Celiac disease (CD) is the medical term for gluten intolerance caused by an autoimmune response. The body destroys its own cells by producing antibodies which attack the lining of the gut and cause inflammation. Gliadin (key peptide in wheat) interacts with intestinal epithelium and triggers villous atrophy. This is caused by ingestion of gluten and gluten-containing foods like wheat, barley, rye, etc. It is assumed that CD affects 1 in 100 people worldwide. The onset of symptoms of CD can occur at any age after people consume medicines or food that has gluten in them. Initial symptoms are pain in the abdomen and diarrhoea. Advancements in modern-day science lead to the invention of high-speed screening methods and increased awareness about the disease. Due to this, we are able to diagnose individuals who are otherwise asymptomatic and have subclinical symptoms. If untreated, celiac disease may lead to supplementary health problems.
How Common Is It?
According to the experts at the International Symposium on Wheat Related Disorders (ISWD) 2019, the prevalence and the widespread of celiac disease has increased four times in India since the 1960s and now eighty lakh people stand affected by the disease. Experts at the conference hosted by the Celiac Society of India (CSI) said that close to 90 % Indians are unaware that they have been affected by gene types which will lead to the onset of disease. Among the Indian population, the disease is more prevalent in the north than it is in the south. Punjab, Haryana, Uttar Pradesh, Bihar, Rajasthan, Uttrakhand and Delhi constitute the Celiac Disease belt in India. The disease is not so common in southern and northeastern parts of the country due to considerable differences in ethnicity and diets. (Yachha, S. K et al, 2007).
At a global level, the prevalence is more in Europe, Oceania followed by Asia, The Americas and Africa. Among the genders, women are found to be highly prone to CD than me. The rate of occurrence and prevalence of disease differs with sex, age and location of the individual. (Celiac Disease Foundation, 2018).
Clinical Features – Signs and Symptoms:
- Headache and fatigue
- Bloating and gas
- Pain in the abdomen
- Iron deficiency anaemia
- Decrease in bone density
- Itching and rash on skin
- Pain in joints
- Decreased functioning of the spleen
Risk Factors and Complications:
- High gluten intake/exposure to gluten e.g.: in populations that consume wheat more often [Europe, Northern India].
- Higher wheat consumption during infancy.
- Having first-degree relatives affected with diabetes or autoimmune disorders [inflammatory bowel syndrome, hay fever, etc].
- Personal history of autoimmune disorders such as rheumatoid arthritis or hay fever.
Do Genes Have Anything To Do With It?
Celiac disease is a multifactorial disease. Factors susceptible for CD are HLA-DQ2 and HLA-DQ8 haplotypes. Research studies reported that CD can be predicted by genes like KIAA, TAGAP and SH2B3 several months before clinical and serological signs take place. It was also found that other genes like Myoxin IX and IL2-IL21 are said to have an association with susceptibility to CD. (Salazar Carolina et al, 2017).
Managing Celiac Disease: Risk- Diet and Lifestyle:
- A balanced diet with different grain sources like, sorghum, quinoa, buckwheat, teff, corn, millet, etc.
- Adherence to a gluten-free diet (GFD) if clinically confirmed/recommended by consulting physician or nutritionist
- Clinical testing (antibodies profile and gluten sensitivity assay) for ruling out gluten intolerance.
To put things clearly, the incidence of celiac disease has raised over the past five years with foods deficient in minerals like iron and B-complex vitamins. The clinical symptoms of CD will keep progressing. In the foregone era, CD was thought of as a rare disorder, but in the modern era, it has become quite common. The association of HLA genotypes with celiac disease is responsible for its relationship with other autoimmune diseases like type 1 diabetes and autoimmune thyroid disease. Scientific advancements in the area of cereal science are targeted at improving the consumption of iron, calcium and fibre for patients suffering with the disease. With regards to the pricing, processed gluten-free products are found expensive when compared with normal gluten-free foods. Moreover, some gluten-free foods might contain other harmful ingredients. That said, research should lay a major emphasis on pseudo-cereals and micro cereals playing a part in treating nutritional deficiencies. With screening tests like MyNutriGene, you can go for optimized meal planning. Our test will also tell you about your metabolism, fat/carbohydrate response, food intolerance and eating behaviours, etc. Knowing what foods work for you will go a long way towards building better health. It’s time to Eat Wise, DNA Wise!
How Can Mapmygenome Help you:
At Mapmygenome, our focus is on proactively leading a healthy life, by discovering the best-suited action plans. Through DNA-based predictive risk assessment, an individual can learn how to eat right, exercise right and adapt to a healthier lifestyle. As the pioneer of personal genomics in India, Mapmygenome has carved out a niche for personalizing health, wellness, nutrition, fitness and medicine. By assessing the variations in people’s DNA, we at Mapmygenome are able to create personalized health plans, like never before. Understanding your genetic framework, biological requirements, strengths, and weaknesses is of paramount importance in our quest to move towards a more personalized, predictive, preventive, and participatory healthcare wellness regime.
A comprehensive wellness assessment like Genomepatri will give an insight into your weaknesses, immunity, drug efficiency, genetic predisposition to specific health conditions, and helps in pre-empting most of these risks. It is an once-in-a-lifetime, painless, simple saliva-based test that scans your DNA for variations which give you insights into how you’re built, right down to the molecular level; MyFitGene can help you personalize your physical training and diet while understanding the strengths and weaknesses of your body; MyNutriGene, can help you choose the ideal diet profile best suited to your biology; Medicamap will help you choose the right drug that’s most effective and least toxic; all based on the information from you hold about yourself on your DNA.
The insights gleaned from the analysis of your genome, coupled with a comprehensive genetic counselling session with our certified experts will aid in the development of a highly personalized and effective plan of action built keeping your genetic uniqueness/individuality at the centre.
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- Salazar, Carolina, Jennyfer M. García-Cárdenas, and César Paz-y-Miño. “Understanding Celiac Disease From Genetics to the Future Diagnostic Strategies.” Clinical Medicine Insights: Gastroenterology 10 (2017): 1179552217712249.
- Barker, Jennifer M, and Edwin Liu. “Celiac disease: pathophysiology, clinical manifestations, and associated autoimmune conditions.” Advances in pediatrics vol. 55 (2008): 349-65. doi:10.1016/j.yapd.2008.07.001
- Yachha, S. K., and U. Poddar. “Celiac disease in India.” (2007).