Bread – it’s a staple in nearly every culture, the comforting smell of a fresh loaf, the satisfying crunch of a toasted slice, the soft texture of a sandwich. But what if this beloved food is more threatening than it appears? For some, bread isn’t just a harmless part of a meal. It could be a hidden threat lurking in plain sight, slowly wreaking damage on their bodies. From digestive issues to unexplained fatigue, the culprit could be sitting right on your kitchen counter. Is your daily bread more dangerous than you think? Let’s explore the surprising reality behind gluten sensitivity and how something as simple as a loaf of bread could be your worst enemy.
When someone consumes gluten, a protein found in wheat and other grains, their body may overreact, leading to damage to the villi—tiny, finger-like projections along the wall of the small intestine. When these villi are harmed, the small intestine cannot effectively absorb nutrients from food. It is known as malabsorption, which can result in malnutrition and various other health issues due to the lack of essential nutrients. In children, it may lead to stunted growth and developmental delays. This condition is known as celiac disease, also referred to as celiac sprue, non-tropical sprue, or gluten-sensitive enteropathy.
Celiac disease is an autoimmune disorder in which the immune system attacks gluten in the small intestine. This condition affects about 1 in 100 people worldwide, with many unaware that they have it. The only way for individuals with celiac disease to prevent symptoms is to eliminate gluten from their diet.
To know this, you have to notice the symptoms of celiac disease to stay on alert. The symptoms of celiac disease can range from mild to severe, and can vary significantly from person to person. They may also change over time. Some common symptoms include digestive issues such as bloating, diarrhea, and abdominal pain, as well as fatigue, weight loss, and skin rashes. Other symptoms can include joint pain, headaches, and neurological issues like numbness or tingling in the hands and feet. Some individuals have no symptoms at all or may only experience them later in life. A person might not realize they have celiac disease until they develop a nutrient deficiency or anemia.
While celiac disease itself isn’t usually life-threatening, it can lead to serious complications and symptoms if it’s not managed. Untreated celiac disease also raises your risk for some types of cancer.
To understand the risks, we must first grasp the cause of celiac disease. It stems from an abnormal immune response to gluten, where the body mistakenly attacks this harmless protein, causing gut inflammation and damaging the villi. The exact reason for this reaction is unclear, but it’s believed to affect those with specific genetic mutations. However, not everyone with these mutations will develop the disease. Triggers may include stressors like viral infections, surgery, pregnancy, or emotional trauma.
Risk factors for celiac disease include having a close family member with the condition, being female, and having other autoimmune disorders. The disease is more common in white individuals and is linked to conditions such as Type 1 diabetes, Hashimoto’s thyroiditis, and psoriasis. It can develop at any age but is often diagnosed in children between 8 months and 1 year or adults aged 40 to 60. Some people may have it for years before being diagnosed.
Celiac disease is often confused with gluten sensitivity and wheat allergy, but they are distinct conditions. Understanding the differences is crucial for proper diagnosis and treatment.
○ Gluten Sensitivity: Causes symptoms similar to celiac disease, such as abdominal pain and tiredness, but does not damage the small intestine.
○ Wheat Allergy: Triggers symptoms like itchy eyes and breathing difficulties, and does not cause long-term damage to the small intestine.
MedBound Times connected with the Gastroenterologist and Hepatologist, Dr Kanwal Butani for his opinion on celiac disease.
Celiac disease is a very dynamic disease with a vast horizon of clinical signs and symptoms. And unfortunately, it’s often misdiagnosed due to its resemblance to small bowel infections. Patients with celiac disease should have a well-disciplined lifestyle, as it’s the need for treatment.Dr Kanwal Butani, Gastroenterologist and Hepatologist, Karachi, Sindh, Pakistan
Celiac disease can lead to several serious long-term complications and as well as other complications, if not properly managed. These complications can impact various aspects of health and well-being.
○ Long-term Complications: Osteoporosis, anemia, malnutrition, nervous system issues, reproductive problems.
○ Rare Complications: Adenocarcinoma of the small intestine, liver damage, non-Hodgkin lymphoma.
○ Ongoing Issues: Weak bones, delayed growth in children, balance issues, nerve tingling, learning difficulties.
○ Chronic Inflammation: Other food intolerances, intestinal blockages, compromised immune system, liver disease, collagenous sprue.
○ Cancer Risks: Higher risk of adenocarcinoma, enteropathy-associated T-cell lymphoma (EATL), and non-Hodgkin’s lymphoma.
Due to untreated celiac disease results that might occur:
○ Other food intolerances, such as lactose intolerance
○ Intestinal sores and scarring, leading to blockages or holes in the intestinal wall
○ A weakened immune system, increasing vulnerability to other illnesses, including autoimmune disorders
○ Liver disease linked to abnormal liver enzyme levels
○ Collagenous sprue (collagen deposits in the small intestine, affecting nutrient absorption)
○ A higher risk of certain cancers, including adenocarcinoma of the small intestine, enteropathy-associated T-cell lymphoma (EATL), and non-Hodgkin’s lymphoma.
The primary treatment for celiac disease is to eliminate gluten from your diet. While you cannot change how your body reacts to gluten, avoiding it prevents triggering this reaction. Stopping gluten consumption allows your small intestine to heal and start absorbing nutrients again. Adhering to a strict, lifelong gluten-free diet is essential to prevent further damage.
Additional treatments may include:
○ Nutritional supplements to address severe deficiencies
○ Medications like dapsone for dermatitis herpetiformis
○ Corticosteroids for severe inflammation not controlled by diet
○ Ongoing follow-up care, including regular tests to ensure disease management
Most people see symptom improvement almost immediately after starting a gluten-free diet. It may take several weeks to correct nutritional deficiencies and several months for full gut healing, with some cases taking longer depending on damage severity and duration. Strict adherence to the diet is crucial for effective healing.
NOTE: Always consult with a healthcare professional for personalized medical advice and treatment options. This information is for educational purposes and should not replace professional medical consultation.
Living with celiac disease requires strict adherence to a gluten-free diet, which can be challenging but improves overall wellness. You need to read labels carefully and avoid contamination, but many resources and support groups are available to help. Your healthcare provider can connect you with a dietitian, and numerous online resources offer guidance. But before following the diet, you need to know what you should have to avoid.
Foods that trigger symptoms include:
○ Grains: Wheat (including semolina, durum, spelt), barley, rye
○ Products: Bread, cereals, pasta, beer, malted liquors, malt vinegar
○ Processed foods: Soups, sauces, dressings, processed meats, dairy products, packaged meals, sweets
○ Develop a gluten-free home menu and keep the necessary ingredients stocked.
○ Carry gluten-free snacks for convenience.
○ Find reliable restaurants with gluten-free options and check menus in advance.
○ Use gluten test strips to check food safety when unsure.
Although there is no cure, the damage is reversible with a strict gluten-free diet. Most people will experience symptom relief and intestinal healing, with only about 1% to 2% not responding to the diet. Adhering to a gluten-free diet can prevent further damage and improve quality of life. Regular follow-up with a healthcare provider and dietitian can help manage the condition effectively. Avoiding gluten in all forms is crucial for long-term health and symptom management.
In summary, while living with celiac disease requires vigilance and dietary changes, proper management can lead to a symptom-free and healthier life. Taking control of your diet and seeking support can make a significant difference in living well with this condition.
REFERENCES:
https://my.clevelandclinic.org/health/diseases/14240-celiac-disease#management-and-treatment
https://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease
https://www.medicalnewstoday.com/articles/38085#summary
https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/definition-facts#complications