Introduction
Question- what month is it? If you said May, you’d be correct, but another correct answer is Celiac Disease Awareness Month. Celiac disease is a genetically transmitted autoimmune disorder which can cause severe damage to the small intestine. It is estimated to affect 1-2% of the population worldwide, but is severely underdiagnosed due to the wide variety of possible symptoms.
Biology
Celiac disease is an autoimmune disorder characterized by an inability to consume gluten. Autoimmune disorders are conditions in which the immune system believes that the body’s own cells are foreign threats and reacts accordingly. Some other examples of autoimmune disorders include type 1 diabetes and rheumatoid arthritis.
In the case of celiac disease specifically, the immune response is triggered by gluten. When a person with celiac diease consumes gluten, the immune system reacts by attacking the villi of the small intestine (small fingerlike projections which line the inside of the small intestine). This in turn damages the person’s ability to obtain nutrition from food, as villi in the small intestine are critically important in absorption of nutrients. This goes beyond a typical food intolerance- damage inflicted by gluten could take weeks, if not months, for the body to repair.[1]
Symptomology and Treatment
Celiac disease can manifest in a variety of ways, which is one of the reasons it is very difficult to diagnose. Typically, it can fall into one of three categories.[2]
Classical celiac disease manifests with gastrointestinal issues (such as diarrhea and constipation) and symptoms of malabsorption, such as weight loss or stunted growth in children.
Non-classical celiac disease is another beast entirely, as it can produce a host of symptoms that are seemingly unrelated to the small intestine; the symptoms can range from mild gastrointestinal issues to chronic migraines, anemia, reduced bone mass, depression, anxiety, and itchy skin rashes.
The third category, silent or asymptomatic celiac disease, is- as the name suggests- asymptomatic. Patients do not suffer from any symptoms, but their small intestine is sustaining damage nonetheless.
There is no ‘treatment’ for celiac disease, per se, as it is not a condition which can be cured. However, the consequences of the disease can be prevented by avoiding gluten entirely. A gluten-free diet will ensure no further damage to the intestinal villi, and the small intestine can repair itself over time. However, it is recommended that patients with celiac disease consult a physician to ensure that they are receiving adequate nutrition- these patients are often deficient in a number of vitamins and minerals, and may require supplements to compensate for these deficiencies.[3]
The Risks of Fad Diets
Gluten-free diets were quite the rage a few years ago, with many celebrities touting the diet as a weight loss strategy. However, there have been no studies to indicate that gluten actually helps with weight loss in any way. In fact, gluten-free diets can potentially be detrimental to health, as they are lacking in certain nutrients such as vitamin B and iron.[4] Unless you have celiac disease or some other gluten intolerance, gluten is not harmful or bad for health.
The gluten-free diet was one of many fad diets that we have seen in recent years- a plan that promises unrealistically fast weight loss with little to no scientific evidence to back the claims being presented. Fad diets can be harmful to the people participating. They are unsustainable and usually constitute a drastic shift in a person’s food habits. They also tend to demonize certain foods, which reinforces an unhealthy relationship with food.[5] Beyond that, however, they can be damaging to unrelated parties. Gluten-free diets becoming a fad meant that patients with celiac disease were not taken as seriously when asking for gluten-free options, as it was assumed they were simply following a trend. Another more recent case is with the keto diet- the ketogenic diet has long been used to manage epileptic seizures in some patients with epilepsy, but now it has become a weight loss phenomenon. When medical diets become weight loss fads, we run the risk of patients who rely on those diets for their health being dismissed as those around them assume they’re being frivolous. With the rise of trends such as these, it’s important to always fact check any diet that is being popularized, and to always take any person’s stated food restrictions seriously even if you disagree with their presumed reasons.
References
Assessed and Endorsed by the MedReport Medical Review Board