Celiac Disease (Sprue)

Celiac disease, also known as sprue, is a form of gluten intolerance. The small intestine consists of thousands of folds and protuberances, so-called villi, which in turn are littered with millions of tiny hairs. This increases the inner surface of the intestine by 300 times and the area through which nutrients are exchanged to 100 to 200 square meters. A highly effective mechanism that is also susceptible to disease. Although nature manages to use this trick to provide a huge exchange area in a small space. But conversely, it also shrinks rapidly when the villi change abnormally, causing problems in feeding and utilization. That's exactly what happens with celiac disease.

What is celiac disease and how does it manifest itself?

Celiac disease is a chronic disease of the small intestine. It appears that in celiac disease patients, an incorrect amino acid is incorporated into the body's own protein, which is used in the detection of enemies. As a result, gluten, an adhesive protein contained in cereals, is bound longer to these immune cells and triggers a - actually unnecessary - foreign body reaction.

However, the immune cells not only attack the gluten, but also damage the intestinal mucosa: Due to the intolerance to gluten shrink the small intestine protuberances. Fats, sugars, proteins, vitamins, minerals and even water can no longer be absorbed properly into the body. The lack of these substances in turn leads to a variety of symptoms and complaints - no two cases of illness are identical.

Celiac disease, sprue or gluten intolerance?

It used to be differentiated between celiac disease and sprue: when the disease occurred in childhood, it was referred to as celiac disease; in adulthood it was referred to as (native) sprue. Today it is only celiac disease because it is the same disease and not, as it was supposed to be, two different disorders.

Also common are the terms gluten intolerance or gluten intolerance. These are more of a general term: in addition to celiac disease, a gluten sensitivity may also be meant by a gluten intolerance. In addition to indigestion, symptoms that are uncommon in celiac disease, such as migraine, depression or muscle ache, may occur. Gluten sensitivity can be sudden and even temporary.

Classic form of celiac disease

The classic symptom is diarrhea: the undigested fats are excreted with the stool, which is therefore voluminous and smelly. Those affected suffer from flatulence, leanness and tend to iron deficiency and anemia (anemia). It can lead to muscle wasting, water retention, increased skin pigmentation and hair loss. Also different signs of vitamin and calcium deficiency such. B. coagulation disorders and osteoporosis occur. After a long course, insomnia, tiredness or depression may also be symptoms.

In children, symptoms appear for the first time as soon as Breikost is supplemented with cereal products - usually from the age of six months. The babies have no appetite, abdominal pain, a bloated stomach and often empties large, bad-smelling stool quantities. They no longer gain weight properly and may develop signs of anemia and dehydration. Typical are a "Tabaksbeutelgesäß", as in the buttocks, the fat reserves are reduced, and a sullen, whiny facial expression as a sign of irritability to the essence of change. Not infrequently, the child's development stagnates or even recoils.

Atypical forms of celiac disease

Unfortunately, almost half of the patients do not have gastrointestinal symptoms. Instead, the condition can only be expressed by one or more of the following symptoms:

  • Skin changes (Dermatitis herpetiformis Duhring)
  • Iron deficiency, short stature
  • Gum shrinkage
  • joint pain
  • hepatitis
  • osteoporosis
  • Depression, irritability, fatigue
  • limited fitness
  • in women too common miscarriage or infertility

These atypical events are difficult to detect, patients often go through a yearlong odyssey until celiac disease is diagnosed.

What is gluten and what effect does it have?

Gluten is a gluten protein that consists of the proteins prolamine and gluteline. It has a central importance for the baking properties of flour and occurs mainly in the cereals wheat, spelled, rye, barley and oats - and thus in many foods.

The gluten contains gliadin, which can cause an immune system reaction that produces antibodies. These are directed against the intestinal mucosa and lead - even in the smallest amounts - to inflammation and permanent damage. The villi flatten out, the surface shrinks, not enough digestive enzymes are formed. Due to these processes, one also speaks of a gluten-sensitive enteropathy (= intestinal disease).

As a result, not enough nutrients can be absorbed by the body, it comes to deficiency symptoms. Prolonged duration of the disease can lead to an increased risk of cancer (lymphoma) due to constant inflammatory reactions.

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