Celiac Disease: Understanding Gluten Sensitivity and Its Management

Celiac disease is a lifelong, chronic sensitivity of the small intestine to a protein called gluten. The foods we consume are broken down into their components in the small intestine and then absorbed into the bloodstream. Adequate nutrient absorption depends on numerous folds in the small intestine called villi.

When individuals with celiac disease consume foods containing gluten, damage occurs to these villi. The folds become flattened and shrink, reducing the surface area of the intestine. As a result, nutrients cannot be properly absorbed. This leads to nutrient deficiencies and various symptoms.

The only treatment is a strict gluten-free diet. Even a daily intake of 50 mg of gluten can cause continued intestinal damage (for comparison, one slice of wheat bread contains approximately 1.6 grams of gluten).

The duration of breastfeeding, the age at which gluten-containing foods are introduced, and the amount of gluten consumed are factors that influence when and how the disease develops. Breastfeeding should be continued for an extended period, and grains should be introduced between the 4th and 7th months when starting complementary feeding.

Symptoms of celiac disease differ between children and adults.

In children, common symptoms include abdominal pain, abdominal bloating, diarrhea, irritability, loss of appetite, increased infections, growth retardation, vomiting, failure to gain weight, and slowed height growth.

In adults, symptoms may include abdominal distension, low body weight for age, muscle weakness, anemia, abnormal stools, increased frequency of bowel movements, diarrhea, vomiting, fatigue, unexplained liver diseases, growth retardation, mouth ulcers (aphthae), loss of appetite, gas complaints, joint and bone pain, irritability, and itchy skin rashes.

Food intolerance tests cannot be used to diagnose celiac disease. Conditions such as food intolerance and food allergy are entirely different from celiac disease.

How Can I Avoid Gluten?

The treatment for celiac disease is a gluten-free diet. In individuals who strictly adhere to the diet, symptoms gradually decrease and disappear. A gluten-free diet must be maintained for life. The most common reason for lack of response to treatment is hidden gluten exposure in the diet.

Foods that individuals with celiac disease should avoid include:

• Wheat

• Barley

• Rye

• Oats

• Wheat products such as pasta, bulgur, semolina, vermicelli, biscuits

• Beverages containing malt (beer, vodka, gin, etc.)

• Chewing gum and chocolate

• All packaged foods labeled “contains gluten”

Foods that can be consumed instead of wheat and other restricted grains include:

• Corn, rice, potatoes

• Bean flour, lentil flour, chickpea flour, chestnut flour

• Gluten-free flour and bread varieties

• Buckwheat (groats), quinoa, amaranth

There is no restriction on consuming other food groups (meat, dairy, fruits, and vegetables) in a healthy and balanced manner. It is essential to develop the habit of carefully reading food labels when purchasing packaged products. During food preparation and serving, utensils and cookware that have come into contact with gluten-containing foods must not be used.

Wishing you healthy days.