Celiac disease

Celiac disease is a condition in which the immune system responds abnormally to a protein called gluten, which can cause damage to the lining of the small intestine. Gluten is found in wheat, rye, barley, and a multitude of prepared foods.

 Damage to the lining of the small intestines can lead to difficulty absorbing necessary nutrients. This problem is referred to as malabsorption. Celiac disease can occur in people of any age and it affects both genders.

SIGNS AND SYMPTOMS

People may have no symptoms . Even in people who have no symptoms, there may be evidence of malabsorption on laboratory testing. As an example, a low blood count may develop as a result of decreased iron absorption.

 Others have more symptoms, including diarrhea, weight loss, abdominal discomfort, excessive gas, osteoporosis, and other signs and symptoms due to deficiencies of specific vitamins and nutrients.

CAUSES

Genetic factors are clearly important since celiac disease occurs primarily in certain groups of people, specifically whites of northern European ancestry.

DIAGNOSIS

Celiac disease can be difficult to diagnose because the signs and symptoms are similar to other conditions. Fortunately, testing is available that can distinguish celiac disease from other disorders.

 Blood tests

The blood level of antibodies (IgA EMA and IgA tTG) become elevated in people with celiac disease. Before having these tests, it is important to continue eating a normal diet, including foods that contain gluten.

 Small intestine biopsy

If the blood tests are positive, the diagnosis must be confirmed by examining a small intestinal biopsy. In people with celiac disease, the lining of the small intestine has a unique appear when viewed with a microscope. Normally, the intestine has finger-like structures, which are called villi. Villi allow the small intestine to absorb nutrients. The villi become flattened in people with celiac disease .

Testing for malabsorption

Patients with celiac disease should be tested for nutritional deficiencies. Common tests include a blood count to detect low levels of iron, folic acid, or vitamin B12, calcium, vitamin D, or vitamin K.

TREATMENT

Gluten free diet

The cornerstone of treatment for celiac disease is complete elimination of gluten from the diet. Patients who are malnourished because of the disease may also need nutritional supplements.Maintaining a gluten-free diet can be a difficult task that requires major lifestyle adjustments. Gluten is contained in the most commonly consumed grains (wheat, rye, and barley) and is included as an additive in a large number of prepared foods . Consultation with an experienced celiac nutritionist is recommended for detailed guidance and written information.

Skin conditions

Celiac disease is associated with a number of skin disorders, of which dermatitis herpetiformis is the most common .Dermatitis herpetiformis is characterized by intensely itchy, raised, fluid filled areas on the skin, usually located on the elbows, knees, buttocks, lower back, face, neck, trunk and occasionally within the mouth .

 IMPLICATIONS FOR THE FAMILY

 Eliminating gluten requires a major lifestyle change for the person who is affected by celiac disease as well as their family. However, with time and practice, it becomes easier to know which foods and ingredients contain gluten and what alternatives are available. Families also need to be aware of their increased risk of celiac disease. Thus, first-degree relatives (parents, brothers, sisters, children) of a person with celiac disease should consider being tested, especially if there are any signs or symptoms of the condition.