Celiac Disease
In brief
Section titled “In brief”- Celiac disease is an autoimmune disease where gluten causes intestinal damage
- Diagnosis via anti-tTG antibodies and often intestinal biopsy
- Strict gluten-free eating is the only effective treatment
- Choose natural foods, avoid ultra-processed gluten-free products
- Gut recovery takes 6-12 months with lifestyle support
What is celiac disease?
Section titled “What is celiac disease?”Celiac disease is a chronic autoimmune disease of the small intestine.
In people with celiac disease, gluten — a protein in wheat, barley, rye and spelt — causes an inflammatory reaction in the intestinal lining. This leads to:
- Damage to the intestinal villi
- Poor absorption of nutrients
- Symptoms such as fatigue, abdominal pain and anemia
A gluten-free diet restores the intestinal wall and prevents further damage.
How does it develop?
Section titled “How does it develop?”Celiac disease develops in people with a genetic predisposition (HLA-DQ2 or HLA-DQ8).
| Fact | Explanation |
|---|---|
| 30-40% have predisposition | But only a small portion develops the disease |
| Triggers | Heredity, infections, stress, dietary habits |
The mechanism
Section titled “The mechanism”Upon contact with gluten:
- The immune system makes antibodies against transglutaminase-2 (tTG)
- These cause an inflammatory reaction
- The intestinal villi flatten (villous atrophy)
- Nutrients are poorly absorbed
Symptoms and consequences
Section titled “Symptoms and consequences”Symptoms vary greatly per person. In some, digestive symptoms predominate; in others, fatigue or deficiencies.
Common symptoms
Section titled “Common symptoms”| Category | Symptoms |
|---|---|
| Gut | Abdominal pain, bloating, variable bowel movements |
| General | Fatigue, concentration problems |
| Deficiencies | Unexplained anemia, low vitamin D and B12 |
| Bones | Bone loss, joint complaints |
| Skin | Dermatitis herpetiformis (skin rash) |
Diagnosis and testing
Section titled “Diagnosis and testing”Diagnosis is based on blood tests and sometimes an intestinal biopsy.
Main tests
Section titled “Main tests”| Test | Meaning |
|---|---|
| Anti-tTG IgA | Positive in active disease |
| Anti-endomysium IgA | Confirmation test |
| Anti-tTG IgG | Use for IgA deficiency |
| Small intestine biopsy | Confirms villous atrophy |
| HLA typing | Exclusionary; negative makes celiac virtually impossible |
Living without gluten — natural foods
Section titled “Living without gluten — natural foods”A gluten-free diet is the only effective treatment.
Products with wheat, barley, rye or spelt:
- Bread, pasta, cookies
- Breadcrumbs
- Sauces with hidden gluten
Choose natural, whole foods
Section titled “Choose natural, whole foods”| Category | Examples |
|---|---|
| Vegetables and fruit | All varieties |
| Proteins | Meat, fish, eggs |
| Nuts and seeds | All varieties |
| Gluten-free grains | Quinoa, buckwheat, amaranth, millet |
| Oats | Only certified gluten-free |
| Carbohydrates | Legumes, potatoes |
Avoid processed ‘gluten-free’ products
Section titled “Avoid processed ‘gluten-free’ products”Practical tips
Section titled “Practical tips”| Tip | Explanation |
|---|---|
| Read labels | Gluten is often hidden in sauces, soups and processed meats |
| Separate kitchen materials | Cutting boards, knives, toasters to prevent cross-contamination |
| Supplements/medications | Ask for gluten-free variants |
Gut recovery and lifestyle support
Section titled “Gut recovery and lifestyle support”After starting the gluten-free diet, the intestinal wall gradually recovers. In this phase, support is important:
Nutrition
Section titled “Nutrition”| Advice | Goal |
|---|---|
| Protein-rich | Meat, fish, eggs, vegetables |
| Micronutrient-rich | Supplementation of deficiencies |
Supplementation
Section titled “Supplementation”Consider supplementation of:
- Vitamin D
- B12
- Folic acid
- Iron
- Zinc
- Magnesium
Microbiome
Section titled “Microbiome”Support the microbiome with:
- Fiber-rich foods
- Fermented products (yogurt, kefir, sauerkraut)
Lifestyle
Section titled “Lifestyle”| Intervention | Effect |
|---|---|
| Daily movement | Walking or cycling promotes digestion |
| Sufficient sleep | Promotes immune system recovery |
| Relaxation | Supports healing |
Family and heredity
Section titled “Family and heredity”Celiac disease regularly occurs in family members.
For first-degree relatives (parents, siblings, children)
Section titled “For first-degree relatives (parents, siblings, children)”| Step | Advice |
|---|---|
| Determine HLA-DQ2/DQ8 | One-time; if negative: no risk |
| With positive predisposition or symptoms | Periodically check anti-tTG and anti-endomysium |
For healthcare providers
Section titled “For healthcare providers”Annual monitoring
Section titled “Annual monitoring”| Parameter | Explanation |
|---|---|
| Anti-tTG | Treatment adherence and disease activity |
| ALAT | Liver function |
| Ferritin, B12, folic acid | Nutritional deficiencies |
| Vitamin D | Bone metabolism |
Recommended
Section titled “Recommended”- Evaluate gut recovery after 6-12 months
- Screen family members with symptoms or positive HLA typing
- Referral to dietitian specialized in celiac disease and lifestyle medicine
Summary
Section titled “Summary”Veelgestelde vragen
What is celiac disease?
Celiac disease is a chronic autoimmune disease of the small intestine. Upon contact with gluten (wheat, barley, rye, spelt), an inflammatory reaction occurs that damages the intestinal villi, leading to poor absorption of nutrients.
How is celiac disease diagnosed?
Through blood tests (anti-tTG IgA and anti-endomysium IgA) and often a small intestine biopsy. HLA typing can rule out celiac disease: with negative HLA-DQ2/DQ8, celiac disease is virtually impossible.
What can I eat with celiac disease?
Choose natural foods: vegetables, fruit, meat, fish, eggs, nuts, seeds and gluten-free grains such as quinoa, buckwheat and amaranth. Avoid processed 'gluten-free' products that are often high in starch and sugar.
How long does gut recovery take?
After starting the gluten-free diet, the intestinal lining usually recovers within 6-12 months. In this phase, support is important through protein-rich nutrition, supplementation of deficiencies and support of the microbiome.
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