Celiac disease (CE) is characterized by being a systemic process of autoimmune nature, the only one of known etiology, affecting primarily, but not exclusively, the digestive tract.
Its diagnosis is confirmed by the presence of chronic diffuse inflammation of the mucosa of the small intestine, which may be associated with a variety of clinical manifestations.
Although it is a process with a well-defined genetic basis, it can appear at any age of life, affecting both children and adults. It has a clear hereditary component and a marked family aggregation.
It is estimated that Europeans and their descendants have a prevalence of celiac disease of 1%, being more frequent in women with a ratio of 2: 1, according to the Federation of Celiac Associations of Spain. They also add that around 75% of celiac patients are undiagnosed.
What are the symptoms of celiac disease?
The symptoms of celiac disease are highly variable, according to the age of presentation of the disease and other exogenous factors. Thus, in children, CD is usually manifested as early as 6 months of age with the introduction of porridge in food, and in severe forms, before age two. It usually occurs in the form of chronic diarrhea , accompanied by abdominal distension , accompanied by weight loss and growth retardation, constituting the so-called "classic form" or triad characteristic. However, other symptoms that also appear with some frequency in childhood, are anorexia , vomiting , irritability and even constipation , which can also be very striking.
The forms of presentation in the adult are very varied and less characteristic, so they are called "atypical forms". Diarrhea occurs in less than 50% of patients and weight loss is not very striking, finding that up to 30% of patients are overweight at the time of diagnosis.
The presence of celiac disease has been described graphically as an "iceberg" in which the visible and clinically manifest part are the classic forms that predominate in infancy, while the atypical or oligosymptomatic forms, which appear predominantly in the adult, constitute its Part hidden.
Other frequent forms include, in addition to chronic anemia , osteoporosis , constipation, onset of neurological symptoms , skin lesions such as dermatitis herpetiformis, hypoproteinemia, hypocalcemia and / or the presence of persistently impaired liver function tests.
The extra-digestive manifestations may be multiple and of a very varied nature, many of them being motivated by chronic deficiencies of trace elements due to their difficulty in intestinal absorption and others of an autoimmune type, forming as a "proteic amalgam" of associated diseases, all with a Common denominator, which is the existing gluten intolerance.
The diagnosis of a celiac patient
Many patients visiting a Digestive System specialist have a long history of evolution based on repeated and repeated digestive and extra-digestive discomforts that have required multiple hospitalizations with different diagnoses that are not well defined and that have even undergone various interventions With indications not well defined, before arriving at the definitive diagnosis of celiac disease.
Occasionally it can be diagnosed in the course of a high endoscopy indicated by other reasons, such as symptoms of gastroesophageal reflux or chronic anemia of non-affiliated origin and it is therefore recommended to take multiple duodenal biopsies before their suspicion, to confirm and avoid So have to repeat it. In addition, patients with Functional Dyspepsia or Irritable Bowel Syndrome have the possibility of being really celiac, in more than 60% of cases. The presence of dermatitis herpetiformis (DH) skin lesions, characterized by the presence of vesicles, crusts and fissures located on the extensor surface of the extremities, but also on palms of the hands, soles of the feet, scalp, accompanied by Intense pruritus, appear in 1 out of 4 celiac patients (25%) and are so characteristic that they are considered as cutaneous EC and the celiac patient's "visiting card".
What is the treatment for celiac disease?
The only treatment currently available to control the disease is the gluten-free diet (DSG), which must be strict and maintained for life.
Is there a risk of associated diseases and complications if I am celiac?
As an autoimmune disease, there are often very different associated diseases of the skin (DH), the thyroid (hypothyroidism), refractory iron deficiency anemia, migraines, osteoporosis, infertility disorders , repetitive abortions , fibromyalgia and others Many and varied.
In addition, both intestinal and extra-digestive complications can occur. In its appearance and development, the diagnostic delay is significantly affected, which should be avoided and shortened to avoid unnecessary discomfort and prevent the development of complications.