Celiac disease – Causes – symptoms- Diagnosis -Treatment – Prognosis & Prevention
Celiac disease Definition
Celiac disease is a disease of the digestive system that damages the small intestine and interferes with the absorption of nutrients from food.
Celiac disease Description
Celiac disease occurs when the body reacts abnormally to gluten, a protein found in wheat, rye, barley, and possibly oats. When someone with celiac disease eats foods containing gluten, that person’s immune system causes an inflammatory response in the small intestine, which damages the tissues and results in impaired ability to absorb nutrients from foods. The inflammation and malabsorption create wide-ranging problems in many systems of the body. Since the body’s own immune system causes the damage, celiac disease is classified as an ‘‘autoimmune’’ disorder. Celiac disease may also be called sprue, nontropical sprue, gluten sensitive enteropathy, celiac sprue, and adult celiac disease.
Celiac disease may be discovered at any age, from infancy through adulthood. The disorder is more commonly found among white Europeans or in people of European descent. It is very unusual to find celiac disease in African or Asian people. The exact incidence of the disease is uncertain. Estimates vary from one in 5000, to as many as one in every 300 individuals with this background. The prevalence of celiac disease seems to be different from one European country to another, and between Europe and the United States. This may be due to differences in diet and/or unrecognized disease. A recent study of random blood samples tested for celiac disease in the US showed one in 250 testing positive. It is clearly underdiagnosed, probably due to the symptoms being attributed to another problem, or lack of knowledge about celiac disease by physicians and laboratories.
Because of the known genetic component, relatives of patients with celiac disease are considered at higher risk for the disorder. Because celiac disease has a hereditary influence, close relatives (especially first degree relatives, such as children, siblings, and parents) have a higher risk of being affected with the condition. The chance that a first degree relative of someone with celiac disease will have the disease is about 10%. As more is learned about celiac disease, it becomes evident that it has many variations which may not produce typical symptoms. It may even be clinically ‘‘silent,’’ where no obvious problems related to the disease are apparent.
Celiac disease Causes
Normally, the body's immune system is designed to protect it from foreign invaders. When people with celiac disease eat foods containing gluten, their immune system forms antibodies to gluten which then attack the intestinal lining. This causes inflammation in the intestines and damages the villi, the hair-like structures on the lining of the small intestine. Nutrients from food are absorbed by the villi. If the villi are damaged, the person cannot absorb nutrients and ends up malnourished, no matter how much he or she eats.
Celiac Disease Symptoms of Celiac Disease
Celiac disease Symptoms of celiac disease vary among sufferers and include:
* Digestive problems (abdominal bloating, pain, gas, diarrhea, pale stools, and weight loss).
* A severe skin rash called dermatitis herpetiformis.
* Iron deficiency anemia (low blood count).
* Musculoskeletal problems (muscle cramps, joint and bone pain).
* Growth problems and failure to thrive (in children).
* Seizures.
* Tingling sensation in the legs (caused by nerve damage and low calcium).
* Aphthous ulcers (sores in the mouth).
* Missed menstrual periods.
Celiac disease Diagnosed?
If your doctor suspects you have celiac disease, he or she will perform a careful physical exam and will discuss your medical history with you. He or she may also perform a blood test to measure for higher levels of certain types of antibodies (substances produced by the immune system to fight harmful invaders) found in people with celiac disease.
Your doctor may perform other tests to detect nutritional deficiencies, such as a blood test to detect iron levels; a low level of iron (which can cause anemia) can occur with celiac disease. A stool sample may be tested to detect fat in the stool, since celiac disease prevents fat from being absorbed from food.
Your doctor may take a biopsy from your small intestine to check for damage to the villi. During a biopsy, the doctor inserts an endoscope (a thin, hollow tube) through your mouth and into the small intestine, and takes a sample of the small intestine with an instrument to examine under a microscope.
Celiac disease Treatment
If you have celiac disease, you can't eat any foods that contain gluten (including wheat, rye, barley, and oats). Dropping gluten from your diet usually improves the condition within a few days and eventually ends the symptoms of the disease. In most cases, the villi are healed within six months.
You'll have to remain on this diet for the rest of your life; eating any gluten at all can damage your intestine and restart the problem.
Some people with celiac disease have so much damage to their intestines that a gluten-free diet will not help them. These patients may have to receive nutritional supplements through an IV.
Celiac Disease – Prevention
Although celiac disease cannot be prevented, symptoms and damage to the small intestine can be reversed by maintaining a strict gluten-free diet. At first, you may also have to avoid milk and milk products. After you stop eating gluten, the intestines begin to heal and you likely will be able to gradually reintroduce milk products into your diet without triggering symptoms.
Some adults with celiac disease have a poorly functioning or nonfunctional spleen, which is a risk factor for developing a pneumococcal infection. For this reason, your doctor may recommend that you get immunized with the pneumococcal vaccine.
Celiac disease Prognosis
Most people who follow a strict gluten-free diet can expect symptoms to improve in a few weeks, and the damage to the intestinal villi typically is reversed in a few months. As long as the diet is followed, people with celiac disease should be able to lead normal lives with no further symptoms. People with celiac disease are at risk of developing another autoimmune disorder. People with celiac disease also have an increased risk of developing small bowel lymphoma, a cancer of the small intestine. Therefore, your physician should consider these possibilities if new problems or symptoms occur.
Left untreated, celiac disease can lead to severe malnutrition and can put you at risk of serious consequences, including osteoporosis (thin bones), anemia, infertility, neuropathy (damaged nerves) and seizures.
Resources
http://www.webmd.com
Gale Encyclopedia of Medicine.
