Celiac Disease - Diagnosis and Therapy

Considering both classical and atypical forms, it is now thought that about 1 in 250 to 500 people are sensitive to gluten. Of these, however, only about 10 to 20 percent have the symptoms typical of celiac disease.

Celiac disease is often observed in:

  • Diabetes mellitus (type 1),
  • Lactose intolerance,
  • Osteoporosis,
  • Thyroid disease,
  • rheumatoid arthritis and
  • in Down Syndrome.

Also first and second degree relatives are more affected than the average population. These individuals should be examined, especially if one or more of the typical signs occur.

Celiac disease patients are more likely to suffer from type 1 diabetes. Both diseases are caused by defects in the immune system. Presumably, a genetic gluten hypersensitivity leads to a chain reaction, as a result of which cells of the immune system overreact and attack the body's own tissue (autoimmune disease). If certain cells of the pancreas are destroyed, develops an insulin deficiency and thus diabetes.

How is the diagnosis made?

The basis for the diagnosis in addition to the clinical symptoms of the detection of specific antibodies (against transglutaminase, endomysium and gliadin) in the blood and the examination of a tissue sample of the small intestinal mucosa under the microscope.

Today's standard endoscopic small bowel biopsy is safe and takes no longer than 10 to 15 minutes. A camera probe is pushed into the small intestine via the mouth, esophagus and stomach, several tissue samples are taken and then examined microscopically.

The antibody test can not replace a small bowel biopsy. Especially in children, the reliable diagnosis through the biopsy is important because they have to eat gluten-free life with a positive diagnosis throughout their lives. If the symptoms improve under a gluten-free diet, this confirms the diagnosis.

Almost all patients show typical change on a particular gene; However, since a quarter of the healthy has these, it is not good for diagnosis, but speaks in the absence of celiac disease.

What is the therapy for celiac disease?

The only treatment so far is the complete, lifetime waiver of gluten-containing foods. Only then can the small intestinal mucous membrane recover and regain its function. However, even the smallest amounts of gluten damage and complaints occur again.

In most cases, just a few weeks after the change in diet, the symptoms improve and then disappear completely.

Can celiac disease be prevented?

It is not yet clear why celiac disease occurs in some people, but it seems to be a genetic predisposition. The only preventive measure currently recommended is to avoid gluten-containing foods in infants less than six months old.

After the diagnosis of celiac disease can be prevented by a consistent diet sequelae.

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