Surely, you have already encountered the terms celiac disease, gluten intolerance or gluten-free diet. A lot of people know these concepts very intimately and live with them every day. We are talking about people with certain form of gluten intolerance.
The occurrence of gluten-related diseases has increased significantly over the last 50 years.
It is estimated that 1 – 2 % of the world’s population suffers from celiac disease. Non-celiac gluten sensitivity (gluten hypersensitivity) occurs approximately in 6 % of the population. The occurrence of wheat allergy is around 2 % worldwide.
The term “gluten-related disorders” covers all diseases related to the gluten intake (gluten). This category includes celiac disease, non-celiac gluten sensitivity (hypersensitivity to gluten), wheat allergy, gluten ataxia and herpetiform dermatitis.
The intestinal microflora plays a key role in maintaining the health of the human body. The development of microbial imbalance in the intestines can lead to the development of diseases that are not only related to the digestive tract and metabolism but to the whole organism.
Negative changes in the composition of the intestinal microflora also play a crucial role in the disease occurrence, such as celiac disease.
Recently, there is growing evidence of a positive effect of probiotics on the course of gluten-related diseases which are thought to be an effective supplement in their treatment.
In order to understand the treatment better, let’s talk more about the gluten intake disorders themselves.
Celiac disease is an autoimmune disease that mainly affects the small intestine. Cause? Gluten intolerance caused by wheat, rye and barley.
A great number of factors is involved in the celiac disease development including abnormal activation of the immune system, genetics, metabolic disorders and gluten-reducing enzyme activity.
In celiac disease, the barrier of the small intestinal mucosa is disrupted which allows harmful substances to enter the body. These substances are a source of immune responses that cause a weakening of the overall immunity and the development of other diseases.
Typical symptoms of celiac disease include diarrhea, bloating, abdominal pressure, weakness, weight loss, depression and changes in the psyche. In children, it is malnutrition and delayed growth.
Side effects include anemia, muscle cramps, joint pain, thinning bones, dry skin, eczema, brittle nails and vitamin deficiencies.
Celiac disease therapy is based on a strict gluten-free diet. Dairy products should also be excluded at the beginning of treatment due to the temporarily impaired ability to break down milk proteins.
Non-celiac gluten sensitivity (gluten hypersensitivity)
Gluten hypersensitivity mainly affects women and young and middle-aged people. The true occurrence of the disease is difficult to determine as the diagnostics is relatively complicated and ambiguous.
We speak about intolerance in which people after gluten intake begin to experience undesirable problems of digestive or extraintestinal origin. The most typical digestive problems are abdominal pain, bloating, nausea, vomiting, feeling full, decreased intestine function and diarrhea.
Extraintestinal symptoms include fatigue, numbness in the upper and lower limbs, muscle cramps, joint and head pain, loss of appetite, mood disorders and eczema.
As previously mentioned, the diagnostics of this disease is relatively complicated. It is due to the high similarity of clinical results with other gluten-related diseases.
Diagnostics is usually made by an excretion method – negative celiac disease, negative histological findings and a negative allergy test.
Subsequently, the diagnosis is confirmed by eliminating gluten from the diet for several weeks and monitoring the improvement of health problems.
The treatment for this disease is based on a gluten-free diet which, however, does not have to be as strict as in the case of celiac disease.
Allergy to gluten or other wheat proteins is an inadequate immune response of the human body caused by specific antibodies.
These bind to specific allergen sites and trigger processes which lead to development of allergic inflammation or allergies.
Typical symptoms are a cold, sneezing, swelling of the mouth mucous, eyes redness, difficulty breathing or itching of the skin.
Wheat is one of the main allergens in preschool children when allergy usually disappears over time. In adults, there may occur a permanent allergy to wheat caused by excessive physical activity.
In this case, it can lead to a disorder of the barrier function of the intestine which will become more permeable to wheat allergens. These can then pass into the whole organism.
An interesting form of wheat allergy is so called “asthma” which is caused by the inhalation of wheat allergens from the air. In this case, people react to raw wheat flour and not to heat-treated food flour.
In case of this allergy it is necessary to eliminate wheat from the diet completely.
Probiotics and celiac disease
The human digestive tract is a complex, unique and dynamic environment that contains a large number of different microorganisms. It is a balanced microecosystem that provides a human body with natural protection against potential pathogens.
Changes in the composition of the microflora can have a negative impact on health and lead to a variety of diseases.
Thanks to long-term research, it is now clear that the intestinal microflora does play an important role in celiac disease.
The question remains whether a change in the composition of the microflora in people suffering celiac disease is a cause or a consequence of this disease. On the one hand, the development of intestinal imbalance has a direct impact on the development of inflammatory diseases like celiac disease.
It is also true that due to celiac disease and a gluten-free diet there are changes in the proportion of individual good and bad bacteria in the intestines. Specific evidence points in particular to a decrease in bacteria from the genera Bifidobacterium and Lactobacillus.
Consequently, an imbalance, which can have a negative impact on health and lead to various diseases, occurs.
To date, only a gluten-free diet is used to treat celiac disease or other gluten-related diseases, i.e., the exclusion of all its food sources.
Science and medicine are constantly advancing and promising solutions have emerged recently, such as genetically modified gluten, various pharmaceutical supplements that help to digest gluten and most recently probiotics.
The health benefits of probiotics can occur through several mechanisms, such as:
- modulation of the composition and function of the intestinal microflora
- production of substances that act against harmful pathogens
- blocking sites to which pathogens may bind
- competing for nutrients with pathogens
- degradation of toxin receptors
- regulation of immunity
- specific strains can help to digest and break down gluten
- reducing the increased permeability of the intestinal wall
- improving the barrier function of intestinal cells
Prebiotics are also recommended along with probiotics as people on a gluten-free diet often suffer from nutritional deficiencies. Specifically, the intake of fiber, iron, calcium and leaf acid tends to be reduced.
For this reason, the diet needs to be supplemented in a suitable way. For example with prebiotics which are also a source of energy for probiotics and stimulate their viability.
At the end, it is important to note that neither probiotics (nor prebiotics) are able to cure celiac disease or other gluten-related diseases.
However, probiotics appear to be a suitable dietary supplement in people with gluten disorders and can help to alleviate the symptoms of these diseases.
In the future, further studies will be needed to describe the effect of probiotics more accurately.
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