptoms may persist for a more extended period. After transitioning to a gluten-free diet, full recovery without symptoms usually takes between 1 and 2 years. 

It is essential to state that although you should avoid grains containing gluten, you should not avoid other whole grains. It is typical for people with celiac disease to be at higher risk of heart disease and severe constipation because of insufficient fiber intake following the removal of grains from their diet. 

Fiber-rich grains are essential to maintaining a healthy microbiome and healthy bowel and immune function. You want to avoid wheat, barley, spelt, rye, and kamut, which all contain gluten, and replace them with healthy gluten-free grains and seeds, including:

  • Sorghum – a grain rich in fiber and antioxidant polyphenols. It is a complete protein with all nine essential amino acids (although not all of its protein is easily digested).
  • Quinoa – a seed rich in fiber, protein, antioxidants, and minerals. 
  • Oats – a grain rich in fiber, vitamins, minerals, antioxidants, especially avenanthramides, and melatonin that helps more tryptophan get into your brain to calm you, help you sleep better, and make you happier.
  • Buckwheat – a seed rich in fiber, protein, antioxidants, and the enzyme trypsin, which has antimicrobial and antibacterial properties.
  • Amaranth – a seed that is a complete protein, rich in vitamins, minerals, and fiber.
  • Teff – a grain that is rich in many vitamins, minerals, and fiber. It is a complete protein that gives you energy due to its unique combination of nutrients.
  • Corn – is rich in protein and carotenoids, which are great for eye and skin health (but you should avoid genetically modified corn).
  • Brown rice – is rich in fiber and very high amounts of vitamins and minerals that have a soothing effect on the nervous system. However, do not consume it daily as brown rice may contain high amounts of arsenic, a naturally occurring toxic element.

When purchasing foods, check their ingredients. Avoid processed foods for your health. Processed foods also include gluten-free versions of bread that are rich in starches. Avoid these as well. Instead, you can buy a small home bread baker and bake your own bread with healthy gluten-free grains. These home bread bakers work automatically and do not require time or effort to make healthful bread. You can also add seeds and spices to add nutrition and flavor to your bread.

Note:

In celiac disease, following a gluten-free diet for life may bring about difficulties as there may be gluten contamination of fields growing gluten-free grains. Digestive enzyme supplementation may be of benefit in such cases. 

To conclude

Although a diagnosis of celiac disease is not easy to digest, overall, when consuming a high fiber gluten-free diet rich in gluten-free grains, fruits, vegetables, nuts, and seeds, while avoiding any unhealthy processed foods, you are setting your future for longevity, health, and much vitality. You will also be avoiding the complications and medications which have serious side effects needed for those with celiac disease who do not adhere to an entirely gluten-free diet.

Make sure you get regular checkups to ensure that you are properly adhering to a gluten-free diet and not developing any of the aforementioned complications. 

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References

  1. Chander AM, Yadav H, Jain S, et al. Cross-talk between gluten, intestinal microbiota and intestinal mucosa in celiac disease: recent advances and basis of autoimmunity. Front Microbiol. 2018;9:2597. doi: 10.3389/fmicb.2018.02597.
  2. Olivares M, Benítez-Páez A, de Palma G, et al. Increased prevalence of pathogenic bacteria in the gut microbiota of infants at risk of developing celiac disease: the PROFICEL study. Gut Microbes. 2018;9:551–558.
  3. Parzanese, Ilaria et al. “Celiac disease: From pathophysiology to treatment.” World journal of gastrointestinal pathophysiology vol. 8,2 (2017): 27-38. doi:10.4291/wjgp.v8.i2.27