No, if you have celiac disease, you should strictly avoid gluten in your diet, even if you experience no noticeable symptoms. Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. Eating gluten when you have celiac disease can cause significant damage to the lining of the small intestine, even in the absence of obvious symptoms.
Celiac Disease but No Symptoms
It may be tempting to “cheat” on the gluten-free-diet, but know one would be making a poor choice by doing so.
Some studies show that patients with celiac disease may be asymptomatic for many years and that the average diagnosis can take more than 10 years to occur following the initial presentation of symptoms.
In one US study where 9,973 children were screened for celiac disease, ~90% of patients positive for transglutaminase autoantibodies (TGA) lacked a family history of celiac disease and ~70% were asymptomatic.
The absence of symptoms does not mean that damage isn’t occurring internally. Over time, the continued ingestion of gluten can lead to serious health problems and complications, such as malnutrition, anemia, osteoporosis, as well as an increased risk of other autoimmune disorders like autoimmune thyroid disease and diabetes, certain types of cancer, and more.
WHAT WE KNOW:
- Significantly less gluten (i.e., approximately 2,000 times less gluten than the current legal threshold of “<20 parts per million [PPM]”) can cause adverse effects in patients with celiac disease.
- Intraepithelial lymphocytes, or T-IELs, a population of T cells in the GI tract, have what are called natural killer (NK) receptors, which detect and initialize a response to threats like infection or malignancy. Ordinarily anti-inflammatory in nature, these T-IELs are rapidly and deliberately activated by gluten to convert to pro-inflammatory cells that go on to kill intestinal tissue instead.
- Tissue-resident immunity is permanently altered by chronic inflammation in celiac patients leaving them susceptible to the development of intestinal immune disorders such as ulcerative colitis and colon cancer.
- Patients with celiac disease are not living healthier or longer lives despite strict adherence to a “gluten-free” diet. Celiac disease causes malnutrition which can lead to an increased risk of hospitalizations, morbidity, and mortality.
Denial as a Defense Mechanism
Nonacceptance can play a significant role in patients with celiac disease who refuse to follow a strict gluten-free diet. Patients may resort to using denial as a defense mechanism rather than accepting or acknowledging a challenging reality, in this case, the reality of having a chronic autoimmune condition that necessitates a major dietary change.
The stakes are even higher for individuals who care for children, elders, or the mentally incompetent; they are held to a higher standard. Those who turn a blind eye to obvious warnings that a product isn’t safe, who deny the existence of their loved one’s illness, or who do not make choices that help the ones they care for maintain strict adherence to a gluten-free diet may be committing medical neglect (i.e., physical abuse) and may be subject to penalties under state and federal laws.
Adhering to a strict gluten-free diet is the only effective treatment for celiac disease, even if you don’t experience immediate or noticeable symptoms after consuming gluten. It’s essential to consult with a healthcare professional, like a gastroenterologist and a knowledgeable registered dietitian that specializes in treating patients with celiac disease, for proper guidance. Finally, join a research-based group to help support you in maintaining a gluten-free lifestyle.