celiac disease

Celiac disease – gluten intolerance

Celiaki means you cannot tolerate the protein gluten found in wheat, rye and barley. Gluten causes the small intestine to become inflamed and unable to absorb nutrition properly. The most common symptoms are diarrhea, stomach gases, fatigue and losing weight, but the symptoms can vary widely. The trouble usually goes when you eat gluten-free foods.

You can get  celiac disease both as a child and as an adult. This text is about celiac disease in adults. Celiac disease is also called gluten intolerance.

Symptoms

You may have one or more of the following symptoms if you have untreated celiac disease:

  • Diarrhea and disorders of the gastrointestinal tract.
  • Fatigue and depression.
  • Weight loss.
  • Joint pain.
  • Rash in the mouth, so-called afte.
  • Vomiting and nausea.
  • Blisters on the skin.
  • Hard to get a pregnancy.

The symptoms you get and how severe they are can differ from person to person. The symptoms can also change with age.  

Diarrhea and disorders of the gastrointestinal tract

It is common to have disorders of the gastrointestinal tract in untreated celiac disease, such as diarrhea that does not pass,  gases in the stomach  and sometimes  constipation . Many adults have had more or less long periods of diarrhea, which once began as a stomach flu.

Having problems from the gastrointestinal tract does not have to be due to celiac disease, but can be symptoms of so-called  sensitive bowel . Sensitive bowel is also called IBS.

Blood in the stool  is not a sign of celiac disease. If you have blood in your stool, you should seek care and be examined as there may be symptoms of any other bowel disease.

Fatigue and depression

You may feel tired and powerless in your body, for example when you are exercising or exercising. You may also feel a general resignation that may be reminiscent of depression . 

The cause is mostly anemia and vitamin deficiency, for example anemia due to iron deficiency  or anemia due to deficiency of vitamins B12  and folic acid.

The fatigue can also be due to the inflammation that occurs in the intestine.

Weight loss

You can lose weight, but it is unusual to lose a lot of weight and lose weight. You may also vomit at times. Losing weight depends on the intestinal damage caused by gluten, but may also be because you may feel ill and have no appetite.

Joint pain

In celiac disease, you can also get pains in the skeleton, especially in the joints .

Celiaki can also sometimes cause  osteoporosis , that is, the skeleton becomes brittle. Osteoporosis usually does not cause any symptoms. The risk of breaking a bone due to osteoporosis is small.

The skeleton strengthens again when you start eating gluten-free foods. Osteoporosis is also called osteoporosis.

Rash in the mouth

You may have had periods of  rashes in the mouth  and burning on the tongue. The fact that it stings on the tongue may be due to a lack of vitamin B12.

Rashes and ulcers in the mouth are also called afte or bleeding ulcers.

Blisters on the skin

There is a skin disease called skin celiac disease. In skin celiac disease, you get skin blisters that itch on the elbows, forearms and buttocks. You do not need to have any clear symptoms from the gastrointestinal tract in skin celiac disease.

Hudceliaki is usually shortened to DH, after the Latin name dermatitis herpetiformis.

Hard to get a pregnancy

With untreated gluten intolerance, you may have difficulty getting a pregnancy known as infertility . When you start eating gluten-free foods, celiac disease no longer affects your ability.

What happens in the body?

Celiac disease means that your immune system reacts to the protein gluten found in wheat, rye and barley.

The immune system reacts

When you eat gluten, your body’s immune system reacts  to the gluten that comes to the small intestine .

The reaction causes the lining of the small intestine to become inflamed and the intestinal mucosa eventually disappears. The intestinal fluid is on the inside of the intestine and absorbs food from the food. As the intestinal fluid disappears, it becomes increasingly difficult for the body to absorb and retain nutrients contained in the food. The greater the amount of gluten you get in you, the more the gut is damaged. 

You can also get  lactose intolerance  that goes over. Lactose intolerance is because the intestine absorbs lactose when the intestinal fluid is destroyed. You can then get diarrhea and get gassy in your stomach when you drink milk. The sensitivity to lactose goes away when you eat gluten-free foods.

Celiaki does not go over

Although the small intestine is damaged by gluten, you do not need to have any obvious gastrointestinal problems, and it can sometimes seem like celiac disease has passed. But it is not, celiac disease is something you have all your life.

Celiac disease can occur in other diseases and conditions

You are more likely to have celiac disease if you also have another disease in which the immune system reacts to its own tissue, a so-called  autoimmune disease . Examples of such diseases are the following:

  • Type 1 diabetes .
  • Thyroid diseases, both hyperthyroidism and hypothyroidism .
  • Autoimmune liver diseases.
  • Rheumatic diseases.

It is also more common to have celiac disease in Down syndrome and  Turner syndrome .

Celiaki is not a grain allergy

Celiaki is not an allergy and should not be mixed with cereal allergy. Cereal allergy occurs in children and usually disappears as the child gets older. Therefore, grain allergy is uncommon in adults.

Cereal allergy means that you are allergic to one or more cereals, ie wheat, barley, oats, rye and rye wheat, maize, rice or millet. A person often responds directly if they come into contact with the allergenic substance. An example of a reaction is that the person can get swollen lips, become clogged and get a swelling in their throat if they have got the substance in their mouth.

You can have symptoms without having a damaged bowel

Many people feel that they get bad from eating gluten, but in studies there is no damage to the small intestine mucosa as in celiac disease. This condition is fairly recently discovered and is likely due to a reaction to another substance in cereals other than just gluten. Research is underway to find out exactly which topic it is.

The treatment is the same as with celiac, eating gluten-free foods. You probably do not need to be as careful that the food is completely gluten free, as you need for celiac disease.

Investigations and investigations

You need to continue eating gluten-free foods right up to sampling. Otherwise, it will not appear in the test answers if you have celiac disease. This means that it takes longer to get the right diagnosis and treatment.

This applies both before blood tests and if you need to have tissue samples from the intestine, so called small bowel biopsy.

You are allowed to submit blood samples

At the health center, you are  given blood tests that show if you have certain types of antibodies in your blood. In celiac disease, a certain type of antibody is usually formed in the blood. If the test shows that you have these antibodies, you are likely to have celiac disease.

Tissue samples are taken from the small intestine – small intestinal biopsy

The doctor may need a tissue sample from the small intestine to safely diagnose celiac disease. The tissue sample is taken by a gastroscopy .

The samples are then examined under a microscope to see if the intestinal fluid is damaged. Damaged bowel noise is the surest sign of celiac disease.

After the investigations

It takes about a week to get an answer to the blood tests. The test results from a small intestinal biopsy usually take about a month.

Treatment

The treatment consists of eating foods that are completely gluten free. Celiaki does not go over, but you need to eat gluten-free foods for the rest of your life.

When you start eating gluten-free foods, the gut heals, usually within a few months. Often the symptoms decrease even before the bowel has healed.

You can read more about what you can eat and not eat in the article Food and cooking at celiac disease .

A dietician tells you what to eat

You usually get to see a dietician after you have been diagnosed. A dietician is a person who specializes in diet. The dietitian goes through what foods you can eat and what to avoid.

It is important that you get good information early in treatment. The more you know about celiac disease and what to eat, the easier it is to avoid gluten and cook good gluten-free foods.

The dietitian also gives you advice on how to get fiber, minerals and vitamins. Otherwise, it can be difficult to get enough of these nutrients.

Even small amounts of gluten damage

It does not pose a long-term health risk to ingest gluten accidentally, but you may get symptoms from your stomach. This is because even small amounts of gluten lead to intestinal inflammation. It is therefore important that all food you eat is gluten free.

If you get gluten in you regularly, your old symptoms will eventually come back. You can also get new symptoms and the risk of osteoporosis increases. Younger people can also find it difficult to get pregnant.

Revisit

Once you have been diagnosed, you will be followed up on a return visit. Then you and the doctor talk about how you feel and how it is possible to eat gluten-free diet. The doctor will also examine you and you will be given blood tests.

You can also meet the dietician at the return visit if you need to.  

Most often, the visits are made at the health center, but you can also have a visit to a hospital six to 12 months after you have received your diagnosis.

What does celiac disease depend on?

It is not clear why some get celiac disease, but heredity is an important cause.

It is also unclear what causes the immune system to attack the gluten that comes to the small intestine.

Living with gluten intolerance

Many people who have been diagnosed with celiac disease find it nice to find out what the problems are due to and that there is treatment. At the same time, it can be painful to realize that you need to eat gluten-free foods for the rest of your life.

There are more and more gluten-free alternatives

Starting to cook and eat gluten-free foods can mean a change, but after a while it becomes a natural part of everyday life. There are many gluten-free products to buy and often cafes and restaurants can arrange gluten-free food. Buffets are often printed on which foods are gluten-free.

You can find recipes for gluten-free food in special cookbooks, on websites and on blogs. There you can also get inspiration for cooking gluten-free foods.

You can also read more about gluten-free foods in the article Food and Cooking at Celiac .

Works well to share kitchen

It is possible to share kitchens with someone who eats gluten-containing foods. But you need to pay attention to whether there is too much crumb or flour containing gluten, for example in a butter box or on a cutting board. In such cases, remove the crumbs from the butter and wipe off the cutting board.

It is possible to use colander, toaster and knives used for food with gluten. Remove any residues of gluten-containing foods, if any.

If you are very sensitive, it may be a good idea to have cooking utensils that are only used for gluten-free foods.

If you are going abroad

It is usually not very difficult to find gluten-free food at restaurants and cafes abroad. In many countries flour of wheat, barley or rye is not used in cooking in the same way as in Sweden.

The labeling of gluten-free products may differ from the labeling in Sweden. Therefore, continue reading the table of contents on food products, as far as possible.

Tell your family, relatives and friends

Tell your family, relatives and friends that you have celiac disease, what you can eat and what to avoid. Explain that it is not possible to make exceptions now and then, and that even small amounts of gluten damage the intestine.

Financial support for gluten-free foods

Gluten-free food costs more. On the Consumer Agency’s website you can read how much more gluten-free food costs . In some county councils, you may receive financial support to cover the additional costs incurred. The financial support varies between the county councils.

You should understand the information

In order to be involved in the care and treatment, it is important that you understand the information you receive  from the healthcare staff. Ask your health care provider if you do not understand.

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