Celiac Disease
Why in News?
A PGIMS Rohtak study reported rising adult and elderly diagnoses, with atypical presentations (anaemia, infertility, nerve issues), especially in wheat-consuming northern states like Haryana.
What It Is & How It Works?
- Autoimmune Mechanism: When a genetically predisposed individual eats gluten, the immune system mistakenly attacks its own healthy tissue in the small intestine.
- Villi Destruction: The resulting inflammation flattens the intestinal villi. Without healthy villi, the body cannot absorb vital vitamins, minerals, and macronutrients.
- Hidden Triggers: Gluten hides not just in food (bread, pasta, beer) but also in everyday products like lip balms, toothpastes, cosmetics, and vitamin supplements.
Common Symptoms
- Gastrointestinal: Chronic diarrhea, abdominal pain, severe bloating, foul-smelling gas, and constipation.
- Systemic & Atypical: Extreme fatigue, iron-deficiency anemia, unexplained weight loss, mouth ulcers, and an intensely itchy skin rash called dermatitis herpetiformis.
- In Children: Stunted growth, delayed puberty, failure to thrive, dental enamel defects, and severe irritability.
Long-Term Complications (If Untreated)
- Severe Malnutrition: Leads to fragile bones (osteoporosis or rickets) due to a lack of calcium and vitamin D absorption.
- Reproductive Issues: Increased rates of unexplained infertility and miscarriages.
- Neurological Conditions: Nerve damage leading to numbness or tingling in the hands and feet (peripheral neuropathy), balance issues, or seizures.
- Cancer Risks: Untreated individuals face a four times greater risk of developing small bowel cancers and intestinal lymphomas.
- Secondary Autoimmunity: Higher probability of developing other conditions like Type 1 diabetes or multiple sclerosis.
Diagnosis & Treatment
- Screening: Initial screening is done via an ELISA blood test called the anti-TG IgA test.
- Confirmation: A definitive diagnosis requires an upper gastrointestinal endoscopy with a duodenal biopsy to visually check for tissue damage. Note: Patients must continue eating gluten during the testing phase, or the results may be inaccurate.
- The Only Treatment: Currently, there is no medical cure or pill. The sole treatment is a strict, lifelong gluten-free diet. Following this diet strictly allows the small intestine to heal completely and eliminates the elevated health risks.
