Celiac disease is an autoimmune disorder that’s triggered when one eats gluten. Sometimes it’s called celiac sprue or gluten-sensitive enteropathy which is simply an immune reaction to eating gluten, a protein found in wheat, barley, and rye. According to WebMd, a health information website, if you have celiac disease, eating gluten triggers an immune response in your small intestine. Overtime, this reaction damages your small intestine lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhoea, fatigue, weight loss, bloating and anaemia, and can lead to serious complications. In children, malabsorption can affect growth and development. Experts say there’s no cure for celiac disease, however, for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing. Yvan Ntwari, a specialist in internal medicine in Kigali, says signs of this condition vary greatly and differ in children and adults. He says digestive signs and symptoms for adults include diarrhoea, fatigue, weight loss, bloating and gas, abdominal pain, nausea, and vomiting, as well as constipation. For the children, he says symptoms include decreased appetite, stomach ache and bloating, poor growth, and weight loss. Causes Ntwari says genes combined with eating foods with gluten and other factors can cause celiac disease, but the precise cause isn’t known. Infant-feeding practices, gastrointestinal infections, and gut bacteria might contribute as well. Sometimes, he says, celiac disease becomes active after surgery, pregnancy, childbirth, viral infection or severe emotional stress. When it comes to the risk factors, studies show that celiac disease tends to be more common in people who have a family member with celiac disease or dermatitis herpetiformis, type 1 diabetes, Down Syndrome, or Turner Syndrome. Complications Ntwari says if untreated, celiac disease can lead to diverse health effects, including malnutrition. Malnutrition, he explains, occurs if the small intestine can’t absorb enough nutrients, and can also lead to anaemia and weight loss in children. Malnutrition can also cause slow growth and short stature. Also, celiac disease can lead to bone weakening, malabsorption of calcium and vitamin D can lead to a softening of the bone (osteomalacia or rickets) in children and a loss of bone density (osteopenia or osteoporosis) in adults. Still, on malabsorption of calcium and vitamin D, Ntwari says it can contribute to reproductive issues. Studies indicate that celiac disease can lead to lactose intolerance, whereby damage to the small intestine might cause abdominal pain and diarrhoea after eating or drinking dairy products that contain lactose. Once your intestine has healed, one might be able to tolerate dairy products again. People with celiac disease who don’t maintain a gluten-free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer. Some people with celiac disease can develop problems such as seizures or a disease of the nerves to the hands and feet (peripheral neuropathy). According to Ntwari, avoid eating any foods which contain gluten. “This will mean that one has to follow a gluten-free diet for the rest of their life. If diagnosed with celiac disease, consulting a dietitian to help you stick to a gluten-free diet is important as there is a need to understand which foods contain gluten and how to maintain a balanced diet,” he says.
