The Clinic of the University of Navarra defines celiac disease as a digestive disease that damages the small intestine, altering the absorption of vitamins, minerals and other nutrients present in food.
Moose celiac disease they are intolerant to a protein called gluten, which is found in grains such as wheat, oats, barley and rye. When you eat foods that contain gluten, your immune system reacts and damages the lining of your small intestine.
But, What are the major differences between celiac disease, allergy and gluten sensitivity? In an exclusive interview for NovaMás Dr. Carlos Miguel De Sola Earledigestive system specialist, Top Doctors member and head of the Digestive Disease Institute at Humanline Hospital Group and NorMed Clinic, answers all these questions and gives us the keys to understanding these gluten-related conditions.
What are the recommended treatments and dietary restrictions? What is the relationship between celiac disease and depression? Find out the answers to these questions and learn about the characteristic symptoms of individual diseases and the long-term complications associated with them.
What are the major differences between celiac disease, gluten allergy and gluten sensitivity?
Celiac disease is a non-allergic chronic inflammatory disease caused by delayed response of the body to gliadin, a protein present in grains such as wheat, barley, rye, and oats. Originally described in children during the Dutch famine of World War II, it is a complex disease that can affect any age and any organ of the body through various inflammatory mechanisms.
There are different forms of gluten-related disease that are not always recognized by doctors who use the term “sensitivity” for those patients who improve with gluten removal but do not meet the diagnostic criteria for celiac disease. In my opinion, this term is misleading and we should use it “suspected celiac disease” until the diagnosis is confirmed.
Gluten allergy should be named wheat allergy and is classified as a food allergy. It does not necessarily coincide with an allergy to rye or other grains. These are acute hypersensitivity reactions that are triggered immediately after contact with foods that contain it.
What are the causes of each?
Both wheat allergy and celiac disease are errors in the immune system, which mistakes food for a microbe or toxic element and considers it harmful, reacts to its presence. Depending on each person, the immune response will be allergic, autoimmune or inflammatory.
The key to these diseases lies in the intestinal permeability. If the gut is diseased, food leaks out before it is fully digested, and some proteins are so large that they take on three-dimensional shapes that the defense cells mistake for parasites (allergies) or bacteria (celiac disease).
Anything that affects the digestive system, the gut microbiota, or the integrity of the gut epithelial barrier will trigger the onset of these diseases. Celiac disease results from a diseased digestive system
What are the characteristic symptoms of celiac disease, gluten allergy and gluten sensitivity?
The allergy to wheat or gluten, like other food allergies, causes everything from an itchy mouth, hives, to severe anaphylactic reactions with bronchial spasms or a drop in blood pressure and shock. A person allergic to wheat should not eat, breathe or touch it.
The Classic celiac disease affects the small intestine from infancygenerating in severe cases chronic diarrhea due to malabsorption of nutrients with subsequent growth retardation. The vast majority of celiacs suffer from less severe symptoms: they have a feeling of discomfort and abdominal distention after eating, chronic constipation, episodes of diarrhea, difficulty swallowing associated with anemia, vitamin deficiency; may have skin disease or headaches.
The fact is that gluten is one of the contributing factors to the disease mammalswhich is able to affect many organs or functions of the body and is behind many migraines, diabetes, osteoarticular pathologies, infertility, kidney disease, chronic pancreatitis, liver disease, arrhythmia, chronic bronchitis, neurological or dermatological diseases, to name just a few others.
Are there long-term complications associated with these disorders?
In predisposed patients, gluten contributes to the increase risk of many inflammatory diseases of our time, i.e. fatty liver and other metabolic abnormalities, joint damage and collagen diseases such as disc herniations, cardiovascular disorders, diabetes, allergies, gastroesophageal reflux, dermatitis, osteoporosis, anemia or infertility. Celiac disease, like other inflammatory diseases, increases the risk of autoimmune diseases and cancer, especially abdominal lymphoma.
Some information suggests that there is a relationship between these pathologies and depression, how can this be explained?
Many diseases are more common in people affected by gluten, including those related to gluten Central nervous system, such as migraine, autism or anxiety-depressive disorders. Depression is a psychiatric illness that is contributed to by factors such as hormonal changes, vitamin and mineral deficiencies, or systemic inflammation, all of which are associated with celiac disease.
What is the recommended treatment for each condition? Are there differences in dietary restrictions between them?
Every patient is different and needs a personalized treatment. I distinguish cases of autoimmune celiac disease that respond only to a strict gluten-free diet and await the adoption of protocols with more complex therapy. For the rest of celiacs, it is necessary to reverse intestinal permeability, modify the aggressive microbiota and reduce intestinal inflammation; and if the process persists, there will be no choice but to avoid foods with gluten.
In both conditions, food allergy or celiac disease, it is necessary to avoid fast and packaged food to restore the prominence of slow and take care of the microbiota taking food from our environment in a traditional way. Let’s say we have to ask our grandparents what we should eat and ignore fashion and food advertising.
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