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August 20, 2018  
EDUCATION CENTER: Medical Conditions
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  • Celiac disease


    Overview:

    Quick Reference

    Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, found in wheat, rye, and barley. Gluten is found mainly in foods, but is also found in products we use every day, such as stamp and envelope adhesive, medicines, and vitamins.

    Detailed Information

    Celiac disease affects people differently. Symptoms may occur in the digestive system, or in other parts of the body. For example, one person might have diarrhea and abdominal pain, while another person may be irritable or depressed. In fact, irritability is one of the most common symptoms in children.

    Symptoms of celiac disease may include one or more of the following (or none):

  • gas recurring abdominal bloating and pain chronic diarrhea
  • pale, foul-smelling, or fatty stool
  • weight loss / weight gain
  • fatigue
  • unexplained anemia (a low count of red blood cells causing fatigue)
  • bone or joint pain
  • osteoporosis, osteopenia
  • behavioral changes
  • tingling numbness in the legs (from nerve damage)
  • muscle cramps
  • seizures
  • missed menstrual periods (often because of excessive weight loss)
  • infertility, recurrent miscarriage
  • delayed growth
  • failure to thrive in infants
  • pale sores inside the mouth, called aphthous ulcers
  • tooth discoloration or loss of enamel
  • itchy skin rash called dermatitis herpetiformis

    Call your doctor if you suspect you or a loved one have celiac disease.

    Diagnosis and Treatment

    When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging the small intestine. The tiny, fingerlike protrusions lining the small intestine are damaged or destroyed. Called villi, they normally allow nutrients from food to be absorbed into the bloodstream. Without healthy villi, a person becomes malnourished, regardless of the quantity of food eaten.

    Because the body's own immune system causes the damage, celiac disease is considered an autoimmune disorder. However, it is also classified as a disease of malabsorption because nutrients are not absorbed. Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.

    Celiac disease is a genetic disease, meaning it runs in families. Sometimes the disease is triggered-or becomes active for the first time-after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.
    Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases. In fact, sometimes celiac disease is confused with irritable bowel syndrome, iron-deficiency anemia caused by menstrual blood loss, Crohn's disease, diverticulitis, intestinal infections, and chronic fatigue syndrome. As a result, celiac disease is commonly under diagnosed or misdiagnosed.

    Recently, researchers discovered that people with celiac disease have higher than normal levels of certain autoantibodies in their blood. Antibodies are protective proteins produced by the immune system in response to substances that the body perceives to be threatening. Autoantibodies are proteins that react against the body's own molecules or tissues. To diagnose celiac disease, physicians will usually test blood to measure levels of:

  • Immunoglobulin A (IgA)
  • anti-tissue transglutaminase (tTGA)
  • IgA anti-endomysium antibodies (AEA)


    Before being tested, one should continue to eat a regular diet that includes foods with gluten, such as breads and pastas. If a person stops eating foods with gluten before being tested, the results may be negative for celiac disease even if celiac disease is actually present.

    If the tests and symptoms suggest celiac disease, the doctor will perform a small bowel biopsy. During the biopsy, the doctor removes a tiny piece of tissue from the small intestine to check for damage to the villi. To obtain the tissue sample, the doctor eases a long, thin tube called an endoscope through the mouth and stomach into the small intestine. Using instruments passed through the endoscope, the doctor then takes the sample.

    Recent findings estimate about 2 million people in the United States have celiac disease, or about 1 in 133 people.

    Complications

    People without symptoms are still at risk for the complications of celiac disease, including malnutrition. The longer a person goes undiagnosed and untreated, the greater the chance of developing malnutrition and other complications. Anemia, delayed growth, and weight loss are signs of malnutrition: The body is just not getting enough nutrients. Malnutrition is a serious problem for children because they need adequate nutrition to develop properly.

    Explore More

    Celiac Disease Foundation
    13251 Ventura Boulevard, #1
    Studio City, CA 91604
    Phone: 818–990–2354
    Fax: 818–990–2379
    Email: [email protected]
    Internet: www.celiac.org

    American Dietetic Association
    120 South Riverside Plaza, Suite 2000
    Chicago, IL 60606–6995
    Phone: 1–800–366–1655 or 1–800–877–1600
    Email: [email protected]
    Internet: www.eatright.org

    National Foundation for Celiac Awareness
    124 South Maple Street
    Ambler, PA 19002
    Phone: 215–325–1306
    Email: [email protected]
    Internet: www.celiacawareness.org

    Gluten Intolerance Group of North America
    15110 10th Avenue, SW., Suite A
    Seattle, WA 98166
    Phone: 206–246–6652
    Fax: 206–246–6531
    Email: [email protected]
    Internet: www.gluten.net

    Treatment/Prevention

    The only treatment for celiac disease is to follow a gluten-free diet. When a person is first diagnosed with celiac disease, the doctor usually will ask the person to work with a dietitian on a gluten-free diet plan. A dietitian is a health care professional who specializes in food and nutrition. Someone with celiac disease can learn from a dietitian how to read ingredient lists and identify foods that contain gluten in order to make informed decisions at the grocery store and when eating out. Following a gluten-free diet means not eating foods that contain wheat (including spelt, triticale, and kamut), rye, and barley. The foods and products made from these grains are also not allowed. In other words, a person with celiac disease should not eat most grain, pasta, cereal, and many processed foods. Despite these restrictions, people with celiac disease can eat a well balanced diet with a variety of foods, including gluten-free bread and pasta. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet. The small intestine is usually completely healed in 3 to 6 months in children and younger adults and within 2 years for older adults. Healed means a person now has villi that can absorb nutrients from food into the bloodstream.

     

    Last updated: 29-Mar-07

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