Celiac disease is a chronic autoimmune disorder that causes an immune reaction of the body to the intake of gluten. In countries like Italy, more than 200,000 patients have celiac disease, but considering undiagnosed cases, the actual number would be around 600,000 – around 1% of the population. 

Celiac disease can be diagnosed at different stages of life, either in infants only a few months old or in adults, who can also be asymptomatic. However, the immune reaction triggered by celiac disease, if left undiagnosed and untreated, can result in inflammation of the small intestine and intestinal villi. This effect prevents the proper absorption of nutrients, severely compromising the affected individual’s health, including complicated forms of celiac disease (e.g., refractory celiac disease and intestinal lymphoma).

What Gluten Is and How Celiac Disease Develops

Gluten is a structural protein found in many grains, such as barley, wheat, and rye. 

Following gluten intake, the person with celiac disease develops intestinal inflammation, resulting in progressive destruction of the intestinal villi and, thus, malabsorption. Therefore, the treatment is to strictly avoid foods containing even small traces of gluten.

Although the main problem is this protein, celiac disease is a multifactorial disease that is also triggered in a predisposed individual by environmental factors (e.g., gastrointestinal infections or pregnancy) or other autoimmune diseases that are associated with this condition, such as: 

  • Type 1 diabetes;
  • Autoimmune thyroiditis;
  • Rheumatoid arthritis;
  • Genetic syndromes such as Down syndrome and Turner syndrome.

How to Recognize Celiac Disease?

Even if it is not always symptomatic in adults, the inflammation caused by the ingestion of gluten causes gastrointestinal symptoms in celiac patients, such as: 

  • Diarrhea
  • Meteorism
  • Abdominal bloating
  • Abdominal cramps
  • Dyspepsia
  • Weight loss 

Other symptoms, such as mouth sores, alopecia, muscle weakness, iron-deprived anemia, unusual hypertransaminasemia, osteopenia and/or osteoporosis, history of infertility and/or poly-abortion, should not be underestimated.

In case of doubt, it is imperative not to improvise do-it-yourself diets, which could be detrimental to one’s health, but to consult a specialist who will prescribe the appropriate tests to get a diagnosis. These tests include serology for celiac disease and gastroscopy with multiple biopsies at the duodenum level in case of a positive result.

Celiac Disease Diet: A Gluten-Free Diet

The intestine and mucosa of the patient with celiac disease must regain their original functionality. For this reason – and to reduce the even disabling symptoms of the disease – the patient must follow a strictly gluten-free diet.

Bread, pasta, cakes, and food made with cereals and flours from oats, wheat, spelt, barley, wheat, Kamut, or malt are prohibited. Yeast and seitan are also to be avoided, as are those ready-made meals that may contain traces of gluten (although, in that case, it should be indicated by law on the label) or milk and yogurt made with cereal and malt. 

Gluten is often used as a thickener, so it is good to always pay attention to the ingredients of sauces, soluble nuts, and even sausages and candies.

Among beverages, beer, instant coffee, and other instant drinks that might hide traces of gluten – as well as flavored teas – are equally prohibited.

Nowadays, a wide range of gluten-free products are sold in supermarkets and grocery stores. These foods can be a safe food resource for patients with celiac disease.