Celiac Disease Dr. Pedro de María Pallarés
Specialist in celiac disease diagnosis and treatment with advanced endoscopy. Specialized celiac consultation at INMEQ Madrid.
What is Celiac Disease?
Definition
Celiac disease is a chronic autoimmune disease caused by permanent gluten intolerance in genetically predisposed individuals. It primarily affects the small intestine, causing inflammation and atrophy of intestinal villi.
Prevalence
Affects approximately 1% of the world population. In Spain, it's estimated that there are more than 450,000 celiac people, although many remain undiagnosed due to symptom variability.
Celiac Disease Symptoms
Digestive Symptoms
- Chronic diarrhea - Main symptom in adults
- Abdominal pain - Cramps and frequent discomfort
- Abdominal bloating - Distension after eating
- Excessive gas - Flatulence and meteorism
- Weight loss - Due to malabsorption
Extradigestive Symptoms
- Iron deficiency anemia - Due to iron deficiency
- Chronic fatigue - Persistent tiredness
- Dermatitis herpetiformis - Specific skin lesions
- Osteoporosis - Loss of bone density
- Infertility - Reproductive problems
Celiac Disease Diagnosis
Serology
- • Anti-transglutaminase antibodies (tTG)
- • Anti-endomysial antibodies (EMA)
- • Anti-deamidated peptide antibodies (DGP)
- • Total IgA (to rule out deficiency)
Duodenal Biopsy
- • Gold standard diagnosis
- • Gastroscopy with biopsy
- • Villous atrophy
- • Crypt hyperplasia
- • Lymphocytic infiltrate
Genetic Study
- • HLA-DQ2 (90-95% cases)
- • HLA-DQ8 (5-10% cases)
- • High negative predictive value
- • Useful in family members
Important
Do not start a gluten-free diet before completing the diagnostic study, as it may alter test results.
Celiac vs Non-Celiac Gluten Sensitivity
| Characteristic | Celiac Disease | Gluten Sensitivity |
|---|---|---|
| Mechanism | Autoimmune | Non-autoimmune |
| Serology | Positive (tTG, EMA) | Negative |
| Biopsy | Villous atrophy | Normal or minimal changes |
| HLA | DQ2/DQ8 positive (99%) | Variable |
| Treatment | Strict gluten-free diet | Low-gluten diet |
Celiac Disease Treatment
Strict Gluten-Free Diet
Only effective treatment - For life
❌ Prohibited Foods
- • Wheat, barley, rye, non-certified oats
- • Bread, pasta, conventional cereals
- • Beer, malt, brewer's yeast
- • Sauces, prepared soups (check labels)
- • Processed products with hidden gluten
✅ Allowed Foods
- • Rice, quinoa, corn, millet
- • Fresh meat, fish, eggs
- • Fruits, vegetables, legumes
- • Natural dairy products
- • Products certified "gluten-free"
Label Reading
Always check ingredients and look for "gluten-free" certification. Pay attention to cross-contamination.
Safe Kitchen
Separate utensils, exclusive toaster, avoid contamination with conventional flours.
Family Support
Family education, adapted menus, psychological support during initial adaptation.
Medical Follow-up and Complications
Regular Follow-up
-
First 6 months:
Serologic control, symptom evaluation, diet adherence
-
Annually:
Complete blood work, nutritional deficits, densitometry
-
Control biopsy:
At 2 years if no clinical improvement
Complications
-
Osteoporosis:
Due to calcium and vitamin D malabsorption
-
Anemia:
Iron, B12, folate deficiency
-
Reproductive problems:
Infertility, recurrent miscarriages
Refractory Celiac
Situation where symptoms and villous atrophy persist despite strict gluten-free diet for more than 12 months.
Type I:
Normal intraepithelial lymphocytes. Better prognosis.
Type II:
Abnormal lymphocytes. Risk of associated T-cell lymphoma.
Specialized Celiac Disease Consultation
Comprehensive diagnosis, treatment and follow-up
INMEQ Consultation
Calle Marcenado 49
28002 Madrid
€150
Specialized celiac consultation
Procedures
Hospital Fuensanta
Hospital San Rafael
Gastroscopy with duodenal biopsy
Endoscopic follow-up
Patient Testimonial
"After years of unexplained symptoms, Dr. Pedro de María diagnosed me with celiac disease. His detailed explanation about the gluten-free diet and personalized follow-up have been fundamental in my recovery. Now I lead a completely normal life."
Carmen M.
Celiac patient - INMEQ
Frequently Asked Questions about Celiac Disease
Can celiac disease be cured?
Celiac disease has no cure, but can be completely controlled with a strict lifelong gluten-free diet. With proper treatment, symptoms disappear and complications are prevented.
How long does it take to improve with a gluten-free diet?
Digestive symptoms usually improve within weeks or months. Complete recovery of intestinal villi can take 1-2 years. Serology normalizes gradually in 6-12 months.
Should my family members be tested for celiac disease?
Yes, first-degree relatives have a 10% risk of developing celiac disease. Screening with serology every 2-3 years is recommended, especially if symptoms are present.
What happens if I accidentally eat gluten being celiac?
Accidental ingestion can cause temporary symptoms in celiac people. It's important to immediately return to a strict gluten-free diet. Frequent transgressions can cause persistent intestinal damage.
Do I need nutritional supplements being celiac?
Initially it may be necessary to supplement iron, vitamin D, B12, folates and calcium due to malabsorption. Your doctor will evaluate your specific needs through regular blood tests.
Do you suspect you may have Celiac Disease?
Consult with a specialist to get an accurate diagnosis and start appropriate treatment
INMEQ - Calle Marcenado 49, 28002 Madrid