Celiac Disease

The small intestine extends from the stomach to the large intestine (colon) and is part of the human digestive tract.

It includes an immobile segment, the duodenum, followed by two mobile segments, the jejunum and the ileum. Its inner layer, the mucosa, contains many glands which secrete protective mucus. The mucosa is also covered in fingerlike projections called villi which increase the internal surface area of the small intestine’s wall, creating a significantly greater potential for the absorption of nutrients. The small intestine varies in length from five to seven meters, with a total absorption surface area equivalent to a tennis court. 

Eating gluten contained in wheat, barley and rye flour triggers an adverse immune reaction. This causes inflammation which destroys the villi in the intestine’s lining, thereby preventing the absorption of nutrients.

• Certain people show no symptoms, while others may experience a wide range of symptoms which vary depending on the degree of malapsorption:
• Digestive symptoms such as chronic diarrhea, bloating and constipation, as well as anemia due to iron and vitamin B9 deficiencies
• Other deficiencies, including calcium and vitamins A, E, K and D

Celiac disease may be suspected based on a clinical examination, supplemented with lab test results suggesting malapsorption. 

To diagnose the disease, tests are available to check for gliadin and transglutaminase antibodies in the blood. A gastroscopy may also be performed in which samples are taken from the duodenum to search for villous atrophy.

Treatment of celiac disease relies on a lifelong gluten-free diet.

People who experience difficulties following a gluten-free diet may seek assistance from a dietician or physician specializing in nutrition, or from celiac disease support groups.

Dietary supplements of vitamins, minerals and iron may be administered depending on the individual’s deficiencies.

If there are no improvements despite a strictly gluten-free diet, tests must be performed to search for a celiac disease-related complication called refractory sprue.

 

• An estimated 700,000 people in France have celiac disease (1 percent of the population)
• Celiac disease generally manifests in childhood (between the ages of six months and two years) and in adults aged 20 to 40
• Food labeled as “gluten-free” must contain less than 20 mg of gluten per kilogram of finished product