Keliakia

Keliakia, known in English as celiac disease, is a chronic autoimmune disorder triggered by gluten intake in genetically predisposed individuals. Gluten is a protein found in wheat, barley, and rye. The immune reaction damages the lining of the small intestine, particularly the villi, which can lead to malabsorption of nutrients and a wide range of symptoms.

Clinical features vary widely. In children, symptoms include chronic diarrhea, abdominal pain, bloating, constipation, vomiting, and growth delay. In adults, symptoms may be diarrhea or weight loss, iron‑deficiency anemia, fatigue, abdominal pain, and non-gastrointestinal signs such as osteoporosis, infertility, or dermatitis herpetiformis. Some people have mild or no symptoms and are identified through screening or family history.

Diagnosis relies on serology and intestinal biopsies. Blood tests detect antibodies such as tissue transglutaminase (tTG) IgA and endomysial antibodies. If positive or suspicion remains high, an upper endoscopy with small‑bowel biopsy is performed to look for characteristic villous atrophy and crypt hyperplasia. Genetic testing for HLA-DQ2 or HLA-DQ8 can support the diagnosis but is not definitive.

Treatment is lifelong and requires strict adherence to a gluten‑free diet, avoiding all foods containing wheat, barley, and rye and minimizing cross‑contamination. Most patients improve clinically and may show mucosal healing with time. Follow‑up typically includes symptom review and periodic serology, with nutritional support as needed. Untreated keliakia increases the risk of complications such as osteoporosis, anemia, certain cancers, and other autoimmune conditions.

Epidemiology: keliakia affects about 1% of many populations and can onset at any age, often in childhood or early adulthood. It is more common in individuals with a first‑degree relative with the condition or with other autoimmune diseases.