Knowledge base - Coeliac disease

Celiac disease, gluten-free baking

Coeliac disease

Celiac disease is an autoimmune disorder in which the lining of the small intestine is damaged by contact with gluten, a protein found in wheat, barley and rye. In celiacs, ingestion of gluten triggers an immune system attack against their own tissues, leading to inflammation and damage to the intestinal mucosa.

Damage to the intestinal mucosa makes it difficult to absorb nutrients and leads to a variety of symptoms and long-term health problems. Celiac disease is a lifelong condition for which there is no cure. The only treatment is a strict gluten-free diet.

Thenumber of people with coeliac disease is on the rise >>
Theimpact of coeliac condition on everyday life >>
Celiac disease symptoms and heredity >>
How is celiac disease diagnosed? >>

The number of people with coeliac disease is on the rise

A study published by researchers at the University of Tampere in autumn 2023 shows that the prevalence of celiac disease has continued to increase in Finland. The same research team from the Celiac Disease Research Centre found earlier that between 1980 and 2000, the number of people with celiac disease in Finland increased tenfold.

In 2000, 2.1% of Finns had celiac disease. The results now show that 2.4% of Finns now have celiac disease.

- This is not only due to better diagnostics, but also to an increase in the actual prevalence of the disease in the population. Celiac disease has become a national disease," says Katri Kaukinen, Director of the Celiac Disease Research Centre and Professor of Internal Medicine.
Link To the Finnish News Agency news.

The impact of coeliac condition on everyday life

Celiac disease is therefore a lifelong condition for which the only treatment is a strict gluten-free diet. This means avoiding all foods and ingredients containing gluten from wheat, barley and rye. Gluten can be found in many unexpected products, so following a gluten-free diet requires attention and knowledge. It is important for people diagnosed with celiac disease to receive guidance from a dietitian to ensure adequate and varied fibre and nutrient intake.

On the positive side, the range of gluten-free products has grown considerably in recent years. A wide range of flours, flour blends and flakes for gluten-free baking and cooking are now available. For those who buy ready-made gluten-free products, there is an increasing range of bread, pasta, dough and many other semi-finished products and foodstuffs. Many restaurants and cafés offer gluten-free options.

Even if a person with celiac disease is asymptomatic, strict adherence to a gluten-free diet is essential as the effects can be severe and take years to become apparent.

Celiac disease symptoms and heredity

The symptoms of celiac disease can vary greatly from person to person and can even be asymptomatic. Early diagnosis and treatment are important to prevent the symptoms and complications of celiac disease.

If you suspect you have celiac disease, it is important that you have tests before switching to a gluten-free diet so that any celiac disease can be reliably diagnosed.

What are the symptoms of celiac disease?

The symptoms of celiac disease vary greatly from person to person. Common symptoms include:

  • Abdominal pain and bloating
  • Diarrhoea or constipation
  • Fatigue and weakness
  • Losing weight
  • Iron deficiency anaemia
  • Skin symptoms such as rash or hives

It is important to remember that not everyone with coeliac disease has symptoms. Celiac disease can be asymptomatic and go undetected for long periods of time. If you suspect that you or a loved one may have celiac disease, it is important to seek medical advice.

According to the Coeliac Society, only around 40,000 Finns have been diagnosed with celiac disease and up to 80,000 people have celiac disease without knowing it. There is a strong genetic predisposition to celiac disease. If you have a close family member with celiac disease, the Coeliac Society recommends that you have your blood tested for celiac antibodies every five years.

Cutaneous celiac disease and its symptoms

Cutaneous celiac disease is a rare autoimmune disease that affects the dermal layer of the skin. It is a disease caused by gluten, which manifests itself as skin symptoms when cereal products containing gluten are ingested.

According to an article in the Health Library, cutaneous celiac disease occurs in about 10% of adults with celiac disease. The main symptom of celiac disease is an intensely itchy, small-cell rash, most commonly found on the elbows, knees and buttocks.

How is celiac disease diagnosed?

Your doctor can diagnose coeliac condition in several different ways:

  • Blood tests: the celiac antibody test is the most common way to diagnose celiac disease. A blood test measures the levels of celiac antibodies in the blood.
  • Bowel biopsy: If a blood test shows elevated levels of celiac antibodies, your doctor may take a bowel biopsy to confirm the diagnosis. The test is taken by endoscopy.

Celiac disease cannot be cured, but it can be treated with a gluten-free diet. A gluten-free diet is a lifelong treatment that prevents the development of symptoms and complications of celiac disease.

Non-celiac gluten sensitivity

An article in the journal Duodecim 6/2021 discusses gluten sensitivity: Gluten sensitivity is an increasingly common health problem, with people experiencing a range of symptoms that are alleviated by following a gluten-free diet. Unlike celiac disease, there is no clear diagnosis or test for gluten intolerance and its pathogenesis is not fully understood.

Possible causes of symptoms associated with gluten intolerance include increased permeability of the small intestinal mucosa, reactions to other cereal constituents and a lack of tolerance to FODMAP carbohydrates.

Typical symptoms of gluten intolerance:

  • Abdominal pain and bloating
  • Diarrhoea or constipation
  • Fatigue and weakness
  • Skin symptoms
  • Neuropsychiatric symptoms (less common)

The most important thing when making a diagnosis is to be able to rule out the possibility of celiac disease and cereal allergy. The relief of symptoms of gluten sensitivity should be demonstrated by a gluten-free diet.

Treatment of gluten sensitivity:

  • Gluten-free diet
  • FODMAP diet can be beneficial
  • Talking to a dietitian is important

When suspecting and treating gluten sensitivity, it is important to be aware of the nutritional challenges of a gluten-free diet. Dietary restrictions and changes should be carefully considered and discussed with a doctor or dietician.

For more information on coeliac disease and gluten sensitivity, see for example:

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