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Dubai, United Arab Emirates, February 26, 2015: The Dubai Health Authority (DHA) held today a twitter clinic known as #smart_clinic to educate the community about celiac disease.
Celiac disease is the inability of the body to digest gluten (a protein found in wheat, rye, barley, and processed oats). When people with this disease eat gluten their body mounts an immune response that attacks the small intestine. These attacks lead to damage on the villi (small finger-like projections that line the small intestine, that promote nutrient absorption.) When the villi get damaged, nutrients cannot be absorbed properly into the body.
Up to one per cent of Dubai's population has celiac disease. DHA's Rashid hospital runs a dedicated adult gastroenterology clinic and Dubai Hospital runs a paediatric gastroenterology clinic. As per Dubai Hospital's paediatric gastroenterology registry, the number of children with celiac disease is approximately 50 and as per Rashid Hospital's adult gastroenterology registry, the number of adults with celiac disease is approximately 25 patients.
Dr Mustafa Sabri, consultant physician and gastroenterologist, digestive diseases unit at Rashid Hospital, “The disease affects people of all ages. Once exposed to gluten, it can occur after several weeks or even after years of eating gluten. We had a case in which a 5 month old baby was exposed to solid food containing gluten and we discoursed the baby had celiac disease. Similarly, we have seen many cases where people have eaten gluten for years and the disease only kicks in at a later stage, the period which is non-symptomatic is termed as the free period.”
Sabri added that often celiac disease is hereditary, meaning that it runs in families. “People with a first-degree relative with celiac disease (parent, child, and sibling) have a 1 in 10 risk of developing celiac disease but this does not mean that those without a family history will not develop celiac disease. High risk patients include patients with other diseases like thyroid , irritable bowel syndrome, low immunoglobin A, down syndrome, type 1 diabetes. These patients may be asked to undergo a test even if they don't have symptoms of the disease.”
Dr Batoul Bashir Samarji, paediatric gastroenterologist at Dubai Hospital. “Different people will experience the disease in different ways, because the symptoms vary greatly from one person to the next. Often, symptoms of celiac disease are confused with other disorders, such as irritable bowel syndrome and lactose intolerance. Patients should undergo the following tests: a blood test to check the antibody level against gluten. The test is known as TTGA Tissue Transglutaminase (tTG) Antibody. They should also get an IgA test done to measure the blood level of immunoglobulin A. The doctor will then decide whether to do an upper endoscopy or not.
“The biggest problem we see is the lack of awareness. It is important for people to understand that wheat allergy is different from celiac disease. To diagnose celiac disease an allergy test is not required and is an incorrect method.”
Samarji said symptoms often differ in children and adults. “Children may experience growth problems, decreased appetite and failure to gain weight, chronic diarrhea, iron deficiency, chronic constipation, vomiting, abdominal bloating and pain, fatigue and irritability. Children may also show signs of malnourishment. That's because the disease prevents the body from absorbing essential nutrients. For adults, the symptoms include iron deficiency, bone or joint pain, arthritis, depression or anxiety, bone loss or osteoporosis, tingling numbness in hands and feet, erratic menstrual periods, fertility problems and dermatology problems.”
In terms of treatment, Dr Dr Wafa Ayesh, director of clinical nutrition at the DHA, said: “Currently, the only treatment for celiac disease is lifelong adherence to a strict gluten-free diet. People living gluten-free must avoid foods with wheat, rye and barley and processed oats. Ingesting small amounts of gluten can also trigger small intestine damage. Therefore people with celiac disease must learn to check labels to ensure the food is absolutely gluten free.
“Products such as stabilizers and emulsifiers that are used in processed foods may contain gluten. Oats are often harvested and processed with the same equipment that is used for wheat, and are therefore easily contaminated. However, pure, uncontaminated oats consumed in moderation is generally tolerated by most people with celiac disease. Look for items labelled gluten-free in all products especially for processed foods such as granolas and granola bars.”
Fatima Saeed Al Khurousie, senior clinical dietician at Dubai Hospital, said: “People with celiac disease must also check their medication labels carefully because not all medicines and vitamins are gluten-free. They must speak to the pharmacist before buying medications and vitamins.”
Nisreen Abu Ghoush, clinical dietician at Rashid Hospital, said: “Cutting out gluten from your diet may seem like a difficult and limiting task. Fortunately, there are many healthy and delicious foods that are naturally gluten-free. People with celiac disease can consume all fresh fruits and vegetables, meats, milk and milk products, legumes and nuts, rice, quinoa, corn, potato, tapioca, millet etc.”
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