Celiac disease, or gluten intolerance, often remains asymptomatic, hence the importance of contacting a doctor who will make a precise diagnosis to confirm or not a specific diet.
Celiac disease is a chronic inflammatory autoimmune enteropathy caused by a food antigen, gluten gliadin (protein fraction of cereals). Concretely, this is a permanent intolerance to a gluten protein, a substance contained in certain cereal products, which destroys the villi of the small intestine. This results in malabsorption of nutrients, especially iron, calcium and folic acid.
According to the French Association of Gluten Intolerant (AFDIAG), one in 100 people can develop this disease in Europe. “In France, only 10 to 20% of cases are now diagnosed,” she says. In affected individuals, signs of the disease may be the diarrhea and worrying weight loss. But they can also present uncharacteristic symptoms (muscle cramps, aphthous stomatitis, osteoporosis, anemia), the number and intensity of which vary from one person to another.
The celiac disease, also called gluten intolerance, should not be confused with gluten allergy : the first may go unnoticed, appear gradually and settle over time when the second causes symptoms of food allergy that occur immediately after ingestion of gluten, considered allergenic. The only treatment for celiac disease is follow a gluten-free diet for life because there is no drug treatment.
Blood tests are essential
But people who think they are intolerant should not remove it from their diet. before having carried out examinations essential for diagnosis. The latter is based on blood tests and if necessary a biopsy of the small intestine. First, several types of antibodies are sought: anti-transglutaminase (anti-tTG-IgA) and / or anti-endomysium (EMA) antibodies.
“If they are absent, gluten intolerance is unlikely. Conversely, the presence of these antibodies reinforces the hypothesis of celiac disease “, indicates Health Insurance. The diagnosis is confirmed by a small intestine biopsy which must be done before any gluten-free diet. An examination that consists of taking tissue fragments from the part of the small intestine closest to the stomach and the results of which may or may not detect lesions.
“However, when symptoms of the disease are present, when specific antibodies are raised, it is possible that intestinal biopsies are not requested “, adds Health Insurance. Finally, once the diagnosis is made, a final assessment is necessary: examinations to look for anemia and to measure bone density in search of osteoporosis. It is after this confirmation that it is recommended to learn to recognize consumable foods and those to avoid.
When to start a gluten-free diet?
“The definitive diagnosis of celiac disease is made after regression of the atrophy intestinal villi and / or the disappearance of clinical symptoms, following a gluten-free diet “, attests to the High Authority of Health. Despite a diagnostic protocol well established by the latter, progress remains to be made in this area because “80% of affected subjects are not diagnosed due to minor symptoms or asymptomatic forms (for example: iron deficiency only) “, underlines AFDIAG.
However, people with but not diagnosed, who therefore do not follow a gluten-free diet are ultimately at high risk for cancers of the digestive tract, upper aerodigestive tract and liver, infertility and autoimmune disease. Conversely, those who adopt a gluten-free diet benefit from the disappearance of their symptoms in a few weeks, the healing of damaged intestinal tissue and the reduced risk of complications.
AFDIAG also explains that in recent years there has been a new type of population, people tested for celiac disease and non-allergic, but who claim to feel better if they no longer eat gluten. We speak then gluten sensitivity or hypersensitivity non celiac, for which there is to date no clearly established scientific cause and where the role of gluten remains to be demonstrated.
“So there are more and more people who eat gluten free, but paradoxically, they are not necessarily those which it is proven that they need to follow a diet, “concludes the association. People who practice it, following a diagnosis or not, exclude all products. container a variety of wheat (durum wheat, spelled, kamut), barley and rye. Thus, they do not consume bread, pasta, cookies or even cold meats and icing sugar, because many foods conceal it.