Celiac disease. Symptoms, diagnosis of the disease, effective gluten-free diet. Gluten intolerance. Symptoms of gluten allergy in adults. Why is it dangerous? Protein metabolism disorder

Update: December 2018

Celiac disease is the name given to celiac disease, in which the intestines do not accept foods containing gluten. Celiac disease is considered a congenital disease that is inherited, but the final mechanisms of its development have not been clarified.

In celiac disease, gluten is not completely broken down, forming toxic substances that damage the inner surface of the intestine. In children, celiac disease manifests itself from the beginning of the introduction of complementary foods. Mom can understand this by foamy stools, vomiting, bloating, and worsening weight gain.

Symptoms of celiac disease in adults are disguised as chronic diseases of the stomach and intestines. A person can treat flatulence, unstable stools and other dyspeptic symptoms for years, but to no avail.

It is for this reason that official data on the prevalence of celiac disease says that in our country only 1 in 1000 suffers from it. And do they even suffer from it? Today, celiac disease is not called a disease, but a way of life that requires adherence to a certain diet. Without contact with gluten, celiac disease cannot occur. The most toxic part of gluten is the alcohol-soluble fraction - gliadin.

• this disease has been known for several millennia: exactly since people began to grow wheat, rye and other grains
• Celiac disease is much more common in women and is practically not observed in Chinese, Japanese and Africans. Most likely, it’s either a special genetic status or nutritional characteristics
• even now in some regions of Russia doctors are prohibited from diagnosing “celiac disease”, since this pathology is not recognized
• some foreign scientists consider celiac disease as a precancerous condition that increases the risk of developing small intestinal lymphoma, intestinal bleeding, and cancer of various parts of the digestive system
• If parents have celiac disease, the risk of having the same child is one in ten.

Causes

So why does gluten intolerance occur? As mentioned above, the exact reasons are not known. But there are assumptions expressed in the form of theories. The most common of them are enzymatic and immunological, with the second being trusted by scientists the most.

• Enzymatic

The small intestine lacks the enzyme responsible for breaking down gluten. This reason is probable, but not fully proven, since by following a diet, the enzymatic function of the intestine is completely restored.

• Immunological

Antibodies to gluten and autoimmune antibodies to intestinal cell structures are detected in the blood. In celiac disease, the number of intraepithelial lymphocytes with other receptors is increased. It is these cells that see gluten as an enemy and damage the intestinal walls.

• Unusual Virus Theory

Studies have shown that 90% of patients with celiac disease have an increased amount of antibodies to a certain type of adenovirus. You shouldn’t believe it if one day your doctor says that celiac disease is caused by an adenovirus. It has nothing in common with a congenital disease: the adenovirus and gluten simply have amazing antigenic similarities.

• Pathoreceptor

believes that the composition of proteins on the surface of the intestine is disrupted, which is why the small intestine is hypersensitive to gluten.

Scientists have come to the conclusion that it is worth combining all the theories into one complex, then the expected picture of the development of gluten intolerance will be obtained: there is no enzyme - gluten is not broken down, accumulates, has a toxic effect on the intestines, which reacts with the help of cells with special receptors. When these cells try to “destroy” gluten, they damage the intestinal epithelium, disrupting the digestion and absorption of food. Adenovirus has been implicated as a possible initiator of the immune response to gluten.

Symptoms

Textbooks distinguish three clinical forms of celiac disease. In fact, its manifestations are much more diverse: the symptoms of celiac disease are disguised as various diseases of the digestive system, hypovitaminosis, dermatological pathologies and many others. That is why the diagnosis of celiac disease is given to a limited number of patients, while the rest are endlessly treated for its manifestations.

On the other hand, there are many clinical cases when all the manifestations of one of the forms of celiac disease are present, even a blood test indicates this. But a biopsy of the small intestine does not confirm the doctors' assumptions.

In 1991, celiac disease was presented in the form of an iceberg: at the top there is a small number of confirmed variants that occur with clear clinical signs. Underwater there is a huge number of those same undiagnosed, “masked” cases. And at the base of the iceberg are people who have a genetic predisposition to celiac disease, but the disease develops only when exposed to provoking factors (stress, decreased immunity, eating a large amount of foods with gluten, and so on).

The earlier and in larger quantities gluten is introduced into food (for example, semolina porridge, beloved by all grandmothers), the faster celiac disease occurs and the more severe it is.

Symptoms in children

“Iceberg” of celiac disease: click to enlarge

The typical form has three prominent symptoms:

• frequent stool (up to 5 times a day or more): there is a lot of it, a mushy consistency, shiny due to the presence of fat, smells bad, can be foamy, of different colors, it is difficult to wash off
• protruding belly: the doctor will say that this is due to, parents will think that the child is just eating well
• lag in height and weight: especially noticeable in the first two years (in weight), and in height - after 2 years. Insufficient weight gain is alarming precisely after the introduction of complementary foods, and until this moment the child gains weight well and grows and develops normally.

Other symptoms of celiac disease in children are associated with insufficiency of nutrients, vitamins and microelements, so they may be different for each child:

• fatigue, lethargy or, conversely, tearfulness, aggressive behavior, increased irritability
• poor skin and hair condition: dryness, weakness,
• frequent fractures even with minor trauma - this despite the fact that fractures are actually rare in children, their bones are elastic
• incorrect posture
• hypotension - insufficient muscle tone
• manifestations in the oral cavity: bleeding gums, caries, crumbling enamel
• anemia (see)
• the child looks unhappy
• a child with celiac disease is compared to a spider due to the presence of a large belly and thin arms and legs

Subsequently, the functioning of the reproductive system in children is disrupted: girls do not get their periods, boys experience sexual dysfunction.

Symptoms in adults

Symptoms of celiac disease in adults are characterized by atypical and latent forms. The atypical form appears only in the third or fourth decade of a person’s life. It represents one of three symptoms of a typical form and two or three accompanying ones. But in general, extraintestinal manifestations of celiac disease predominate:

• neurological: migraine, depression, etc.
• dermatological: herpetiformis or
• dental: , atrophic glossitis, enamel hypoplasia
• renal: nephropathy
• articular: arthritis, joint pain of unknown cause
• strange changes in biochemical blood tests: decreased cholesterol, increased alkaline phosphatase, transaminases, albumin
• reproductive: infertility

In clinical studies, 4-8% of women unsuccessfully treated for infertility were diagnosed with celiac disease. All of them managed to become happy mothers after being prescribed a gluten-free diet.

The latent form may not manifest itself at all, only occasionally causing concern with minor intestinal disorders or external manifestations (dermatitis and so on). Celiac disease is detected only during random examination.

Complications of gluten intolerance

With a long course of the latent form of celiac disease, the risk of developing serious diseases increases:

• gastrointestinal oncology
• , autoimmune hepatitis
• rheumatoid arthritis
• myasthenia gravis, scleroderma
• recurrent pericarditis and others.

Diagnostics

Most often, celiac disease is detected when the whole body is diagnosed for one of the diseases listed above. Targeted diagnosis of celiac disease consists of three stages.

• Stage 1 – immunological blood tests. The level of antigliadin antibodies, the presence of autoimmune antibodies to reticulin, tissue transaglutaminase, and endomysium are determined.
• Stage 2 - if immunological tests are positive, a biopsy of the mucous membrane of the small intestine is performed, and the condition of its villi, the presence of inflammation and lymphocyte cells with altered receptors (discussed above) are determined. The second stage is the most important for making an accurate diagnosis.
• Stage 3 – prescribing a gluten-free diet and monitoring the patient for six months. If there is an improvement in the general condition and a reverse development of the symptoms of the disease, the diagnosis of celiac disease is made definitively.

The third stage of diagnosis is carried out with positive immunological tests and questionable and even negative biopsy results. If after six months the patient’s condition improves, a diagnosis of celiac disease is made. This form of celiac disease is called potential.

A year later, a repeat immunological examination is prescribed. It should reveal positive dynamics. And after one and a half to two years they do a second biopsy: the villi of the small intestine should be completely restored during this time.

Differential diagnosis

Doctors are usually in no hurry to diagnose celiac disease and especially to prescribe a procedure such as an intestinal biopsy performed under anesthesia. Celiac disease is distinguished from food allergies, immunodeficiencies, intestinal infections and other non-hereditary intestinal diseases.

Celiac disease can be distinguished from these pathologies by the absence and good effect of a gluten-free diet, and a positive immunological examination for the above antibodies.

Treatment

Lifelong consumption of food is the only effective salvation. A diet for celiac disease involves excluding bread, pasta, confectionery, some cereals (oatmeal, semolina, pearl barley), sauces, store-bought cutlets, cheap sausages, and sausages. Hidden gluten can be contained in mayonnaise, ketchup, cheese curds, jarred yoghurts and curds, ice cream, canned food, coffee, cocoa, kvass, beer, dyes, and malt extract.

It is critical that 100 grams of product contain more than 1 milligram of gluten.

What then can you eat?

• legumes
• eggs, natural dairy products
• vegetables fruits
• buckwheat, corn, millet
• meat fish
• sweets - chocolate, marmalade

Children under 1 year of age are prescribed mixtures based on casein hydrolyzate or soy (see list in the article). Special gluten-free cereals are sold for complementary feeding.

After the diagnosis is made, symptomatic therapy is carried out:

• Correction of intestinal microflora: intestinal antiseptics (), probiotics (, Actimel, cm), prebiotics ()
• Treatment of bloating: Espumisan, Plantex (see list in article)
• Improved digestion: pancreatic enzymes (Creon, Pancreatin)
• Treatment of diarrhea: oak bark decoction, Imodium
• Treatment of malnutrition: nutritional correction, increasing calorie intake
• Therapy for hypovitaminosis: multivitamins orally; in severe cases, nicotinic acid, vitamins A, B, E, D, K are administered intravenously
• Treatment of autoimmune diseases: glucocorticosteroids
• Correction of water and electrolyte balance: calcium gluconate
• Elimination of protein deficiency: mixtures of amino acids, albumin.

At the same time, the patient is treated and observed for concomitant diseases (for example, diabetes mellitus and others).

Attention! You cannot use those medications (tablets and pills) that contain gluten in the shell (for example, Complivit, Mezim Forte, Festal, etc.). Some liquid preparations contain malt (for example, Novo-Passit), which is contraindicated in case of gluten intolerance.

Celiac disease is not a death sentence

Many children are given a disability when diagnosed with celiac disease. But in fact, with strict adherence to the diet, the prognosis is extremely favorable. Within a couple of weeks, the intestinal symptoms of celiac disease disappear, and during the first two months, the vitamin-mineral, water-electrolyte, and protein balance is restored.

Over the course of a year, children catch up with their peers in weight, height and development. However, the diet must be strictly followed for life, otherwise there is a high risk of the return of all pathological phenomena and the possibility of developing gastrointestinal cancer.

The disease is diagnosed in childhood; it appears less frequently in adults.

Gluten is found in wheat, oats, rye, and barley. This is a vegetable protein. It contains 18 amino acids that the body cannot produce on its own.

Amino acids are essential for humans:

1. Lysine essential for the human immune system. With its participation, tissue regeneration occurs. Lysine has antiviral properties.
2. Threonine responsible for tissue growth, maintains normal gastrointestinal functions.
3. Methionine participates in the body's metabolic processes and in the synthesis of hemoglobin.

Gluten is isolated from cereals and added to seasonings, sauces, yoghurts, sausages, and cosmetics. On product packaging it is designated as modified starch.

Vegetable protein is a stabilizer and preservative. It has no taste or smell. This is gluten, which gives products a thick consistency.

Despite the benefits of gluten, not all people are recommended to consume foods rich in this substance. Gluten can envelop the villi of the small intestine, disrupting the absorption of nutrients into the blood.

Gluten gradually accumulates on the intestinal mucosa: toxins are produced. Harmful substances cause gastrointestinal dysfunction, endocrine system disorders, and negative neurological manifestations.

Gluten intolerance in an adult manifests itself in the form of symptoms of true or false allergy. The protein contains L-gliadin. The substance is toxic.

Gluten allergies do not always appear in childhood. Recent studies have shown that the disease can occur at any age.

The body completely breaks it down and removes it. If there is a disturbance in the enzyme system, L-gliadin remains intact or is not completely separated. Toxins, poisoning the body, cause allergic reactions.

An insufficient amount of enzymes is caused by a hereditary factor. Gluten allergies do not always appear in childhood. Recent studies have shown that the disease can occur at any age.

There are 5 causes of allergies, celiac disease, to gluten:

• immunological– the body produces antibodies to protein components and autoimmune antibodies to gluten, and celiac disease develops;
• enzyme system disorder intestinal mucosa;
• protein disorders in the intestinal mucosa, which interfere with the breakdown of gliadin;
• increase in antibodies to adenovirus: the body mistakes them for antibodies to gluten; studies have shown that the antigens are similar to each other;
• provoking factors, which trigger the allergy mechanism are past viral diseases, aggressive environment, work with chemical reagents, uncontrolled use of medications.

Note! Some believe that signs of gluten intolerance appear if you eat large amounts of foods containing this protein.

Experts refute this opinion. Celiac disease is hereditary, and excessive consumption of gluten-containing foods will lead to excess weight and disruption of internal organs.

Symptoms of gluten intolerance in adults are similar to those of a bowel disorder, therefore, the therapist is not immediately able to determine an accurate diagnosis. The patient is prescribed urine, blood and stool tests.

There is a diagnosis of gluten intolerance. Symptoms in adults are similar to intestinal disorders.

As a result of the examination, a high level of alkaline phosphatases in the blood, low cholesterol levels, and excessively elevated albumin are observed. Data indicate inflammatory and necrotic processes in the liver, kidneys, bone and muscle tissue.

The patient develops arthritis: treatment does not bring results. Dentists establish hypoplasia of tooth enamel, stomatitis, atrophic glossitis, which indicates inflammation of internal organs.

With gluten intolerance in adults, symptoms of cerebral circulatory disorders appear, which leads to migraine pain and the development of neurological diseases.

The patient's general condition worsens. He feels constant fatigue and malaise. Against the general background of symptoms, depression begins to develop.

An allergic reaction to foods containing gluten should not be confused with the development of intolerance to this protein.

A gluten allergy is indicated when even a small piece of baked goods causes intestinal discomfort. There is a feeling of seething in the abdomen with characteristic sounds, and colic appears.

The allergy is complicated by nausea, less often vomiting. Processes in the gastrointestinal tract are disrupted: pieces of undigested food remain in the stool. The patient is prescribed a gluten-free diet. Symptoms disappear after 2 months. In the future, you should avoid foods that contain gluten.

If you ignore the symptoms of a mild form of allergy, complications develop. An imbalance in the intestines is disrupted: loose stools are replaced by constipation. The doctor prescribes complex therapy for the treatment of dysbiosis. Discomfort in the gastrointestinal tract enters another phase of development.

Latent allergies develop into celiac disease. Gluten intolerance causes symptoms in adults that indicate complex diseases of the digestive system.

Gluten allergy leads to intestinal diseases if its symptoms are not relieved. Gastroenterologists diagnose malabsorption: a chronic form of digestive disorder and dysfunction of the small intestine.

The patient has intestinal symptoms:

• diarrhea: loose stools more than 6 times a day; dangerous due to dehydration;
• excretion of fat in feces: with gluten intolerance in adults, symptoms of steatorium are detected; the disease leads to sudden weight loss;
• The process of decay develops in the body, which leads to necrotic processes;
• increased gas formation in the intestines; the patient feels severe stabbing sharp pains;
• lack of appetite; the body does not receive enough proteins, minerals, vitamins;
• P an unpleasant putrid odor appears from mouth.

Intestinal disorders due to malabsorption require long-term treatment. Therapy continues for up to 6 months.

Celiac disease is diagnosed with low hemoglobin levels. Iron deficiency anemia develops. The patient develops shortness of breath with little physical exertion and fatigue. A person constantly feels weakness in the muscles.

Immunity decreases sharply: there is a predisposition to viral and infectious diseases. The process of rehabilitation after illness increases. Intellectual abilities decrease.

The person cannot concentrate Memory and the ability to analyze and perceive information deteriorate. Ulcers appear on the mucous membranes, and the tongue darkens.

Allergic a reaction to gluten is accompanied by manifestations on the skin: red rashes, peeling skin. If you do not find out the cause of mild dermatitis, then the next step will be the development of psoriasis and the formation of eczema.

Irritation is found on the scalp, which leads to detachment of the upper epidermis and dandruff. The skin is itchy and itchy. Hair becomes weak and brittle.

Headache, joint, and muscle pain are associated with gluten intolerance. Symptoms in adults are accompanied by diarrhea, nausea, and redness of the skin.

It is important to know! Small amounts of gluten are found in skin care products. Protein is included in soaps, bathing gels, shampoos, and face creams.

Gluten intolerance will not cause symptoms in adults if gluten-containing cosmetics are used.

Skin rashes appear if the protein enters the intestines.

Headache, joint, and muscle pain occur for various reasons. Symptoms are associated with an allergic reaction to gluten, if diarrhea, nausea, and redness on the skin appear.

The head begins to ache due to a violation of biochemical metabolism in the body. The brain does not receive enough nutrients and oxygen. A sharp reduction in cholesterol contributes to the loss of vascular elasticity. Spasms occur.

Headaches are treated with antispasmodics. Otherwise it will turn into a migraine.

The nutrition of muscle tissue is disrupted. This leads to pain, swelling and cramps in the limbs. A vascular network forms on the skin. Insufficient blood supply affects the heart muscle. The risk of myocardial blockage increases.

General intoxication of the body and impaired microcirculation affect the health of the joints. Swelling and pain occurs in small joints: fingers, hands, feet, spine. If celiac disease progresses, then inflammatory processes affect the knee, hip, and elbow joints. Arthritis develops.

Weakened immunity, insufficient intake of vitamins and mineral complexes into the body, changes in blood vessels lead to neurological diseases. A person’s response to pain and temperature changes in the muscles of the limbs decreases, and reflex movements are lost.

Short-term memory deteriorates, which entails changes in behavior. Sleep is disturbed and fatigue syndrome develops. Older people with celiac disease suffer from dementia and motor impairment. They experience obsessive movements and incoordination of limb movements.

Celiac disease affects the functions of the endocrine glands and endocrine glands, which are responsible for the production of hormones. Improper functioning of the pituitary gland leads to obesity or sudden weight loss, and increased blood sugar.

The thyroid gland enlarges: heart rate increases, sweating and excitability increase. Changes occur in the functioning of the adrenal glands. With increased gland function there is a risk of developing tumors in the organs of the reproductive system.

Decreased adrenal function increases skin pigmentation, and blood pressure drops. Pancreatic dysfunction leads to the development of diabetes mellitus.

Gluten intolerance and symptoms in adults manifest as severe complications. One of the most dangerous is cancer of the small intestine. Against the background of food rotting processes, ulcerative enteritis develops in the gastrointestinal tract.

With the development of iron deficiency anemia caused by gluten intolerance, 8% of women suffer from infertility. Vitamin deficiency, mineral and protein deficiency during pregnancy affects the development of the fetus.

In case of gluten intolerance, therapy is prescribed that eliminates the symptoms of the disease.

Important to remember! Allergy to gluten requires special treatment. Experts recommend eating legumes, fish, meat, vegetables, and fruits. Among the cereals you are allowed to eat buckwheat, corn, and millet.

Flour products labeled gluten-free should be purchased with caution. It is impossible to completely remove gluten from cereals. The inscription on the product packaging is an advertising ploy.

Celiac disease cannot be cured. The effect of gluten on the body cannot be reduced. In case of gluten intolerance, therapy is prescribed that eliminates the symptoms of the disease. Treatment is the prevention of allergic complications.

To learn what gluten intolerance is and what its symptoms are, watch this video:

Symptoms and signs of gluten intolerance:

Gluten allergy is a type of food allergy, expressed in hypersensitivity to the plant protein gluten (another name is gluten), which is found in cereal grains: wheat (up to 80%), oats, barley, rye.

The disease is very common. According to WHO, every hundred people suffer from this hypersensitivity.

It should be distinguished an allergic reaction to gluten from another disease that has similar symptoms, but develops for different reasons and, accordingly, has a different treatment mechanism.

Celiac disease is a genetically predisposed gluten intolerance associated with impaired synthesis of enzymes responsible for the breakdown and absorption of gluten in the small intestine.

In this case, gluten damages the villi on the intestinal wall, inflammation develops, leading to impaired absorption of nutrients, which leads to the characteristic symptoms of celiac disease:

Celiac disease, like allergies, is quite common; according to WHO, it affects 0.5 to 1% of people. Celiac disease is also diagnosed in animals, such as dogs and cats.

Possible causes of gluten allergy:

Gluten allergens have been identified and characterized.

The proteins gliadin (alcohol-soluble) and glutenin (insoluble in alcohol) form a “complex” called gluten, so gluten consists of gliadin and glutenin. Wheat flour contains from 7 to 12% gluten proteins by weight.

The symptom complex of the disease is very extensive; the specific manifestations of an allergic reaction to gluten depend on the age of the patient and the general condition of the body.

Gluten allergy in adults has the following symptoms:

Indigestion

Symptoms associated with poor absorption of nutrients and metabolic disorders

In addition, hypersensitivity may lead to or worsen atopic dermatitis.

Occupational allergies

For example, it can occur in people working in the baking industry, as well as in people living near a flour products production plant. Sensitization occurs by inhalation and causes asthma and rhinitis.

Gluten allergy in a child

Photo: Manifestation of an allergic reaction to wheat (gluten) in a child

In children, due to active growth, the lack of nutrients is more obvious. Symptoms of a gluten allergy in an infant usually include:

• rash like urticaria or eczema,
• stool disorder,
• insomnia,
• irritability,
• lack of appetite.

Hypersensitivity to gluten in a child may be accompanied by the following symptoms:

• Iron-deficiency anemia;
• Lack of weight gain or weight loss due to an increase in the size of the abdominal area;
• Swelling in the lower extremities caused by vitamin A deficiency;
• Increased nervousness, aggressiveness, or vice versa - indifference, indifference to everything that happens;

The disease is dangerous not only by the possibility of developing urticaria, Quincke's edema, bronchospasm and anaphylactic shock, but also by its detrimental effect on metabolic processes in the body, which in the long term leads to toxic damage to organs, frequent illnesses, and retardation in physical development.

Diagnosing a gluten allergy in a newborn is also complicated by the fact that the reaction to gluten may not appear immediately, but several days after contact, which complicates the search for the allergen.

To the observer, it looks as if gluten accumulates in the body and leads to hypersensitivity, which is why this disease is also called accumulative allergy.

Although this is not entirely true - the amount of allergen does not affect the strength of the allergic reaction. Even in minimal quantities, gluten causes allergies in people predisposed to it.

However, as pediatrician and TV presenter Dr. Komarovsky noted, gluten is a normal and fairly common component of food, and you should not refuse to consume it without medical contraindications.

Gluten allergy during pregnancy

During pregnancy, the allergy itself does not have any negative effect on the fetus, but an indirect effect may occur due to the resulting insufficient supply of nutrients, vitamins and minerals to the body.

In addition, the use of most antihistamines is contraindicated, especially in the first trimester, i.e. medications can have a negative effect on the fetus.

Gluten, like any protein, is broken down into oligopeptides and amino acids before absorption by the intestinal wall, and therefore is absent in the blood and cannot pass into mother’s milk. Therefore, exclusively breastfed infants cannot develop an allergy to gluten.

However, it is not uncommon for a child to simultaneously develop a food allergy to both milk (the milk protein casein) and gluten. In this case, the rash appears both when feeding cereals and during breastfeeding, which makes it difficult to determine the allergen.

To identify allergies, doctors use the following diagnostic methods:

• Checking blood for the presence of IgE-specific immunoglobulins;
• Excluding gluten from the patient’s diet and monitoring his condition;

A blood test is decisive in determining gluten allergy; on its basis, a final diagnosis is made, after which the treatment process begins.

In addition to a special diet, the following are used:

1. antihistamines (Loratadine, Cetirizine) to relieve general reactions;
2. glucocorticosteroid ointments (Hydrocortisone, Beloderm), eliminating rash and itching.

Homeopathy also offers a number of remedies for the symptomatic treatment of allergies (Sulfur 6, Rhus toxicodendron 3).

The main treatment method is a gluten-free diet.

Photo: Products containing gluten

Sick it is forbidden consume the following foods:

• Wheat, barley, oats, rye, spelt;
• Bakery products, pasta, cereals (oatmeal, semolina), flour, bran, breaded dishes prepared from these grains;
• Semi-finished meat products, soy meat substitutes;
• Some medications (Allohol, Festal);
• Candies;
• Sauces;
• Spices;
• Alcoholic drinks based on gluten-containing grains: whiskey, beer, vodka, gin, bourbon;
• French fries, chips;
• Soups, industrial dressings, bouillon cubes;
• Wheat starch and dextrin;
• Essences and tinctures;
• Caramel color;
• Coffee drinks, flavored coffee;
• Bananas (cause cross-allergy);

It should be noted that oats are naturally gluten-free.

However, as a result of cross-pollination with wheat, a hybrid is formed that is capable of its synthesis and accumulation. Contamination of oats with wheat is typical due to the use of the same fields, combines, and mills for cultivating and processing these crops.

You may not expect to come into contact with gluten...

It happens that in addition to food products, ordinary household items also cause an allergic reaction, for example, mailing envelopes with starch glue or plasticine in which wheat starch is used as a filler.

For allergies Can consume the following products:

A nutritionist should select a diet for a child, since an incorrectly prepared diet for gluten allergies can cause no less harm than the disease itself.

Due to the fact that a gluten-free diet is not complete, vitamin complexes, calcium and iron supplements are often used to compensate for deficiency conditions.

In addition to people with celiac disease and allergies, gluten-free diets are very common among children with autism, but there is no objective evidence that a gluten-free diet improves autism symptoms.

If an allergic reaction develops only to wheat, but does not occur to other gluten-containing products, the patient is likely allergic to specific components of this cereal. In this case, there is no need for such a strict dietary restriction; it is enough to give up wheat and products made from it (wheat flour, wheat starch, semolina, pearl barley).

Often this reaction is found in children under one year of age. The intestines at this age are not yet fully formed, gluten is poorly absorbed, which leads to allergies. To avoid this, it is recommended to start feeding cereals after one year.

With age, when the digestive system has fully developed and normal intestinal microflora has been established, complete recovery is possible.

If the reaction to gluten is caused by dysbacteriosis or an intestinal infection, then after the infections are cured and the microflora is normalized, the allergy may disappear.

In other cases, a lifelong gluten-free diet is indicated to ensure a comfortable life without allergy symptoms.

Before talking about the insidious disease called celiac disease (gluten intolerance), it is worth making an important note, which is necessary for a correct understanding of the existing problem. Its essence is that until recently even doctors had a misconception about celiac disease, believing that it was a rare childhood disease, and therefore doctors attributed manifestations of gluten intolerance in adults to other diseases, making incorrect diagnoses. This misconception arose due to the fact that gluten intolerance, as a hereditary disease, was simply bound to manifest itself from childhood. However, as practice shows, the first signs of the disease can appear even in adulthood, and therefore 97% of people with this disease are still unaware of the existing problem, attributing the unpleasant symptoms that appear to other “known” diseases.

Celiac disease is a hereditary pathology caused by intolerance to gluten (gluten) - a special protein found in grain crops - wheat, barley, rye and products made from these grains. That is, outwardly a person with celiac disease looks absolutely healthy, but if bread, baked goods or any other product containing gluten enters his body, an autoimmune reaction breaks out, causing inflammation of the mucous membrane and manifesting itself with the most unpleasant symptoms. And this process continues until the person stops eating gluten-containing foods. And if you consider how widespread flour products are in our country, there is no doubt that people (including those with celiac disease) come into contact with gluten every day.

Another feature of the disease appears here. It seems incredible to many that illness occurs due to the consumption of bread, familiar to us from childhood. And if such a person decides to completely exclude food containing this protein from his diet for several months (the effect is not felt immediately), he will be able to experience a significant improvement in his well-being. By the way, history knows thousands of similar cases of “miraculous healing.”

Today it is known that people of any gender, age and race can suffer from celiac disease. This is why it is important to know the symptoms to help identify intolerance at an early stage.

According to doctors, today there are more than 300 known symptoms and disorders that this disease provokes. A completely logical question arises: how can one disease provoke so many unpleasant symptoms? However, everything can be explained if you pay attention to the processes that occur in the intestines when gluten enters. Prolonged contact with this protein provokes an immune response, as a result of which the intestinal mucosa becomes inflamed and the functioning of this organ is disrupted. But the intestines are responsible for the absorption of all substances necessary for the body, including proteins, fats, carbohydrates and other valuable substances. The lack of these elements affects the functioning of all organs and systems of the body, which ultimately leads to a variety of symptoms and significantly complicates the diagnosis of celiac disease.

It must be said that with age, the symptoms of gluten intolerance change significantly, and therefore in this article we will look at the signs of this unpleasant disease in different age groups.

The first manifestations of gluten intolerance appear from about the 4th month of life until the age of two, that is, during the period when the baby first begins to consume foods containing gluten. The disease manifests itself with symptoms such as:

1. Copious watery diarrhea. Such as with an infectious disease.

2. Periodically occurring nausea and vomiting.3. The baby refuses to eat.4. Problems with weight gain (weight loss).5. Lack of interest in surrounding things, apathy.6. Tearfulness and irritability.7. Drowsiness.

If the intolerance in question is not identified in a timely manner in a child whose body is not yet fully formed, celiac disease will lead to serious consequences, including developmental delays and physical exhaustion.

In older children, this intolerance manifests itself somewhat differently. In this case, the child may feel:

1. Periodic abdominal pain.

2. Unexplained attacks of nausea and vomiting.3. Alternation of constipation with diarrhea.4. Problems with physical development.

Serious changes in symptoms appear in adolescents who enter puberty. The lack of vitamins, minerals and other valuable substances manifests itself in them with the following symptoms:

1. Short stature. Approximately 15% of short adolescents are gluten intolerant. When performing an analysis, it is revealed that the growth hormone in such individuals is reduced and does not return to normal even after taking hormonal drugs. If gluten is abandoned, the hormonal levels gradually return to normal, and the teenager begins to grow.

2. Delayed puberty. In girls, it is manifested by the absence of signs of breast swelling at the age of thirteen and the absence of the appearance of menstrual flow at the age of fifteen.

3. Anemia. The most common manifestation of gluten intolerance is low hemoglobin levels, which do not improve even after taking a course of iron supplements. The reason for this process is precisely the inability of the inflamed intestine to absorb iron, and for this reason the patient is forced to suffer from a whole complex of unpleasant symptoms, including weakness and paleness of the skin, tinnitus and headaches, fatigue and sleep disturbances, anorexia and tachycardia , heart failure and impotence. It is for this reason that adults who develop anemia must undergo examination to eliminate the possibility of this intolerance. And further. Representatives of the fairer sex who have developed gluten intolerance suffer from irregular periods; getting pregnant is a big problem for such women, and even if this happens, the risk of miscarriage is high. In addition, in an advanced state, celiac disease can cause infertility.

4. Osteoporosis. Another common manifestation of this disease is osteoporosis - a systemic disease that affects the human skeleton and, above all, destroys cartilage tissue. The manifestation of this disease is frequent pain in the back, elbows and hands, night cramps and brittle nails, stoop and periodontal disease. If celiac disease manifests itself in this way in a teenager, completely avoiding gluten-containing foods can restore bone density in about a year. In adults, this process is much slower.

5. Appearance of itchy blisters. Small itchy blisters, also signaling the development of cereal protein intolerance, appear on the elbows and also on the knees. This rash is nothing more than antibodies that are produced by the immune system in response to contact with a protein that causes an autoimmune reaction.

6. Follicular keratosis. This anomaly, better known as “chicken skin,” is a drying of the skin followed by the appearance of keratinized epithelial cells that line the backs of the hands. This manifestation of celiac disease is associated with a deficiency of provitamin A and fatty acids, which are poorly absorbed by the intestinal walls.

7. Small grooves on the surface of the teeth. This disorder occurs infrequently, only with advanced disease, however, its development clearly indicates that the body does not accept gluten. This anomaly can be noticed only in adolescents and older people, since grooves do not appear on the baby teeth of children.

8. Fatigue and brain fog. A person who suffers from gluten intolerance experiences a “heavy” headache after eating flour foods. He thinks poorly, loses concentration, becomes lethargic and apathetic. As a rule, this unpleasant symptom goes away after 1-2 hours.

As for adults, their signs of gluten intolerance largely repeat the symptoms that appear in adolescents. In adults there is:

1. Gastrointestinal manifestations:

• greasy, foamy stool that is difficult to flush down the toilet;
• frequent stomach pain;
• chronic diarrhea or constipation;
• bloating with the formation of gases that smell bad;
• occasional nausea.

2. Violation of vitamin absorption. As a result, brittleness and hair loss, splitting of nails.

3. Chronic fatigue and fatigue.4. Skin rash, dryness and flaking of the skin.5. Lactose intolerance.6. Joint pain.7. Periodic nausea.8. Fibromyalgia.9. Autoimmune diseases: rheumatoid arthritis and Hashimoto's disease, lupus erythematosus and ulcerative colitis, thyroiditis and multiple sclerosis.

Dr. Emmy Myers of the American Celiac Disease Research Center in Maryland adds to this list by pointing out two more symptoms of celiac disease:

1. Neurological symptoms. Dizziness and feeling of loss of balance.

2. Hormone imbalance. Which affect the disappearance of secondary sexual characteristics, menstrual irregularities and even the development of infertility.

There are also less obvious signs of gluten intolerance. In this regard, Dr. Emmy Myers recommends focusing on the following symptoms:

1. Acne. You're an adult, but your skin breaks out like a teenager's acne. The skin is a mirror that reflects the state of the entire internal body, and therefore persistent acne, which is not removed by cosmetics, is a sign of gluten intolerance.

2. Fatigue after sleep. You wake up feeling like you didn't get enough sleep. Of course, if you go to bed after midnight, your rest routine may make you feel tired in the morning. However, if you sleep for 8 hours and still feel groggy in the morning, there is a good chance that celiac disease is to blame.

3. You suffer from mood swings, anxiety and depression. Scientists have not yet figured out how gluten intolerance affects the nervous system, but there is ample evidence that this disease intensifies existing neurosis and can provoke a depressive state.

4. You have pain in your elbows, knees and hip joints. Unreasonable pain in the joints, as a rule, hints at the development of arthritis. But, according to experts, gluten intolerance may be a trigger for the development of arthritis.

5. You suffer from headaches and migraines. The causes of migraines are varied and mysterious, but some researchers link them specifically to celiac disease.

To identify the disease, specialists conduct an immunological analysis to determine antibodies to tissue transglutaminase and gladin. As a rule, such analyzes are 95–97% reliable. In addition to this analysis, doctors perform an intestinal biopsy, which helps determine the accumulation of lymphocytes in the mucosa and villous atrophy on the surface of the intestine. Of the additional diagnostic techniques, the most commonly used are endoscopic examination of the intestine, ultrasound of the abdominal cavity, CT, MRI and fluoroscopy of the intestine.

– a genetically determined dysfunction of the small intestine associated with a deficiency of enzymes that break down the gluten peptide. With celiac disease, malabsorption syndrome of varying severity develops, accompanied by foamy diarrhea, flatulence, weight loss, dry skin, and delayed physical development of children. To detect celiac disease, immunological methods are used (determination of antibodies to gliadin, endomysium, tissue transglutaminase), and small intestinal biopsy. Once the diagnosis is confirmed, a lifelong adherence to a gluten-free diet and correction of the deficiency of essential substances are required.

General information

Celiac disease in children usually begins to appear between 9 and 18 months. Frequent and loose stools with a large amount of fat appear, and there is a decrease in body weight and stunted growth. In adults, the development of clinical symptoms of celiac disease can be triggered by pregnancy, previous surgical interventions, or infection. Persons suffering from celiac disease often note a tendency to drowsiness, decreased performance, often rumbling in the stomach, flatulence, and stool instability (diarrhea followed by constipation). Elderly patients may experience pain and aches in the bones and muscles.

Stools are usually frequent (5 or more times a day), liquid, foamy with remnants of undigested food. With prolonged diarrhea, there is a possibility of developing signs of dehydration: dry skin and mucous membranes.

The progression of malabsorption syndrome leads to the development of severe disorders of the body's internal homeostasis.

Celiac disease treatment

The goal of therapy for celiac disease is to restore intestinal function, normalize body weight and correct the deficiency of essential substances.

Pathogenetic treatment consists of following a gluten-free diet, that is, directly avoiding the action of the damaging factor. Following a gluten-free diet is necessary throughout your life. Most often (in 85% of cases) this measure leads to the subsidence of symptoms and the restoration of normal intestinal activity. As a rule, final recovery occurs no earlier than after 3-6 months, so it is necessary to adjust the content of substances necessary for the body throughout the entire recovery period. If necessary, parenteral nutrition, administration of iron and folic acid supplements, saline solutions, calcium, and vitamins are prescribed.

Those patients who do not find a positive effect of the diet are prescribed hormonal drugs (prednisolone) for 6-8 weeks as anti-inflammatory therapy.

The absence of positive dynamics when excluding gluten from the diet for three months may indicate that the diet is not fully followed, with violations, or there are concomitant diseases (disaccharidase deficiency, Addison's disease, small intestinal lymphoma, ulcerative jeunitis, giardiasis, lack of minerals in the diet : iron, calcium, magnesium).

In such cases, additional diagnostic measures are carried out to identify these conditions. If all possible reasons for the lack of improvement are excluded, hormonal therapy is prescribed. After three months of a course of prednisolone, a biopsy of the small intestine is performed.

Gluten-free diet

Gluten is found in the following products: bread and any products made from wheat, oat, barley and rye flour, pasta, semolina. In small concentrations, gluten can be found in sausages and frankfurters, canned meat and fish, chocolate, ice cream, mayonnaise and ketchup, various sauces, instant coffee and cocoa powder, soy products, instant soups, bouillon cubes, and products containing malt extract. As for drinks, you should avoid beer, kvass, and vodka.

People with celiac disease should often limit their consumption of whole milk because they may be lactose (milk sugar) intolerant. Currently, special dietary gluten-free products (marked with a crossed out spike) are available for sale.

Prevention of celiac disease

There is no primary specific prevention for celiac disease. Secondary prevention of the development of clinical symptoms is to follow a gluten-free diet. If your closest relatives have celiac disease, it is advisable to conduct periodic examinations to identify specific antibodies.

Pregnant women with celiac disease are at risk for developing heart defects in the fetus. Pregnancy management in such women should be carried out with increased attention.

Prognosis and clinical examination

It is currently not possible to correct the sensitivity of epithelial cells to gluten, so patients with celiac disease must follow a gluten-free diet throughout their lives. Careful adherence to it leads to maintaining the quality and length of life. If the diet is not followed, survival rate drops sharply; deaths among patients with celiac disease who violate a gluten-free diet are 10-30%, while with strict adherence to the diet this figure does not exceed one percent.

All persons suffering from celiac disease should be registered with a gastroenterologist and undergo an annual examination. For patients who do not respond well to eliminating gluten from the diet, clinical observation is indicated twice a year. The prognosis worsens markedly if this disease is complicated by the occurrence of small intestinal lymphoma.

Before talking about the insidious disease called celiac disease (gluten intolerance), it is worth making an important note, which is necessary for a correct understanding of the existing problem. Its essence is that until recently even doctors had a misconception about celiac disease, believing that it was a rare childhood disease, and therefore doctors attributed manifestations of gluten intolerance in adults to other diseases, making incorrect diagnoses. This misconception arose due to the fact that gluten intolerance, as a hereditary disease, was simply bound to manifest itself from childhood. However, as practice shows, the first signs of the disease can appear even in adulthood, and therefore 97% of people with this disease are still unaware of the existing problem, attributing the unpleasant symptoms that appear to other “known” diseases.

What is celiac disease

Celiac disease is a hereditary pathology caused by intolerance to gluten (gluten) - a special protein found in grain crops - wheat, barley, rye and products made from these grains. That is, outwardly a person with celiac disease looks absolutely healthy, but if bread, baked goods or any other product containing gluten enters his body, an autoimmune reaction breaks out, causing inflammation of the mucous membrane and manifesting itself with the most unpleasant symptoms. And this process continues until the person stops eating gluten-containing foods. And if you consider how widespread flour products are in our country, there is no doubt that people (including those with celiac disease) come into contact with gluten every day.

Another feature of the disease appears here. It seems incredible to many that illness occurs due to the consumption of bread, familiar to us from childhood. And if such a person decides to completely exclude food containing this protein from his diet for several months (the effect is not felt immediately), he will be able to experience a significant improvement in his well-being. By the way, history knows thousands of similar cases of “miraculous healing.”

Today it is known that people of any gender, age and race can suffer from celiac disease. This is why it is important to know the symptoms to help identify intolerance at an early stage.

Symptoms of gluten intolerance

According to doctors, today there are more than 300 known symptoms and disorders that this disease provokes. A completely logical question arises: how can one disease provoke so many unpleasant symptoms? However, everything can be explained if you pay attention to the processes that occur in the intestines when gluten enters. Prolonged contact with this protein provokes an immune response, as a result of which the intestinal mucosa becomes inflamed and the functioning of this organ is disrupted. But the intestines are responsible for the absorption of all substances necessary for the body, including proteins, fats, carbohydrates and other valuable substances. The lack of these elements affects the functioning of all organs and systems of the body, which ultimately leads to a variety of symptoms and significantly complicates the diagnosis of celiac disease.

It must be said that with age, the symptoms of gluten intolerance change significantly, and therefore in this article we will look at the signs of this unpleasant disease in different age groups.

Symptoms of the disease in infancy

The first manifestations of gluten intolerance appear from about the 4th month of life until the age of two, that is, during the period when the baby first begins to consume foods containing gluten. The disease manifests itself with symptoms such as:

1. Copious watery diarrhea. Such as with an infectious disease.
2. Periodically occurring nausea and vomiting.
3. The baby refuses to eat.
4. Problems with weight gain (weight loss).
5. Lack of interest in surrounding things, apathy.
6. Tearfulness and irritability.
7. Drowsiness.

If the intolerance in question is not identified in a timely manner in a child whose body is not yet fully formed, celiac disease will lead to serious consequences, including developmental delays and physical exhaustion.

Symptoms of the disease in childhood

In older children, this intolerance manifests itself somewhat differently. In this case, the child may feel:

1. Periodic abdominal pain.
2. Unexplained attacks of nausea and vomiting.
3. Alternation of constipation with diarrhea.
4. Problems with physical development.

Symptoms of the disease in adolescence

Serious changes in symptoms appear in adolescents who enter puberty. The lack of vitamins, minerals and other valuable substances manifests itself in them with the following symptoms:

1. Short stature. Approximately 15% of short adolescents are gluten intolerant. When performing an analysis, it is revealed that the growth hormone in such individuals is reduced and does not return to normal even after taking hormonal drugs. If gluten is abandoned, the hormonal levels gradually return to normal, and the teenager begins to grow.

2. Delayed puberty. In girls, it is manifested by the absence of signs of breast swelling at the age of thirteen and the absence of the appearance of menstrual flow at the age of fifteen.

3. Anemia. The most common manifestation of gluten intolerance is low hemoglobin levels, which do not improve even after taking a course of iron supplements. The reason for this process is precisely the inability of the inflamed intestine to absorb iron, and for this reason the patient is forced to suffer from a whole complex of unpleasant symptoms, including weakness and paleness of the skin, tinnitus and headaches, fatigue and sleep disturbances, anorexia and tachycardia , heart failure and impotence. It is for this reason that adults who develop anemia must undergo examination to eliminate the possibility of this intolerance. And further. Representatives of the fairer sex who have developed gluten intolerance suffer from irregular periods; getting pregnant is a big problem for such women, and even if this happens, the risk of miscarriage is high. In addition, in an advanced state, celiac disease can cause infertility.

4. Osteoporosis. Another common manifestation of this disease is osteoporosis - a systemic disease that affects the human skeleton and, above all, destroys cartilage tissue. The manifestation of this disease is frequent pain in the back, elbows and hands, night cramps and brittle nails, stoop and periodontal disease. If celiac disease manifests itself in this way in a teenager, completely avoiding gluten-containing foods can restore bone density in about a year. In adults, this process is much slower.

5. Appearance of itchy blisters. Small itchy blisters, also signaling the development of cereal protein intolerance, appear on the elbows and also on the knees. This rash is nothing more than antibodies that are produced by the immune system in response to contact with a protein that causes an autoimmune reaction.

6. Follicular keratosis. This anomaly, better known as “chicken skin,” is a drying of the skin followed by the appearance of keratinized epithelial cells that line the backs of the hands. This manifestation of celiac disease is associated with a deficiency of provitamin A and fatty acids, which are poorly absorbed by the intestinal walls.

7. Small grooves on the surface of the teeth. This disorder occurs infrequently, only with advanced disease, however, its development clearly indicates that the body does not accept gluten. This anomaly can be noticed only in adolescents and older people, since grooves do not appear on the baby teeth of children.

8. Fatigue and brain fog. A person who suffers from gluten intolerance experiences a “heavy” headache after eating flour foods. He thinks poorly, loses concentration, becomes lethargic and apathetic. As a rule, this unpleasant symptom goes away after 1-2 hours.

Symptoms of the disease in adulthood

As for adults, their signs of gluten intolerance largely repeat the symptoms that appear in adolescents. In adults there is:

1. Gastrointestinal manifestations:

• greasy, foamy stool that is difficult to flush down the toilet;
• frequent stomach pain;
• chronic diarrhea or constipation;
• bloating with the formation of gases that smell bad;
• occasional nausea.

2. Violation of vitamin absorption. As a result, brittleness and hair loss, splitting of nails.
3. Chronic fatigue and fatigue.
4. Skin rash, dryness and flaking of the skin.
5. Lactose intolerance.
6. Joint pain.
7. Periodic nausea.
8. Fibromyalgia.
9. Autoimmune diseases: rheumatoid arthritis and Hashimoto's disease, lupus erythematosus and ulcerative colitis, thyroiditis and multiple sclerosis.

Dr. Emmy Myers of the American Celiac Disease Research Center in Maryland adds to this list by pointing out two more symptoms of celiac disease:

1. Neurological symptoms. Dizziness and feeling of loss of balance.

2. Hormone imbalance. Which affect the disappearance of secondary sexual characteristics, menstrual irregularities and even the development of infertility.

There are also less obvious signs of gluten intolerance. In this regard, Dr. Emmy Myers recommends focusing on the following symptoms:

1. Acne. You're an adult, but your skin breaks out like a teenager's acne. The skin is a mirror that reflects the state of the entire internal body, and therefore persistent acne, which is not removed by cosmetics, is a sign of gluten intolerance.

2. Fatigue after sleep. You wake up feeling like you didn't get enough sleep. Of course, if you go to bed after midnight, your rest routine may make you feel tired in the morning. However, if you sleep for 8 hours and still feel groggy in the morning, there is a good chance that celiac disease is to blame.

3. You suffer from mood swings, anxiety and depression. Scientists have not yet figured out how gluten intolerance affects the nervous system, but there is ample evidence that this disease intensifies existing neurosis and can provoke a depressive state.

4. You have pain in your elbows, knees and hip joints. Unreasonable pain in the joints, as a rule, hints at the development of arthritis. But, according to experts, gluten intolerance may be a trigger for the development of arthritis.

5. You suffer from headaches and migraines. The causes of migraines are varied and mysterious, but some researchers link them specifically to celiac disease.

Diagnosis of the disease

To identify the disease, specialists conduct an immunological analysis to determine antibodies to tissue transglutaminase and gladin. As a rule, such analyzes are 95–97% reliable. In addition to this analysis, doctors perform an intestinal biopsy, which helps determine the accumulation of lymphocytes in the mucosa and villous atrophy on the surface of the intestine. Of the additional diagnostic techniques, the most commonly used are endoscopic examination of the intestine, ultrasound of the abdominal cavity, CT, MRI and fluoroscopy of the intestine.