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Journalism of Courage
Centuries ago, the Roman philosopher Luceritius had noted, “What is food to one is poison to another.” That’s the best description for celiac disease, a condition where an individual is intolerant to gluten, a protein found in cereals like wheat, oats, barley, rye, for life. With million metric tonnes of wheat grown and eaten, wheat is the world’s most consumed grain. Yet, it puts millions of humans at risk of illness.
Awareness about this condition as well as the means to manage it are limited in India (food options are restrictive and food labeling inadequate). The disease occurs globally, has no socio-economic boundaries and can occur at any age. Twenty-five per cent of the cases are patients over 60 years of age. Eating foods with gluten causes an immune reaction in the small intestines that can damage the lining of the intestines and lower absorption of essential nutrients leading to mal-absorption and nutritional deficiencies. Typical symptoms of celiac disease include diarrhea, gastrointestinal disturbances like abdominal distension, flatulence, pain, constipation, nausea, vomiting, growth problems, stunting and anemia. But not everyone has the same problem. In fact, only 50 per cent of the cases may present with diarrhoea. Other symptoms include weight loss, lethargy, tiredness, bone problems like osteoporosis and cramps, skin problems, infertility, mouth ulcers, numbness and behavioural problems like depression, anxiety, irritability and poor school performance. Absence of typical symptoms makes the diagnosis difficult and often leads to ill health and life threatening maladies.
People with hidden celiac disease are more in danger as they are at a higher risk of developing severe form of malnutrition and non-specific ill-health. If the disease remains unnoticed, it can prove fatal. Celiac disease can increase the risk to disorders like type-1 diabetes mellitus, autoimmune diseases, liver diseases, thyroid disorders, pulmonary diseases such as asthma; ulcerative colitis, Crohn’s disease as well as cancer.
Diagnosis can often be overlooked and many patients have been considered for growth hormone therapy for short stature, or been through rounds of hospital admissions due to debility and ill health, and even put on anti-tubercular treatment for unexplained diarrhoea and weight loss, only to worsen their condition. Diagnosis is done using serological markers (blood tests) and endoscopy. Correct diagnosis is imperative.
Celiac disease is certainly more common than previously appreciated. It’s fairly common in the West with 1 in 100 people in Europe and 1 in 133 people in the US, suffering from celiac disease. Data in India is still not available, but according to projections it is estimated that there may be at least 4 million cases in India. .
This is a permanent condition and requires life long strict restriction to gluten along with nutritional supplements to correct deficiencies. Gluten-free diet usually helps restore normal health. Living with celiac disease in developed countries is easier as food labeling is better, conveniently packed food is available and restaurants and fast foods provide gluten-free choices. The same, however, is not true for India, so far.
