Untreated coeliac disease may cause malabsorption, reduced quality of life, iron deficiency, osteoporosis, obstetric complications ( stillbirth, intrauterine growth restriction, preterm birth, low birthweight, and small for gestational age), an increased risk of intestinal lymphomas and greater mortality. People may develop severe disease symptoms and be subjected to extensive investigations for many years before a proper diagnosis is achieved. Ĭoeliac disease affects approximately 1–2% of the general population all over the world and is on the increase, but most cases remain unrecognized, undiagnosed and untreated, exposing patients to the risk of long-term complications. Added difficulties for diagnosis are the fact that serological markers ( anti-tissue transglutaminase ) are not always present, and many people with coeliac may have minor mucosal lesions, without atrophy of the intestinal villi. Coeliac disease is not only a gastrointestinal disease, because it may affect several organs and cause an extensive variety of non-gastrointestinal symptoms, and most importantly, it may often be completely asymptomatic. It is caused by the ingestion of gluten, which is present in wheat, barley, rye and derivatives. ![]() Rationale behind adoption of the diet Ĭoeliac disease ( American English: celiac) (CD) is a chronic, immune-mediated, and mainly intestinal process, that appears in genetically predisposed people of all ages. Pseudocereals ( quinoa, amaranth, and buckwheat) and some minor cereals are alternative choices. Ī gluten-free diet may be based on gluten-free foods, such as meat, fish, eggs, milk and dairy products, legumes, nuts, fruits, vegetables, potatoes, rice, and corn. Nutritional complications can be prevented by a correct dietary education. Children especially often over-consume these products, such as snacks and biscuits. Some gluten-free commercial replacement products are not as enriched or fortified as their gluten-containing counterparts, and often have greater lipid/ carbohydrate content. Replacing flour from wheat or other gluten-containing cereals with gluten-free flours in commercial products may lead to a lower intake of important nutrients, such as iron and B vitamins. However, an unbalanced selection of food and an incorrect choice of gluten-free replacement products may lead to nutritional deficiencies. Gluten proteins have low nutritional and biological value and the grains that contain gluten are not essential in the human diet. There is no good evidence that gluten-free diets are an alternative medical treatment for people with autism. ![]() In addition, a gluten-free diet may, in at least some cases, improve gastrointestinal or systemic symptoms in diseases like irritable bowel syndrome, rheumatoid arthritis, or HIV enteropathy, among others. ![]() People with a poor understanding of a gluten-free diet often believe that they are strictly following the diet, but are making regular errors. This is mainly caused by inadvertent ingestion of gluten. In these people, the gluten-free diet is demonstrated as an effective treatment, but several studies show that about 79% of the people with coeliac disease have an incomplete recovery of the small bowel, despite a strict gluten-free diet. Gluten may cause both gastrointestinal and systemic symptoms for those with gluten-related disorders, including coeliac disease (CD), non-coeliac gluten sensitivity (NCGS), gluten ataxia, dermatitis herpetiformis (DH), and wheat allergy. The inclusion of oats in a gluten-free diet remains controversial, and may depend on the oat cultivar and the frequent cross-contamination with other gluten-containing cereals. A gluten-free diet ( GFD) is a nutritional plan that strictly excludes gluten, which is a mixture of proteins found in wheat (and all of its species and hybrids, such as spelt, kamut, and triticale), as well as barley, rye, and oats.
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