Celiac disease, also called gluten-sensitive enteropathy, is a complex, polygenic multifactorial autoimmune disease. It is caused by a permanent intolerance to gluten (found in many grains such as rye, oats, wheat, barley and triticale) that results in an inflammatory destruction of the small intestine. This results in the malabsorption of many nutrients, in particular, iron, calcium and folic acid. This disease is now considered to be the most common genetic disorder in Europe and North America.

How common is celiac disease?

With a prevalence of 1%, an estimated 300,000 Canadians are affected by the disease, including over 76,000 in Quebec. According to some studies, 9 out of 10 sufferers are unaware they have it.

Celiac disease affects people of all ages, children and adults alike. About 10% of people who have celiac disease have family members who suffer from it. In addition, celiac disease is more common in patients with juvenile diabetes, thyroid disease and in individuals with Down syndrome. At puberty and during adolescence, symptoms fade or subside, however, this is not a sign that the disease has been cured and the sufferer should continue to avoid gluten.

Diagnosis

Symptoms often resemble other diseases, including irritable bowel syndrome and can therefore be difficult to diagnose. According to the results of a Canadian survey conducted in 2007 on celiac disease, after the onset of symptoms, an average of 12 years was required for the diagnosis of celiac disease in adults. Because of the wide variety of symptoms*, patients reported consulting various medical specialists including, among others, gastroenterologists, hematologists, neurologists, psychiatrists and dermatologists, before a diagnosis was finally made.

 *(Some common symptoms include: recurrent diarrhea, constipation, weight loss or gain, abdominal pain, bloating, flatulence, anemia, fatigue, irritability, stunted growth (in children), muscle cramps, unexplained neurological disorders. The nature, number and intensity of symptoms vary from person to person).

Celiac disease can be detected by blood tests: immunoglobulin A and G, anti-endomysium and anti-transglutaminase antibodies. Following a positive blood test, an intestinal biopsy is required for definitive diagnosis. Following a gluten-free diet before blood tests and the biopsy are completed is not advised in order to establish a more accurate diagnosis. Early diagnosis of celiac disease can make all the difference in the quality of a person’s life. It is well known that patients in whom the disease is undetected and therefore untreated, are at greater risk of serious long-term complications such as: lymphoma, autoimmune disease, infertility, anemia, malnutrition, osteoporosis and psychosocial-neurological disorders.

Treatment

Strictly following a gluten-free diet for life is the only effective treatment!

Gluten is a protein found in cereals such as wheat (including spelt and kamut), rye, barley and malt, triticale, regular* oats and derivatives of these cereals.

People with celiac disease must avoid eating any food containing gluten. Many baked goods and pastries, pasta and a variety of processed foods, in which gluten can hide under various names such as hydrolyzed vegetable protein and modified starch, are prepared from cereals mentioned above and should therefore be avoided.

 *Until recently, oats were thought to potentially have negative effects on the health of people with celiac disease. According to recent studies, pure oats that are uncontaminated by other cereals (as opposed to normal large-scale sold oats) could be tolerated in moderate amounts.

Probiotics and celiac disease

Some probiotics can be beneficial for celiacs because they break down gluten proteins into harmless peptides before reaching the duodenum. Studies in Finland have shown that probiotics can reduce intestinal cell damage after consumption of gluten in the diet. In addition, certain probiotics are known to promote the repair of the tight junctions of intestinal mucosa cells, which reduces the direct transfer of toxic peptides into the bloodstream.

Certification

All fresh Bio-K + products are certified gluten-free by the Gluten-Free Certification Organization (Certification # 395). Bio-K + products can be incorporated into all gluten-free diets.

References

All information about celiac disease from the Quebec Celiac Disease Foundation website (www.fqmc.org ).

D’Arienzo, R. et al. 2008. Adjuvant effect of Lactobacillus casei in a mouse model of gluten sensitivity. Immunol. Let. 119:78-83.

Gobbetti, M. et al. 2007. Sourdough lactobacilli and celiac disease. Food Microbiol. 24:187-196.

Helmerhorst, E.J. et al. 2010. Discovery of a novel and rich source of gluten-degrading microbial enzymes in the oral cavity. PLoS ONE, 5(10):e13264.