Celiac disease

Good day, Mr. Pharmacist,

It seems to me that the common denominator of lactose intolerance and celiac disease is a disrupted gut microbiome, possibly coupled with the development of leaky gut syndrome. You mention that these problems are less common in breastfed children, as they have a higher chance to develop a healthy microbiome thanks to breast milk. I have personally experienced after severe stress (and certainly not a very healthy diet) the development of lactose intolerance and a casein allergy, which significantly diminished after modifying my diet (eliminating sugar, milk, gluten, and highly processed foods) for about 2 months to the point that I can occasionally enjoy a dairy product without any of the unpleasant symptoms that bothered me before. Is it possible, then, that these issues (especially if they develop in adulthood) can be alleviated/treated by changing one's diet, specifically by focusing on restoring a healthy gut microbiome? Perhaps I am oversimplifying my perspective, and I would appreciate your insight and response.

Kind regards and best wishes for a nice day.

The situation you describe occurs quite frequently in practice. Moreover, nutritional trends and health forecasts for the population indicate that the numbers will increase in the future. When addressing health issues, it always depends on the underlying cause, which then determines the targeted treatment. Damage to the mucous membrane of the small intestine due to an unsuitable diet or stress-related manifestations leads to decreased production of certain enzymes, and the digestive tract thus fails to manage some functions fully. However, once you address the issue and establish the necessary conditions, the probability of restoring the situation to its original state significantly increases. In relation to humility towards one's body and its functioning, it is reasonable to acknowledge that it is not a certainty, but "only" an increased probability.
The intestinal microbiome plays a significant role in these problems, so in addition to dietary adjustments, it also makes sense to target supportive supplementation with probiotics and prebiotics.

Good day, Mr. Jelínek.
Is it possible for rye sourdough bread to be tolerated by celiacs and people with a gluten allergy? In other words, does fermentation lead to the breakdown of gluten?
Thank you for your response.

During the fermentation of dough made from gluten flour, only partial hydrolysis of the gluten structure occurs. This process is not sufficient for the proteins to break down completely (as is the case with miso paste, for example), so individuals with gluten intolerance or allergy must also avoid sourdough bread made from gluten-containing grains.

Good day,

I was beginning to rejoice that I finally understood the difference between celiac disease and a wheat allergy. Today's lesson has confused me a bit again. We learned that an allergy is conditioned by immune reactions, while intolerance is caused by a metabolic disorder (most commonly enzyme deficiency). So, is celiac disease considered a food intolerance, even though the immune system is involved in its development, unlike other food intolerances?

Furthermore, I wanted to ask if celiac disease is truly an incurable condition. As a child, I was diagnosed with celiac disease, but nowadays (and probably since the age of 10), I have no problem with gluten. Was it then a misdiagnosis?

Thank you.

Celiac disease is a genetically determined disorder of mucosal immunity that reacts abnormally to gluten and prolamins. It is an intolerance (= metabolic disorder) that involves the immune system. Modern medicine defines it as incurable, meaning a lifelong disease. In practice, I have witnessed several situations where individuals overcame this diagnosis, in cases where the diagnosis was conducted in a standard (comprehensive) manner (= with a low probability of diagnostic error). However, I cannot conscientiously say whether this was a statistically insignificant exception or an intervention by the body's homeostatic self-healing systems. These cases are commonly categorized by medicine under the label "spontaneous remission"...