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Vivir sin gluten, el reto al que se enfrentan cada vez más personas

La celiaquía es una enfermedad en la que el sistema inmune responde anormalmente contra el gluten, una proteína se encuentra en alimentos como el trigo, centeno y cebada. Actualmente, se considera que la avena no es perjudicial para los pacientes con enfermedad celíaca, aunque la alta posibilidad de que esté contaminada con gluten hace que se recomiende no comerla. «Cuando los pacientes con enfermedad celíaca ingieren alimentos que contienen gluten se desarrolla una inflamación en el intestino que produce un daño del tejido, con una alteración en la absorción de nutrientes. La inflamación, la malabsorción o la combinación de ambas llevan a la aparición de los síntomas y signos de la enfermedad», explica nuestro jefe del Servicio de Aparato Digestivo el Dr. Manuel van Domselaar.

Síntomas

Los más comunes son la diarrea, pérdida de peso, falta de crecimiento, dolor abdominal y anemia. Sin embargo, solo una minoría de los pacientes desarrolla todos estos síntomas y más de dos tercios de los pacientes solo tienen síntomas leves o inespecíficos como distensión abdominal, cansancio, hierro bajo en sangre, elevación de las enzimas hepáticas, osteoporosis y otras enfermedades asociadas.

Aún no está claro el componente familiar de la enfermedad, ya que el riesgo varía entre un 5% y 20% de desarrollar enfermedad celíaca entre los familiares directos. No obstante, se recomienda hacer las pruebas si se tienen familiares directos con la enfermedad.

PAsta y gluten

Una vez diagnosticada la enfermedad, ¿cómo se puede vivir con ella?

Según el jefe de nuestro Servicio de Aparato Digestivo, la vivencia que tiene cada paciente es particular. Algunos se adaptan bien desde el principio y a otros les cuesta más. Como regla general, sí que tienen que estar siempre atentos en cuanto a los alimentos que ingieren, lo que puede afectar su vida social. Como regla general, todo alimento procesado tendrá gluten, salvo que se aclare lo contrario. Afortunadamente, cada vez se tiene más en cuenta a los pacientes con enfermedad celíaca y no es raro ver menús para celíacos en restaurantes, aviones, hoteles …

Pero el paciente se tiene que adaptar a su nueva situación. En este contexto, tanto en la comunidad médica como en las asociaciones de celíacos y redes sociales son de gran ayuda, ya que pueden compartir sus experiencias, lo que ayuda a que los pacientes se adapten mejor a su situación.

Hay que tener en cuenta que los pacientes con celiaquía que no cumplen bien la dieta sin gluten continuarán con síntomas digestivos. Además, aumentará el riesgo de desarrollar complicaciones de la enfermedad celíaca, como es anemia, osteoporosis, problemas de la piel, tumores del intestino delgado y esófago, y linfoma intestinal.

Tratamiento

En cuanto a disponer de un medicamento para que los celiacos puedan tomar alimentos con gluten, el Dr. Manuel van Domselaar recuerda que hay varias líneas de investigación en enfermedad celíaca. Unos trabajos se centran en fármacos que favorecen la digestión del gluten, otros que disminuyen las vías que activan la inflamación intestinal, y vacunas que actuarían de la misma manera que en procesos alérgicos. De momento, ninguno de estos fármacos está disponible, pero es muy probable que en los próximos años se disponga de algunos de ellos.

 

 

Contenido validado por el Dr. Manuel Van Domselaar, Jefe de Servicio de Aparato Digestivo del Hospital de Torrejón



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