Gluten Intolerance - Everything About Celiac Disease

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Gluten Intolerance - Everything About Celiac Disease
Gluten Intolerance - Everything About Celiac Disease
Video: Gluten Intolerance - Everything About Celiac Disease
Video: The Difference Between Celiac Disease and Gluten Intolerance 2023, February
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Gluten intolerance

Gluten intolerance is a mixture of allergy and autoimmune disease. If gluten intolerance occurs in childhood, it is called celiac disease. In adulthood, one speaks of native sprue. An immune reaction of the intestine leads to chronic inflammation and subsequently to damage to the intestinal mucosa, especially in the duodenum. There are genetic strains that are responsible for the risk of the disease, the individual characteristics of the clinical picture and the time of occurrence.

Gluten is contained in certain types of grain and is also added to bread in bakeries to increase its elasticity. In those affected, mainly due to the triggered immune response, it leads to severe damage and a loss of surface area of ​​the small intestinal mucosa and its bulges (intestinal villi).

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  • Continue reading
  • more on the subject
  • Advice, downloads & tools
  • What are the symptoms of gluten intolerance?
  • Gluten in food
  • Food labeling
  • How is the diagnosis made?
  • How is gluten intolerance treated?
  • Whom can I ask?

The result is a greatly reduced absorption of nutrients into the bloodstream via the intestines. Serious deficiency symptoms and secondary diseases are possible. Since the complaints can be very different and unspecific from person to person, it often takes many years to achieve the correct diagnosis.

What are the symptoms of gluten intolerance?

Typical physical symptoms of gluten intolerance primarily affect the gastrointestinal tract, including:

  • Diarrhea,
  • Constipation,
  • Flatulence,
  • Stomach cramps,
  • Intestinal bleeding.

Various other symptoms of gluten intolerance arise from the subsequent general malnutrition with resulting protein and vitamin deficiencies. These include general malaise with tiredness, nervousness or headache or weight loss. Vitamin deficiency can manifest itself, for example, in night blindness or inflammation of the mucous membranes. In (small) children, celiac disease manifests itself in diarrhea, bloating and failure to thrive, which typically occur after the first grain feed (after the sixth month of life).

Gluten in food

The following grains contain gluten:

  • Wheat,
  • Rye,
  • Oats,
  • Barley,
  • Spelt,
  • Green kernels,
  • One and two grains (emmer),
  • Primeval grain,
  • Kamut,
  • Triticale,
  • Wild rice (black-brown).

All these types of grain must be strictly avoided if you are gluten intolerant. Caution is also advised with cereal products such as bulgur (broken wheat) or couscous (semolina mostly made from durum wheat or barley).

Since the composition of the gluten can vary, other types of grain or carbohydrate suppliers such as corn, (natural) rice, millet, amaranth, quinoa and buckwheat are tolerated. They are easy to digest and help cover the carbohydrate requirement in the case of gluten intolerance. Legumes, soy, nuts and seeds do not cause any problems either. The range of gluten-free cereal products is now very extensive and ensures variety.

The diagnosis is made by a specialist who specializes in gastrointestinal tract (the gastroenterologist), a pediatrician or a clinical immunologist, by putting antibodies against gluten and the endogenous tissue transglutaminase (TTG) antigen can be detected. Intestinal biopsies show a change in the mucous membrane.

For more information, see Laboratory / Autoimmune Diseases.

A balanced diet is also possible with absolute avoidance of gluten. Many foods are naturally gluten-free. The Austrian food pyramid should serve as the basis of nutrition. Exchange tables and replacement products can be found in various guides. You can find gluten-free cooking and baking recipes on the website of the German Celiac Society. Qualified nutritional advice is also helpful. For more information, see Nutritional Advice and Therapy

Food labeling

According to the EU Consumer Information Regulation, cereals containing gluten and products made from them must be labeled and highlighted in the list of ingredients, for example by means of font or background color. This extended labeling requirement has been mandatory for packaged and unpackaged goods (open, loose goods) since December 2014.

Since cereals or gluten are used in many foods as additives or, for example, carriers, goods that are not obviously related to cereals can also be problematic. According to Codex Alimentarius B14 (Austrian Food Book, a project of the Federal Ministry for Labor, Social Affairs, Health and Consumer Protection), Austrian sausage products may not contain wheat flour or other flours containing gluten or protein preparations containing gluten.

Further information is available from:

  • Obligation to label incompatible substances
  • EU rules on food labeling
  • Brochure of the Chamber of Labor "Food Labeling"

How is the diagnosis made?

Because gluten intolerance is a mixed form of allergy and autoimmune disease, the diagnosis is made through the detection of antibodies against gluten and against the body's own antigen tissue transglutaminase (TTG) in the blood. To confirm the diagnosis, a gastrointestinal mirror with an included small intestine biopsy (tissue examination) can be performed.

The tissue sample taken from the small intestine is then examined microscopically to detect villous atrophy, i.e. a reduction in the surface area of ​​the small intestinal mucosa. Since celiac disease is a hereditary disease, the family history is discussed in detail in the anamnesis interview. In addition, a diet and symptom log is helpful, as it allows certain connections to be established between complaints and the food consumed.

Note For general information, see Diagnosis and Therapy of Food Intolerance.

How is gluten intolerance treated?

Since the adhesive protein and the subsequent immune reaction against gluten and self-antigens cause severe damage to the intestinal mucosa, a strict gluten-free diet must be adhered to - for a lifetime. If gluten is still eaten, albeit in very small quantities, the intestinal villi can be destroyed (villus atrophy) with serious secondary diseases. If the diet is adhered to, damage to the intestinal villi that has already occurred can regress completely and consequential damage is avoided. Note that even small amounts of gluten are very harmful. Often, gluten intolerance leads to lactose intolerance or fructose intolerance. If the condition of the intestine improves by avoiding gluten, the intolerance to lactose disappears in most cases.

Behavioral tips for people with gluten intolerance

If you are diagnosed with gluten intolerance, the following measures are helpful:

  • Avoid bread, pastries, cakes, dumplings, muesli, pasta, breaded products etc. made from gluten-containing grains.
  • Be particularly careful with dairy products (e.g. cheese fondue, reduced-fat milk and cheese preparations), ready-made products (e.g. soups, sauces), beer, malt and grain coffee and flavored teas (gluten serves as a carrier for the flavors).
  • Also be careful with cheese with culture mold such as blue mold or Roquefort cheese.

Whom can I ask?

The following bodies are responsible for the diagnosis and treatment of gluten intolerance:

  • General Practitioner,
  • Specialist in gastroenterology,
  • Specialist in paediatrics and adolescent medicine,
  • clinical immunologist,
  • Allergy outpatient clinic.

NoteMore recent findings show that the so-called “ATIs” (amylase trypsin inhibitors) present in some types of wheat but also in other foods (principally gluten-containing) can trigger hypersensitivity. They seem to be found in higher quantities, especially in industrial grain breeding. This so-called celiac disease or gluten-wheat sensitivity is specifically triggered by wheat in sensitive people. The immune system in the sense of a classic allergy is not involved and the symptoms tend towards irritable bowel syndrome. More studies have to be done to give clear recommendations here, but wheat, barley, rye, kamut, spelled, emmer should be avoided, while corn, potatoes, rice, amaranth, lentils and oats, soy, buckwheat, and millet should be avoided lower ATI content can be eaten.

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