NUTRITION IN CELIAC DISEASE – A GLUTEN-FREE DIET

Celiac disease is an immune-related systemic illness resulting from the use of gluten and related proteins in wheat, rye, barley and in some cases ovine in genetically predisposed subjects. It is one of the most common chronic diseases in children and adults. For celiac disease in Europe, 1% of people are sick. Many patients are undiagnosed.

The only way to treat is a strict non-glycated diet (BGD).

Freegluten diet

Immediately after diagnosis, a patient with celiac disease should avoid gluten, even if it is traceable. By excluding gluten from the diet, the causative agent for the harmful reaction of the immune system is removed. Symptoms and signs of the disease also disappear. But this does not mean that we always greet the disease. After the resuscitation of gluten, cells of the immune system begin to react, which again leads to a systemic reaction. When performing a strict diet, the antibodies associated with celiac disease gradually normalize and the affected tissues return to their original state. This process can last for several months, and signs of illness are more rapid (especially in children). Although a severe non-glucose diet requires a major change in lifestyle, the diet does not have negative side effects. Diet should be administered carefully and best under the supervision of a doctor and / or dietitian. For the successful delivery of the diet, it is necessary to know for the following groups of nutrients.

Nutritionals that naturally contain gluten

Only a few cereals contain gluten, but because of their properties, they are massively grown all over the world. Among the important properties is the gluten content, which significantly affects the quality of bakery products. Cereals containing gluten include, among others, wheat and all its varieties (pira, kamut, triticale, bulgur or their crosses), rye and barley. Patients with celiac disease should avoid all gluten-containing cereals and all products made from them, e.g. bakery products (bread, desserts and pizzas), pasta, fried foods and beers.

Foods that do not naturally contain gluten

The number of nutrients that naturally do not contain gluten is much greater than the number of those that it. Some are not related to cereals, such as fruits, vegetables, animal products (meat, milk and eggs), potatoes and roots. There are also cereals naturally free from gluten, such as rice and corn. The number of such cereals is higher, but many of us are not well known. They can replace cereals containing gluten in the diet.

Processed foods not from cereals

Gluten can also be found in foods that you would not expect (cheese, sweets, soy sauce and many others). Gluten is in these foods as an additive that improves their properties.

Other products

Gluten can also be found in non-nutrient products. Drugs, cosmetics and toys containing gluten are known. It was also found in envelopes and postage stamps, the use of which could lead to a worsening of the disease in a patient with celiac disease. It is controversial to be only ingestion, not skin contact.

How strict should it be a gluten-free diet?

It is currently considered that the maximum permitted concentration of gluten in foods for patients with celiac disease should not exceed 20 mg per kilogram of the finished product, provided that they are consumed in normal quantities. Often, this value is expressed as 20 particles per million (parts per million ppm). Patients should not be misled by the term “safe” amount of gluten in food. A safe amount of gluten does not exist and all efforts should aim at completely eliminating gluten from the diet.

Patients should not be misled by the term “safe” amount of gluten in food. A safe amount of gluten does not exist and all efforts should aim at completely eliminating gluten from the diet.

Cross-contamination

Cross-contamination can occur during food processing (from harvest to final nutrient processing) and it is very difficult to avoid it. Unintentional contamination can be an important problem for the patient, because it is unknowingly consuming gluten, which leads to tissue damage, especially during prolonged exposure.

Cross-contamination may occur anywhere. Patients should be aware of potential contamination sites and should avoid them. prevent it.

Komplianca

It is very important that the complexant to the gluten-free diet is high. Certain patients abandon a strict diet for various reasons. The most common are abandonments in adolescence and adulthood. The reasons may be financial, cultural or psychosocial. We need to be alert to them and warn them as part of regular controls with a doctor or dietitian.

The long-term effects of an unrecognized or untreated celiac disease

In the case of a patient with celiac disease, due to careful administration of a strict diet, practically all symptoms of illness are eliminated. The likelihood of complications of celiac disease is increased by inadequate diet and in non-diagnosed patients. These complications are rarely present in children. Later, they can lead to irreversible complications that can not be welcomed by the subsequent proper administration of a strict gluten free diet. They can affect the gastrointestinal tract or any other organ system. One of these complications in adulthood is the refractory celiac disease, where damage to the small intestine of the small intestine remains present despite a strict diet. Another complication of the gastrointestinal tract may be the release of the exocrine function of the pancreas. Fertility problems may also be due to prolonged contact with gluten due to chronic inflammation and nutrient deficiency. Unhealed celiac disease can lead to neurological disorders such as epilepsy and ataxia. Bone density can decrease, leading to more frequent bone fractures. In some patients it is suspected that untreated celiac disease has caused inflammation of the heart muscle and psychiatric illness. It is also known that type 1 diabetes and thyroid disease are more common in patients with celiac disease. The development of long-term effects in non-diagnosed and / or inadequately treated celiac disease is an important reason for increasing the efforts for early diagnosis (and proper treatment) of the disease in all symptomatic patients, as well as in all patients from groups at higher risk of developing the disease. that untreated celiac disease caused inflammation of the heart muscle and psychiatric illness. It is also known that type 1 diabetes and thyroid disease are more common in patients with celiac disease. The development of long-term effects in non-diagnosed and / or inadequately treated celiac disease is an important reason for increasing the efforts for early diagnosis (and proper treatment) of the disease in all symptomatic patients, as well as in all patients from groups at higher risk of developing the disease. that untreated celiac disease caused inflammation of the heart muscle and psychiatric illness. It is also known that type 1 diabetes and thyroid disease are more common in patients with celiac disease. The development of long-term effects in non-diagnosed and / or inadequately treated celiac disease is an important reason for increasing the efforts for early diagnosis (and proper treatment) of the disease in all symptomatic patients, as well as in all patients from groups at higher risk of developing the disease.

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