Celiac disease in adults
Definition
Celiac disease, characterized by malabsorption syndrome, is very common. It is caused by digestive intolerance to gluten proteins from certain cereals: wheat, barley or rye. In the most serious manifestations of this disease, there are significant vitamin deficiencies, undernutrition and staturo-ponderal delay (i.e. changes in weight and height with age), but this is exceptional.
Epidemiological data
Celiac disease affects both adults and children. Family cases were found in 3,6 to 20% of cases. It is also concomitant, in 50% of cases, with gastritis and/or lymphocytic colitis.
Symptoms of the disease
Sometimes asymptomatic, the celiac disease is however identified due to:
- minor signs of malabsorption associated with mild diarrhea, sometimes chronic;
- abdominal pain ;
- meteorism (swelling of the abdomen, bloating);
- sometimes constipation:
- extra-digestive symptoms such as dermatitis herpetiformis, arthralgia (pain in the joints) and various autoimmune manifestations.
Treatments
• For this disease, a gluten-free diet is generally recommended: this involves completely eliminating wheat, rye and barley from the diet. On the other hand, rice, maize and oats are allowed. It is a difficult diet to implement, especially since gluten can be found, without being reported, in dishes cooked without cereals or even in the coating of certain drugs.
• It can happen, in 5% of cases, that the patient makes a resistance to the gluten-free diet. It is often due to poor compliance with the diet, but resistance is possible. In the latter case, corticosteroid therapy can restore sensitivity to the gluten-free diet.