Myth 1: Celiac Disease is the same as Gluten Sensitivity
Fact: Celiac disease is not the same as Gluten Sensitivity or Gluten Intolerance. Celiac disease is an autoimmune disorder or reaction that occurs with the presence of gluten in the intestine. Although gluten sensitivity and celiac disease have some common symptoms, gluten sensitivity is not an autoimmune disorder. Instead, scientists believe that the cytotoxicity effects of gluten and other wheat molecules can be the primary cause behind gluten sensitivity. Whereas, scientists believe that the following factors can cause celiac disease:
- T-cell mediated autoimmune response to dietary prolamin.
- Chromosomal mutations of HLA-DQ2 and HLA-DQ8 genes.
- Rotavirus or intestinal adenovirus, and other autoimmune conditions such as type 1 diabetes, primary biliary cirrhosis, and autoimmune thyroid disease (both hyper and hypothyroidism).
- Medical conditions such as viral infection, surgery, emotional trauma, or pregnancy can trigger celiac disease.
The proposed criteria for clinical diagnosis of gluten sensitivity include:
- Monitoring the improvement in the gastrointestinal symptoms and extra-intestinal manifestations after including a gluten-free diet (GFD) with the help of a rating scale.
- Duodenal biopsies and evaluation of the presence of antigliadin antibodies are also essential parameters to diagnose gluten sensitivity.
- Absence of serological CD markers.
In contrast, the gold standard to diagnose celiac disease is an endoscopy biopsy study. The endoscopy takes a small sample of tissue from the intestine to analyze the damage done by Celiac disease on the villi. Capsule endoscopy is also used to diagnose celiac disease.
Myth 2: Celiac disease is not an actual disease
Fact: Celiac disease is a real and serious condition that can make a person weak. Celiac disease, if left untreated, can lead to other health complications, including miscarriage, infertility, coronary heart disease, pancreatitis, osteoporosis, thyroid disease, several cancers, and even neurodegenerative disorders like Alzheimer’s, dementia, and Parkinson’s disease. Thus, it is essential to understand the symptoms of Celiac Disease and get it diagnosed by a registered physician before it is too late.
Myth 3: Celiac Disease affects only children
Fact: No, celiac disease can affect anyone and at any phase of life. It is a misconception that celiac disease affects only children. The common symptoms to children and adults include abdominal pain, diarrhea, and an itchy skin rash called dermatitis herpetiformis. Adults can have signs that can be related or not related to the digestive system. The symptoms associated with the digestive system can be diarrhea, fatigue, and heartburn, gradual weight –loss, bloating, flatulence, pain in the abdomen, nausea, vomiting, and constipation. Thus, if your child or you as an adult have any of the symptoms of celiac disease, it is better to visit a doctor and get it diagnosed.
Myth 4: If you have Celiac Disease, then you should eat food that is entirely gluten-free and uses only gluten-free shampoo and cosmetics
Fact: Celiac disease is caused when there is ingestion of gluten-containing food. Thus, it is easy to understand that the diet should be completely free from gluten. However, in reality, getting a diet completely free from gluten daily and at every place is a challenging task, or we can say an impossible feat. It is impossible to remove all gluten from food. Researchers agree that people with celiac disease can tolerate gluten safely up to 20 ppm. Moreover, manufacturing entirely gluten-free food items (gluten concentration at 0 ppm) will increase the price of such products. Thus food items containing gluten concentrations below 20 ppm are safe for celiac patients.
Now, coming to the use of gluten-free shampoo and cosmetics in patients with celiac disease, scientists have found that gluten in shampoo and cosmetics are not a threat except for lipstick or hand lotion that can be easily ingested. Since gluten cannot be absorbed into the bloodstream from the skin unless there is an open wound, thus people can apply gluten-containing products to their skin and hair. However, celiac patients should wash their hands properly after using any topical gluten product to prevent unintentional ingestion.
Myth 5: If a person’s symptoms do not match the symptoms of their friend or relative diagnosed with celiac disease, then the person does not have celiac disease
Fact: This is not true. The symptoms and onset of celiac disease vary from person to person. Children will have different symptoms than adults. Genetic factors do play a role in Celiac disease. If a person has celiac disease, then there is a chance that his 1st and 2nd-degree relatives may also develop Celiac Disease.
Moreover, the symptoms of celiac disease can be related to the digestive system or not associated with the digestive system. Below are the symptoms found in adults who have celiac disease.
The symptoms related to the digestive system include:
- Diarrhea (loose, watery stools that frequently occur than usual)
- Fatigue and Heartburn
- Gradual weight-loss
- Bloating and flatulence
- Pain in the abdomen
- Nausea and vomiting
- Constipation
The symptoms of celiac disease that are not related to the digestive system include:
- Deficiency of iron in the blood, i.e., Anemia
- Osteoporosis, Osteomalacia, and Arthralgia
- Dermatitis herpetiformis (itchy, blistering skin disease on the elbows, knees, torso, scalp, and buttocks)
- Ulcers in the mouth
- Swollen, red patches present in the corners of the lips that is visible from outside
- Change of color of the teeth.
- Headache and Fatigue
- Difficulty in balancing the body, injury to the nervous system
- Presence of numbness and tingling in the feet and hands
- The function of the spleen decreases
In children, the symptoms of celiac disease are related to the digestive system, which includes:
- Nausea and Vomiting
- Chronic diarrhea
- Abdominal distention ( swollen stomach)
- Constant Difficulty in motion ( Constipation)
- Flatulence
- Pale and foul-smelling stool
Thus, it is always better to diagnose from a certified physician to confirm if your symptoms are related to celiac disease. “DO NOT COMPARE OR SELF ANALYZE”
Myth 6: Celiac Disease will get cured of its own
Fact: At present, there are no drugs to cure celiac disease permanently. The treatment involves following a strict gluten-free diet to manage the severe complications of the disease. Even if symptoms go away completely, reintroducing gluten will again cause severe celiac disease complications to return. Thus, diagnosis of Celiac disease should be made as early as possible to prevent serious health complications. The patient should religiously practice a gluten-free diet for the rest of their life.
REFERENCES
- Celiac Disease—Myths and Facts. Accessed at
https://www.pfizer.com/news/featured_stories/featured_stories_detail/celiac_disease_myths_and_facts - Myths and Facts-Celiac India. Accessed at
http://celiacindia.org.in/about-celiac-disease/myths-and-facts/ - 13 Myths About Celiac Disease You Should Know About Today. Accessed at
https://www.imaware.health/blog/myths-about-celiac-disease - Myths about Celiac Disease, Gluten Sensitivity, and The Gluten-Free Diet. Accessed at
https://www.beyondceliac.org/celiac-disease/myths/ - Celiac vs. Gluten Intolerance: Is There a Difference Between Celiac Disease and Gluten Intolerance? Accessed at https://www.schaer.com/en-us/a/celiac-vs-gluten-intolerance
- Connie Brichford (2009). Diagnosing Celiac Disease: The Role of Biopsy with Endoscopy. Accessed at https://www.everydayhealth.com/celiac-disease/celiac-disease-diagnosis-biopsy-with-endoscopy.aspx
- Elli, L., Branchi, F., Tomba, C., Villalta, D., Norsa, L., Ferretti, F., Roncoroni, L., & Bardella, M. T. (2015). Diagnosis of gluten-related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World journal of gastroenterology, 21(23), 7110–7119.
https://doi.org/10.3748/wjg.v21.i23.7110 - Mayo Clinic. 2021. Celiac disease – Symptoms and causes. [online] Available at <https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220> [Accessed 31 August 2021].
