Gluten intolerance leads to digestive symptoms. Often, it remains asymptomatic or is only responsible for minor disorders. The diagnosis is based on analyzes. A gluten-free diet makes symptoms go away. Without dietary measures, complications remain possible.
SYMPTOMS OF CELIAC DISEASE
The majority of people with gluten intolerance remain symptom-free for a very long time or even their entire life. When they appear, they vary according to the age of onset.
Manifestations of Celiac Disease in Infants
The first symptoms of gliadin intolerance appear a few weeks after the introduction of gluten in the diet. This change triggers diarrhoea which becomes chronic (lasting more than 15 days), with heavy stools.
The baby lacks appetite and changes behaviour, becoming less active.
His weight may stagnate and then decrease, and his growth in height is sometimes disturbed.
Symptoms of celiac disease in children
There are two kinds of manifestations.
The digestive disturbances of gluten intolerance
This may be, for example, chronic or intermittent diarrhoea, nausea and vomiting, and/or lack of appetite.
Sometimes the child also suffers from recurrent abdominal pain or a meteorism, due to a buildup of intestinal gas.
The non-digestive symptoms of gluten intolerance
We can see :
- weight loss and/or growth retardation (short stature for age);
- a tiredness chronic or irritability;
- anaemia by iron deficiency ;
- a delay in the onset of puberty ;
- of ulcers Recurrent;
- dermatitis herpetiformis (skin manifestation of the reaction to gluten, causing itching and flare-ups of blisters grouped in clumps).
Symptoms in adults with gluten intolerance
Digestive manifestations of gluten intolerance
Chronic diarrhoea is the most common symptom, but sometimes constipation occurs.
In some cases, the affected person suffers from abdominal pain or bloating (feeling of tension in the abdomen), associated with gas (emission of intestinal gas).
The person can also lose weight.
Frequent and often prominent non-digestive symptoms in gluten intolerance
They appear when the diagnosis is not made early. There are many, namely:
- tiredness extended;
- deficiency anaemia of iron or vitamin B9 (folic acid);
- of ulcers Recurrent;
- dermatitis herpetiformis;
- an osteoporosis fracture ;
- a sterility unexplained otherwise;
- a neuropathy peripheral (damage to the nerves of the limbs).
HOW DO YOU KNOW IF YOU ARE GLUTEN INTOLERANT?
Your doctor suspects gluten intolerance
Different situations make it possible to evoke the diagnosis:
in the event of symptoms suggestive of celiac disease and unexplained by another disease;
if one or more of your immediate family has gluten intolerance.
Your doctor will then refer you to a gastroenterologist for a complimentary assessment, in several stages.
A blood test
It allows you to find:
of tissue transglutaminase antibodies, IgA and IgG classes?
and anti-endomysium class IgA antibodies (the most specific for celiac disease ). If they are absent, gluten intolerance is unlikely. Conversely, the presence of these antibodies reinforces the hypothesis of celiac disease.
To demonstrate a genetic predisposition, the doctor requests an HLA genetic typing of the person: an examination highlighting the HLA DQ2 and HLA DQ8 genes, often present in gluten intolerance.
Often biopsies of the small intestine
The diagnosis is confirmed by biopsies of the small intestine (taken before any gluten-free diet).
This test involves taking four to six pieces of tissue from the part of the small intestine closest to the stomach (the duodenum). It is performed during upper digestive endoscopy (by mouth) without general anaesthesia in adults or under general anaesthesia in children.
The analysis of the samples makes it possible to detect any lesions on the internal wall of the small intestine.
However, when symptoms of the disease are present, specific antibodies are elevated, and the HLA group is typical, intestinal biopsies may not be requested.
Once the diagnosis of gluten intolerance has been made, an additional assessment is necessary
A blood test for liver abnormalities, iron deficiency anaemia… completes the assessment.
Bone densitometry measures bone density to look for osteoporosis…
THE EVOLUTION OF GLUTEN INTOLERANCE
Adopting a gluten-free diet allows:
- the disappearance of symptoms in a few weeks and antibodies after a year;
- healing of damaged intestinal tissue (more or less long term);
- reducing the risk of complications;
- in infants, the end of diarrhoea, normalization of behaviour and catching up of growth curves.
- In the absence of a gluten-free diet, and after a long course, celiac disease is at high risk for:
- cancers of the digestive tract such as intestinal lymphoma or adenocarcinoma of the small intestine;
- sterility (risk concerning 12% of patients);
- cancer of the upper aerodigestive tract and liver;
- slowed growth in children.