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Celiac disease

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Celiac disease is an autoimmune and digestive system disease. The exact cause of it is unknown but many factors can contribute to the disease such as stress, genetics, and other diseases that give people a higher chance of developing it. It can cause malnutrition, bone and joint problems, behavioral issues and many other symptoms. It is mostly known for damaging the small intestine. No actual medication or treatment is known except to completely remove gluten from the patients diet. As this disease is becoming more prevalent, more gluten free choices are becoming available for those who struggle with the disease. Celiac disease affects about 1 in every 141 Americans and it is more common in Caucasians and females. Many cases remain undiagnosed or misdiagnosed due to the variety and ambiguity of symptoms. [1]

Symptoms

Left side is healthy, right side is damaged Intestinal villi

Symptoms for celiac disease can sometimes be hard to identify because they vary from person to person. There are around 300 known symptoms that affect the digestive system and other parts of the body. Symptoms are more common in young children and infants, while some people don't even have symptoms, although the disease still causes dangerous long term complications. Some of the symptoms recognized in children are: bloating and abdominal pain, chronic diarrhea and constipation, vomiting, bad smelling, pale, or fatty stools, weight loss, fatigue, irritability and other behavioral problems, enamel defects on permanent teeth, delayed growth and puberty, including short stature, and ADHD.

Symptoms in adults include such things as: iron deficiency anemia, fatigue, bone or joint pain, arthritis, bone loss, osteoporosis, depression or anxiety, numbness and tingling in the hands and feet, seizures, migraines, missed menstrual periods, canker sores, infertility or miscarriages, and itchy rash on the skin called dermatitis herpetiformis. [2] Sometimes the symptoms caused by celiac disease can be mistaken for symptoms of other disorders such as irritable bowel syndrome or lactose intolerance. Another potential symptom in children could be undernourishment due to their bodies not being able to absorb nutrients as well. Sometimes, symptoms don't show until the body becomes stressed. Although somewhat rare, some other long term effects of celiac disease could include liver disease or intestinal cancer. In teenagers and young adults, celiac disease can cause hair loss. [3]

Causes

Hand with dermatitis, one of the side effects of celiac disease

Celiac disease, which can also be called celiac-sprue or gluten sensitive enteropathy is caused by the immune system's response to gluten. Gluten is a protein that is found in rye, barley, wheat, and every food containing these grain products.

The small intestines have small hair like structures called villi on the inside lining. The villi absorb nutrients from the food that passes through the intestine. If the villi are damaged, this inhibits the absorption of nutrients and can cause serious problems such as malnutrition. In celiac disease, the immune system, which normally protects the body from harmful invaders, forms antibodies to gluten and then these antibodies attack the lining of the intestine. [4] A simple analogy can be used to describe the effect that the ingestion of gluten can have on a person with celiac disease. On the microscopic scale, the villi in the small intestine looks similar to a thick carpet, after the effects of celiac disease, the inside surface of the small intestine resembles a tile floor.

The exact cause of celiac disease is unknown, however some gene mutations can increase the risk for developing the disease. Celiac disease can also be triggered as a result of surgeries, pregnancy, childbirth, viral infections and even emotional stress. It can affect anyone, but the risk is greater for people that have a family member with the disease, dermatitis herpetiformis,Down syndrome or Turner syndrome, type 1 diabetes, autoimmune thyroid disease, Sjogren's syndrome,and microscopic colitis. [5]

Treatments

dLabel showing a product that contains wheat flour, which contains the protein gluten

No treatment for celiac disease exists except for the permanent removal of gluten from the affected person's diet. This action lets the intestinal villi heal and for normal absorption of nutrients to occur. Removing gluten from the diet can cause symptoms to improve in quite a short time, sometimes just a few days. However, it can range from several months to several years for the villi to heal completely (it also takes longer for this healing to occur in adults than in children). Usually, people that have been diagnosed with the disease will have access to a nutritionist/dietitian that can help advise them on which foods they should avoid and other important dietary choices. Foods and drinks that should be avoided are anything containing these ingredients: wheat, spelt (a variation of wheat), barley, triticale, bulgur, durum, farina, graham flour, semolina, malt and rye. These gluten containing foods can be replaced by gluten free varieties such as buckwheat, corn, amaranth, arrowroot, cornmeal, rice, soy, and corn flour, flour made from potatoes or beans, quinoa, and tapioca. Other foods that are available to those with celiac disease are fresh meats, poultry and fish that have not been processed, breaded, coated or marinated, most dairy products, potatoes (as mentioned before), including sweet potatoes, vegetables, wine, distilled liquors, ciders and spirits. Foods such as beer, bread, cakes and pies, candy, cereals, cookies, crackers, croutons, gravies, imitation meats or seafood, oats, pasta, processed lunch meats, salad dressings, sauces (includes soy sauce), self-basting poultry, and soups should also be avoided unless they are specifically labeled "Gluten-free" products. [6]

The person may also need to take dietary supplements to make up for any nutrients they might be missing. Some of these include: Calcium folate, iron, vitamin B-12, vitamin D, vitamin K, and zinc. They can be taken in pill form or through an injection if the digestive tract has difficulty absorbing it. Steroids can also be prescribed to ease inflammation while the intestine heals. Depending on the symptoms that the individual has, other medications may be recommended such as skin medication (dapsone). [5]

Diagnosis

There are two major steps in diagnosing celiac disease. The first includes a blood test designed to discover gluten autoantibodies (antibodies produced by the body that attack its own tissues). The second step is a biopsy done on the bowels to find out how much damage has been done to the gut. For people who have dermatitis herpetiformis, a biopsy can be performed on the skin near the affected area. It is easiest to properly diagnose the patient before they have made gluten restrictions to their diet. A health care provider can also consider such factors as medical and family history because it plays a big role if the one the patients relatives or family members also suffer from the disease. The intestinal biopsy that can be done involves taking a piece of tissue from the small intestine to examine. They do this using an endoscope which is a small camera with a light. This test displays the damaged intestinal villi characterized by celiac disease. In the skin biopsy, they test for the the same antibodies as in the bowel biopsy. This test is usually backed by blood tests as well to ensure the accuracy of the diagnosis. A genetic test can also be done. This is because a person with celiac disease has a gene pair that has a human leukocyte antigen (HLA) gene variant. But such variants can also exist in people without the disease, so this is not always an accurate diagnosis for celiac disease.[1]

Video

A brief explanation of celiac disease.

Immunity diseases

References

  1. 1.0 1.1 . Celiac Disease Nih.gov. Web. updated June 25, 2015​​ Author unknown.
  2. . CELIAC DISEASE SYMPTOMS Celiac Disease foundation. Web. accessed 10/22/15 author unknown.
  3. . Celiac Disease Symptoms WebMD. Web.Accessed 10/22/15 Author unknown.
  4. . Celiac Disease Web MD.com. Web. Accessed 10/13/15 Author unknown.
  5. 5.0 5.1 . Diseases and Conditions Celiac disease Mayo Clinic. Web. Accessed 10/13/15 Author unknown.
  6. Lights, Verneda. Celiac Disease (Gluten Intolerance) healthline.com. Web. Published 7/25/12.