Or is it celiac disease?

This question should be asked by anyone who cannot find the cause of their ailments. Where does this assumption come from? First, celiac disease can show up at any age. Second, it has many different symptoms. And thirdly, nearly 360 thousand. Poles do not know that he has it.

Research shows that, on average, one in XNUMX people has celiac disease in each population. In Poland, only a few percent of people in this group know about their disease. Celiac disease is an autoimmune disease of genetic origin, characterized by intolerance to gluten, i.e. the protein hidden in cereals (wheat, rye, barley, oats). In patients, gluten acts as a toxic substance that destroys the villi of the small intestine and thus impairs the absorption of nutrients. We talk to Małgorzata Źródlak, President of the Polish Association of People with Celiac Disease and Gluten-Free Diet about how to recognize and treat this disease.

Why such a low celiac disease detection rate?

There is still a myth (also among doctors) that celiac disease is a childhood disease that grows out of it after a few years of a gluten-free diet. It’s not true. Often we come to people who are “cured” of celiac disease in childhood, who in their adult life suffer from serious diseases caused by non-compliance with the diet. In addition, celiac disease can show up at any age, for example during adolescence, during pregnancy, after a strong infection, when living under stress, or after major surgery. Increasingly, celiac disease is detected in people aged 30-50 years. Women get sick twice as often as men.

What symptoms should worry us?

The symptoms may vary from person to person. They are also often confused with irritable bowel syndrome or an allergy. Full-blown celiac disease is characterized by abdominal pain and bloating, fatty or watery diarrhea, weight loss, developmental disorders (in children), change of disposition (often depression), deficiency symptoms (e.g. persistent anemia). Most patients, however, have a mildly symptomatic form of celiac disease, which is why it is so difficult to detect. Its signal may be, for example, elevated cholesterol levels, aphthas or ulcerative stomatitis, constant fatigue, persistent headaches, bone and joint pain, early osteoporosis, neurological disorders, skin problems, problems with getting pregnant.

What should someone who suspects celiac disease do?

You need to tell your primary care physician about your suspicions and any symptoms. Theoretically, we will then receive a referral for further examinations by a gastroenterologist. It is important not to follow a gluten-free diet on your own, as this may prevent a correct diagnosis. The next step is to perform blood serological tests recommended by the gastroenterologist. Usually, the concentration of two of the three antibodies is determined: EmA, tTG, DGP (GAF). You can also do these tests privately, the cost is about PLN 90 (for one antibody). In order to fully diagnose the disease, it is also necessary to perform a biopsy of the small intestine. It is performed endoscopically (during gastroscopy). The disappearance of the villi structure, the presence of at least one of the tested antibodies and the improvement of well-being after introducing a gluten-free diet are sufficient conditions for the diagnosis of celiac disease.

What about genetic testing?

They can be helpful in detecting treatment-resistant celiac disease because the results do not change when you go on a diet. If a patient does not have the HLA: DQ2 or DQ8 version of the genes that are characteristic of celiac disease, 99 percent of the gene is available. exclude. However, on the other hand, the presence of these genes is not synonymous with disease, nearly 30 percent. of the population has them, and it only shows a certain “genetic susceptibility” to this celiac disease.

How is this disease treated?

There are no drugs or complicated therapies. Treatment for celiac disease involves the need to follow a strict gluten-free diet. Permanently! At the same time, we must be aware that the full regeneration of intestinal villi usually takes from several weeks to several months, or even several years (in some adults). In the case of a large disappearance of intestinal villi, a lactose-free diet (without dairy products) is also temporarily introduced.

What is the biggest problem for people with celiac disease?

At the beginning? Diet. Most of us are aware that gluten is in bread or pasta. However, no one expects it in yoghurt, vanilla sugar or cottage cheese. So you need to learn to read all the labels of the products you buy (which takes a lot of time), give up buying food by weight, because you do not know if it is not contaminated with gluten. It also happens that producers change the composition and something that has already been “proven” begins to hurt us. All trips and family celebrations are also troublesome. Because a person with celiac disease cannot eat many things. There are pressures like: “A little will not hurt”, “Try at least”. Meanwhile, gluten is a poison for a person with celiac disease and even a small dose will always be harmful.

What else do people with celiac disease struggle with?

For example, all hospital stays are troublesome. In such establishments, a gluten-free diet is usually not available or it consists only in the fact that you do not get any bread.

How many people apply for help to the Polish Association of People with Celiac Disease and on a Gluten-Free Diet?

Every day we add a few new people to the Association, we reply to numerous e-mails. We advise which products are safe, organize workshops, conferences, trips for children and run the campaign “GLUTEN-FREE MENU”. Restaurants, hotels and catering companies from all over Poland come to us. After thorough analysis of the menu, controls and audits, we issue our certificates to selected establishments. All information on celiac disease and the gluten-free diet can be found on the website www.celiakia.pl.

Tekst: Joanna Szutkowska