Celiac disease

What is celiac disease?

Symptoms of celiac disease

Causes of celiac disease

Consequences of celiac disease

Prevention / remedies / treatment for celiac disease

References

What is celiac disease?

Coeliac disease (celiac disease) is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from infancy onwards. It is caused by an inflammatory reaction to various wheat and grain proteins which shortens the villi lining the small intestine (villous atrophy) and inhibits the absorption of nutrients.

Officially, about 1% of people suffer from coeliac disease and 90% of cases have a genetic predisposition. Among those who have gastrointestinal problems, the prevalence is about 3%. Coeliac disease is frequently confused with IBS. A large proportion of coeliacs remain undiagnosed. (4) People of African, Japanese and Chinese descent are rarely diagnosed. Coeliac disease is more prevalent in women than in men. 5-10% of those suffering type 1 diabetes, Down and Turner syndromes and autoimmune thyroid diseases have celiac disease.

Unofficially, the incidence of coeliac disease is far higher. Numerous cases of coeliac disease go undiagnosed. Many people do not show severe outward symptoms when they eat gluten, but but the inflammatory reaction in the small intestine still occurs.

Coeliac disease is also triggered by wheat subspecies such as spelt, semolina, triticale, kamut and durum, and other cereals of the tribe triticeae such as barley and rye. A small minority of coeliac patients also react to oats. Other cereals such as maize(corn), millet, sorghum, teff, rice and wild rice are normally safe, as are non-cereals such as amaranth, quinoa and buckwheat. Other carbohydrate-rich foods such as potatoes and bananas do not contain gluten and so do not trigger symptoms.

Coeliac disease is not the same as wheat allergy.

Symptoms of celiac disease

• Diarrhoea. Pale, loose, greasy stool with a bad smell.
• Abdominal pain, cramping, bloating.
• Mouth ulcers.
• Fatigue.
• Anaemia. Being less able to absorb nutrients, minerals and the fat-soluble vitamins A, D, E, and K. This leads to other symptoms of malnutrition.
• Osteopenia or osteoporosis because of calcium and vitamin D malabsorption.
• Small intestinal bacterial overgrowth (SIBO).
• Weight loss.
• Failure of children to gain weight and thrive.
• Lactose intolerance may develop.
• Dermatitis.
• Allergies.
• Infertility.
• Abnormal liver function.

Causes of celiac disease

• If you have celiac disease or a severe intolerance to gluten, it is possible that the cause is a chemical heavily used in processed foods. According to research published in December 2018, (9) microbial transglutaminase is a bacterial enzyme often added to all kinds of processed foods, including cheese and other dairy products, fish and meat products, some drinks, tofu, noodles, bread and other baked goods. It improves the food's texture, palatability, flavour and shelf-life.
  
  Unfortunately it is not required to be labelled as an ingredient, so it is hidden from public knowledge.
  
  In its bibliography, this research paper (9) lists other published warnings about the dangers of using or consuming this enzyme and how mTg may be the immunogenic in celiac disease patients.
  
  "This enzyme functions like the transglutaminase produced by our body, which is known to be the target of autoimmunity in celiac disease" says co-author Aaron Lerner. "Our own transglutaminase has a different structure to the microbial sort, which allows its activity to be tightly controlled," he said.
  
  The problem is that this enzyme actually changes the structure of gluten protein peptides, making them harder for the body to break down than they are already. "These unusual peptides are particularly likely to resist further breakdown, and to be recognized as 'foreign' by HLA-DQ immune receptors inside the gut wall - but only in those carrying the HLA-DQ variants associated with celiac disease," Lerner added.
  
  The enzymes may also break down the intestinal wall's barrier, meaning more gluten-derived proteins and microbial transglutaminase molecules are able to get through and interact with the body's immune cells.
  
  "While the relatively indiscriminate microbial transglutaminase is produced by some of our normal gut fauna, the amount of the enzyme could be significantly increased when this microbial population is altered by factors like infection, antibiotics or stress - or, indeed, through consumption of industrially processed foods."
• Genetically modified foods.
• An inflammatory reaction to various wheat and grain proteins. Gluten proteins include gliadin, prolamin, glutenins and agglutinin. In a 2007 study, 83% of the population developed gut inflammation after eating wheat gluten. (5) This is why I suggest in Grow Youthful that everyone should avoid all grains. However, less than 1% of the population develops full-blown celiac disease, where systemic antibodies attack their own cells in the intestine, thyroid, pancreas and elsewhere.
• Infection by rotavirus. (1)
• Infants exposed to wheat, barley, or rye before the gut barrier has fully developed (within the first three months after birth) had five times the risk of developing coeliac disease relative to those exposed at four to six months after birth. Those exposed even later than six months after birth were found to have only a slightly increased risk relative to those exposed at four to six months after birth. (2)
• Early weaning. Breastfeeding may also reduce risk. A meta-analysis indicates that prolonging breastfeeding until the introduction of gluten-containing grains into the diet was associated with a 52% reduced risk of developing coeliac disease in infancy; whether this persists into adulthood is not clear. (3)

Consequences of celiac disease

• An increased risk of bowel and other cancers, mostly in the first year after diagnosis with celiac disease. This is probably because the patients had been eating wheat and other grains and stop consuming them after diagnosis.
• Hypothyroidism. (6,7)
• Leaky gut leading to a variety of autoimmune disorders such as lupus, type 1 diabetes, multiple sclerosis, Sjogren syndrome and Hashimoto's thyroiditis. (8)
• Zinc deficiency.

Prevention / remedies / treatment for celiac disease

• Avoid all processed foods. Any food that has been packaged in a food factory may have had the enzyme microbial transglutaminase added. This additive is not required to be listed on the label. (9) Try avoiding all processed foods and only eat real foods that you have prepared yourself using ingredients that have integrity.
• Gluten-free diet. Strict adherence to the diet allows the intestines to heal, leading to resolution of all symptoms in most cases and, depending on how soon the diet is begun, can also eliminate the heightened risk of osteoporosis and intestinal cancer and in some cases sterility.
• Avoid all grain proteins. Wheat is the worst, but also eliminate rye, barley, oats and alcohol.
• Avoid genetically modified foods. Consume only certified non-GMO foods which are also organically grown.
• Probiotics.
• Glutamine.
• See details of remedies recommended by Grow Youthful visitors, and their experience with them.

References

1. Stene L, Honeyman M, Hoffenberg E, Haas J, Sokol R, Emery L, Taki I, Norris J, Erlich H, Eisenbarth G, Rewers M. Rotavirus infection frequency and risk of celiac disease autoimmunity in early childhood: a longitudinal study. 2006; Am J Gastroenterol 101 (10): 2333-40.

2. Norris JM, Barriga K, Hoffenberg EJ, Taki I, Miao D, Haas JE, Emery LM, Sokol RJ, Erlich HA, Eisenbarth GS, Rewers M. Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease. 2005; JAMA 293 (19): 2343-2351.

3. Akobeng A, Ramanan A, Buchan I, Heller R. Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies. 2006; Arch Dis Child 91 (1): 39-43.

4. Zipser R, Farid M, Baisch D, Patel B, Patel D. Physician awareness of celiac disease: a need for further education. 2005; J Gen Intern Med 20 (7): 644-6.

5. Bernardo D. et al. Is gliadin really safe for not coeliac individuals? Production of interleukin 15 in biopsy culture from non-coeliac individuals challenged with gliadin peptides. Gut 2007 June; 56(6):889-90.

6. Ch'ng CL. et al. Celiac disease and autoimmune thyroid disease. Clin Med Res. 2007 October; 5(3):184-92.

7. Naiyer J. et al. Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid disfunction. Thyroid 2008 November; 18(11): 1171-8.

8. Fasano A. Systemic autoimmune disorders in celiac disease. Curr Opin Gastroenterol. 2006 November; 22(6):674-9.

9. Matthias Torsten, Lerner Aaron. Microbial Transglutaminase Is Immunogenic and Potentially Pathogenic in Pediatric Celiac Disease. Frontiers in Pediatrics, 11 December 2018.