Celiac disease and dietetic products for persons intolerant to gluthen

Abstract

Celiac disease (gluten sensitive enteropathy) is a chronic, lifelong inflammatory disease of the small intestine that occurs in genetically predisposed individuals, and is characterized by a permanent specific hypersensitivity to wheat, rye, barley and oat gluten. Gluten intake in these individuals leads to damage of the small intestine mucosa, which is manifested by abdominal problems, resulting in reduced absorption of nutrients, leading to secondary disorders and diseases such as rachitis, osteoporosis, arthritis, delay in growth and development, anemia, sterility, neurological disorders, skin changes, intestinal lymphomas. The prevalence of celiac disease is about 1% in the general population. The diagnostic procedure includes histological and serological tests, and a strict gluten-free diet is a lifelong treatment of celiac disease and is a main requirement for any further treatment of the consequences of nutritional deficits. The main problems in implementing a gluten-free diet is the presence of hidden gluten in food, medicines and cosmetics, and gluten contamination during production, storage and food preparation. According to the international Codex alimentarius standard (CODEX STAN 118-1979) and national regulations, gluten-free dietary products must not contain more than 20 mg/kg of gluten.

Celijačna bolest (gluten senzitivna enteropatija) je hronično doživotno inflamatorno oboljenje tankog creva koje se javlja kod genetski predisponiranih osoba, a odlikuje se trajnom specifičnom preosetljivošću na gluten pšenice, raži, ječma i ovsa. Unos glutena kod ovih osoba dovodi do oštećenja sluznice tankog creva koje se manifestuje abdominalnim problemima što rezultuje smanjenom apsorpcijom hranljivih sastojaka, što dalje uzrokuje razvoj sekundarnih poremećaja i oboljenja kao što su rahitis, osteoporoza, artritis, zastoj u rastu i razvoju, anemija, sterilitet, neurološki poremećaji, kožne promene, intestinalni limfomi dr. Prevalenca celijačne bolesti je oko 1% u opštoj populaciji. Dijagnostička procedura uključuje histološka i serološka ispitivanja a striktna dijeta bez glutena je doživotni tretman celijakije i uslovljava svako dalje lečenje posledica nutritivnih deficita. Najveći problem u sprovođenju dijete bez glutena je prisustvo skrivenog glutena u hrani, lekovima i kozmetičkim proizvodima i kontaminacija glutenom tokom proizvodnje, čuvanja i pripreme hrane. Prema međunarodnom standardu Codex alimentarius-a (CODEX STAN 118-1979) i nacionalnoj regulativi dijetetski proizvodi bez glutena ne smeju da sadrže više od 20 mg/kg glutena.