Overview Of Celiac Disease
Celiac disease is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine.
When people with celiac disease eat gluten (a protein found in wheat, rye, and barley), their body mounts an immune response that attacks the small intestine. These attacks lead to damage to the villi, small finger-like projections that line the small intestine, that promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.
Celiac disease is hereditary, meaning that it runs in families. People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease.
Celiac disease can develop at any age after people start eating foods or medicines that contain gluten. Left untreated, celiac disease can lead to additional serious health problems.
Commonly Associated With Celiac Disease
Sprue; Nontropical sprue; Gluten intolerance; Gluten-sensitive enteropathy; Celiac sprue
Causes Of Celiac Disease
The exact cause of the celiac disease is not known. The lining of the intestines has small areas called villi which project outward into the opening of the intestine. These structures help absorb nutrients.
When people with celiac disease eat foods with gluten, their immune system reacts by damaging the villi. Because of the damage, the villi are unable to properly absorb iron, vitamins, and other nutrients. This may cause a number of symptoms and other health problems.
The disease can develop at any point in life, from infancy to late adulthood.
People who have a family member with celiac disease are at greater risk of developing the disease. The disorder is most common in Europeans.
People with celiac disease are more likely to have:
- Autoimmune disorders such as rheumatoid arthritis, systemic lupus erythematosus, and Sjögren syndrome
- Addison disease
- Down syndrome
- Intestinal cancer
- Intestinal lymphoma
- Lactose intolerance
- Thyroid disease
- Type 1 diabetes
Symptoms Of Celiac Disease
Celiac disease symptoms in children
Children with celiac disease can feel tired and irritable. They may also be smaller than normal and have delayed puberty.
Other common symptoms include:
•persistent diarrhea or constipation
•pale, fatty, foul-smelling stools
Celiac disease symptoms in adults
Adults with celiac disease may experience digestive symptoms. In most cases, however, symptoms also affect other areas of the body.
These symptoms may include:
•joint pain and stiffness
•weak, brittle bones
•numbness and tingling in the hands and feet
•tooth discoloration or loss of enamel
•pale sores inside the mouth
•infertility and miscarriage
Treatment Of Celiac Disease
The gluten-free diet is a lifetime requirement. Eating any gluten, no matter how small an amount, can damage the small intestine. This is true for anyone with the disease, including people who do not have noticeable symptoms.
Antibody levels take a long time (sometimes more than a year) to normalize after a person has stopped eating gluten. The doctor will assess if the intestinal damage is improving satisfactorily or not, based on, based on the pace of the decline of antibody levels. Depending on a person’s age at diagnosis, some problems, such as delayed growth and tooth discoloration, may not improve.
Exams and Tests
The following tests may be performed:
- Bone density
- Cholesterol (may be low)
- Complete blood count (CBC – test for anemia)
- Comprehensive metabolic panel
- Folate level (serum)
- Iron level (serum)
- Ferritin level
- Prothrombin time
- Vitamin B12 level (serum)
- Vitamin D level