Celiac Disease

CELIAC DISEASE

Last Updated October 23rd, 2019

Overview

Gluten is a kind of naturally occurring protein that is found in wheat, barley, rye and other related grains. Thus, it is present in a variety of everyday foods such as breads, cereals, soups and beer. Some people suffbreadm a digestive disorder that causes inflammation in the small intestine whenever they consume foods containing gluten. This is known as celiac disease and it is an autoimmune disorder. Unless they switch over to a gluten-free diet, the patient’s system can lose the ability to absorb other nutrients as well. It is estimated that as much as 0.3 to 1% of the global population suffers from this disease.

Definition

CELIAC DISEASE cautionCeliac disease is a chronic genetic autoimmune disorder of the small intestine. When a person suffering from this disease consumes any food containing gluten, an aberrant immune response causes inflammation in the small intestine. This eventually leads to permanent damage of the villi in the inner lining of the small intestine. The villi are long hair-like structures that are responsible for the absorption of fluids and nutrients such as vitamins and minerals from food as it passes through the small intestine.

Once diagnosed, the patient will be advised to switch over to a completely gluten-free diet so that the symptoms can be kept at bay. This also allows the intestinal villi to heal. However, if this disease goes untreated, the person’s small intestine permanently loses the ability to absorb a variety of nutrients, leaving the body feeling tired and malnourished. For instance, patients with celiac disease are very likely to develop iron-deficiency, leading to anemia. The ability of the small intestine to effectively absorb calcium, folate and vitamins A, D, E and K are also reduced.

Symptoms can manifest at any age. Both children, as well as adults, are known to suffer from this disease although it tends to affect adults more often.

What Causes Celiac Disease?

In individuals suffering from celiac disease, certain substances contained in gluten are mistaken by the immune system as a threat to the body. It attempts to fight this threat by producing antibodies. These antibodies end up causing the inner lining of the small intestine to become swollen and inflamed, damaging the intestinal villi. The function of the villi is to provide an increased surface area within the small intestine for the absorption of nutrients. In celiac disease, inflammation of the small intestine causes the villi to shrink, effectively reducing the ability of the organ to perform its designated function.

CELIAC DISEASE glutenTherefore, the direct cause of celiac disease is an abnormal immune response triggered by the consumption of foods containing gluten. Although celiac disease is an inherited disorder, not everyone who has the genes for it will necessarily develop this disorder. Those who are genetically susceptible will find that it tends to be triggered by stress, gastrointestinal infections or even pregnancy. Therefore, this disease is generally attributed to a mix of genetic and environmental factors.

Risk factors include:

  • Having a close family member suffering from celiac disease increases one’s own chances as much as tenfold.
  • Similarly, having a family member suffering from dermatitis herpetiformis.
  • Other autoimmune disorders such as rheumatoid arthritis and type 1 diabetes. This also includes autoimmune endocrine disorders such as thyroid disease or Addison’s disease.
  • Chromosomal abnormalities such as Down’s syndrome or Turner syndrome.
  • Ulcerative colitis and microscopic colitis, two kinds of inflammatory bowel disease.
  • Epilepsy.

What Are Some Symptoms?

As is often the case with autoimmune inflammatory disorders, there can be periods of varying severity of symptoms and the manifestations of the disease can vary widely from one individual to the next. For instance, some may lose weight while others might be overweight.

Patients with celiac disease typically suffer from certain gastrointestinal symptoms but there is also a range of other symptoms not directly related to the digestion. In fact, even the reproductive and nervous systems may be affected. One particular form of the disease, known as dermatitis herpetiformis, presents with an itchy rash appearing on both sides of the body and often in areas such as the elbows, knees, neck and upper back. This afflicts one in every five individuals with celiac disease. Possible symptoms include:

  • Indigestion.
  • Acid reflux.
  • Recurrent bouts of diarrhea or constipation.
  • Vomiting
  • Abdominal bloating or gas.
  • Bone pain or joint pain.
  • Mouth ulcers.
  • Swollen ankles or swollen hands.
  • Migraine headaches.
  • Severe fatigue.
  • Itchy skin rash known as dermatitis herpetiformis.
  • Damaged enamel of the teeth.
  • Abnormal sensations such as numbness or tingling in the extremities.

As compared to adults, the disease manifests differently in children. Signs of celiac disease in infants and young children include:

  • Irritability.
  • Vomiting.
  • Distended belly.
  • Chronic diarrhea.
  • Loss of appetite.
  • Poor growth or short stature.
  • Delayed onset of puberty.

What Are The Different Types of Celiac Disease?

CELIAC DISEASEThere are a number of different manifestations of Celiac disease, including:

  • Classical form: The patient exhibits the typical symptoms of celiac disease including abdominal bloating and diarrhea.
  • Atypical form: There may be little or no gastrointestinal disturbance. Instead, this form is more likely to present atypical symptoms such as osteoporosis, dermatitis herpetiformis, infertility, and anemia.
  • Silent form: Patients are usually asymptomatic, although blood tests and biopsies do indicate positive findings for celiac disease.
  • Latent form: This can have two main variants. The first includes patients diagnosed with celiac disease who have responded well to treatment and now show normal biopsy results although the blood may contain certain antibodies associated with the disease. The other category includes those who are currently asymptomatic but who are likely to eventually develop the disease.
  • Refractory Celiac Disease: This type is so named because it is resistant to normal modes of treatment. Symptoms tend to be more severe than in the other types. Only about 1-2% of those suffering from celiac disease are expected to develop this type. It is generally found to affect individuals over the age of 50. It is extremely rare in children.

Are There Likely To Be Any Complications?

When it remains untreated, celiac disease can lead to a number of other serious health problems such as diabetes and even cancer in some rare cases. Potential complications are listed below:  

  • Reduced ability of the small intestine to absorb vital nutrients can lead to anemia, folate deficiency and other nutritional deficiencies. In children, this can be responsible for reduced growth.
  • Lactose intolerance.
  • Bone disorders such as osteoporosis can result from the reduced absorption of calcium and vitamin D. This can also cause a bone disorder known as rickets.
  • Loss of fertility.
  • Pregnancy complications.
  • Seizures.
  • Increased risk of developing certain kinds of cancers of the gastrointestinal tract.

What Tests Are Needed To Diagnose It?

The following tests are helpful in making a diagnosis of celiac disease:

  • Physical examination and medical history.
  • Blood tests to check for the presence of certain antibodies such as tTG that indicate celiac disease. Testing the blood also helps detect certain nutritional deficiencies.
  • Stool samples are tested for the presence of fat.
  • Biopsy of a sample of tissue taken from the small intestine.

In order to ensure accurate results, the patient must make sure not to initiate a gluten-free diet before the blood test and intestinal biopsy have been completed.

Low FODMAP for Celiac Disease

The FODMAP diet is a diet that is prescribed to those who have chronic gastrointestinal symptoms such as gas, bloating, cramps, diarrhea or constipation. FODMAP diet consists of small carbohydrates in certain forms. If broken down the FODMAP consists of the following –

  • Fermentable – These can be broken down in the large intestine by bacteria.
  • Oligosaccharides – These are individual sugars that are joined in a chain. ‘Oilgo’ meaning ‘few’ and ‘saccharide’ meaning ‘sugar’.
  • Disaccharides – Double sugar molecules. ‘Di’ meaning two.
  • Monosaccharides – ‘mono’ meaning single. These are single sugar molecules.
  • And Polyols – These are sugar alcohols.

If these saccharides and sugar alcohols are not digested properly in the large intestine they tend to absorb water into the intestine and release carbon dioxide, hydrogen and or methane gas making the intestines stretch and expand.A low FODMAP diet, helps in relieving symptoms of digestive issues, but can also be used as a treatment for other medical conditions such as –

  • Irritable bowel syndrome (IBS)
  • Other forms of functional gastrointestinal disorders (FFID)
  • Small intestinal bacterial growth (SIBG)
  • Certain autoimmune conditions such as rheumatoid arthritis, eczema or multiple sclerosis.
  • Health issues that may have been triggered to certain foods.
  • Inflammatory bowel disease (IBD)

Celiac disease tends to occur in those who cannot tolerate gluten that is found in wheat, barley, and rye. It is important to know that gluten is not a FODMAP, but certain FODMAP foods do contain gluten such as fructose. Studies indicate that those who have gastrointestinal symptoms while on gluten-free diet could benefit from adopting a low-FODMAP diet to ease their symptoms.

Treatment and Prevention

Treatment – there is no known way to treat the celiac disease as it is an autoimmune disease.

  • Make sure that you stay away from gluten for the rest of your life.
  • Get a team of skilled physicians’ and dentitions to help you manage your disease.
  • Have proper and thorough knowledge of celiac disease and a gluten-free diet.

Prevention – there is no sure shot prevention methods for celiac disease. But there are methods to reduce the symptoms.

  • Eating gluten-free foods.
  • Avoiding grain and grain by-products.
  • Diagnosing the disease as early as possible.
  • Go for products that are an alternative to gluten like – corn, rice, millets, quinoa, soy etc.

Facts

  • Nearly 3 million Americans suffer from celiac disease.
  • Those who have been diagnosed with celiac disease cannot tolerate gluten.
  • A person with celiac disease has to wait 6-11 years to be diagnosed with this disease as symptoms are not very evident.

Facts

  • There are more than 300 symptoms of celiac disease. Some people do not have any symptoms.
  • It is an autoimmune disease. Therefore, you cannot “grow out” of it.

Facts

  • More children have celiac disease than Crohn’s, ulcerative colitis and fibrosis combined.

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Dos and Don'ts

Dos
  • Get to know gluten. Make sure to be aware of what form of gluten you can or cannot tolerate.
  • Check the ingredients whenever buying food,
  • Pay attention to serving size of the gluten product being consumed. If you can tolerate only a certain amount of gluten, make sure to consume only that much and not more.
Don'ts
  • Go to a restaurant unprepared.
  • Consume wheat or wheat products.
  • Consume any dairy products that may contain gluten.

 

 

 

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Endomysial Antibodies (EMA) Test EMA test is an investigative blood examination to locate the presence of certain antibodies, called Endomysial antibodies or…
Hysteroscopy_procedure
Hysteroscopy Hysteroscopy is a minimally invasive tool to help specialists view the uterus to diagnose and even treat several…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
carrageenan seaweed
Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
Pumpkin Seeds: Why pumpkins are more than just for pies! Pumpkins have been long associated with Halloween carvings and delicious pies. But did you know that pumpkin seeds…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
hepatitis B envelope antigen
Hepatitis B Envelope Antigen (HBeAg) The HBeAg or hepatitis B envelope antigen test is a screening test used to diagnose the onset of…
dhea adrenal
Androstenedione Test Androstenedione is produced by the adrenal gland, the test of the levels of Androstenedione helps in the evaluation…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Tattoo Aftercare: The best practices to follow once you get inked Planning getting permanently inked? Make sure you follow these critical tattoo aftercare techniques to avoid infectious agents attacking…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
Beware of these common foods that cause high bodily inflammation! Maybe its the long list of inflammatory foods in your diet that is making you frequently sick. Find…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The complete “what to eat” guide for gluten intolerance Does eating breads and pastas often makes you nauseous? Gluten intolerance is a common reason why you might…
Hibiscus: Nourish your beauty and health with these vibrant blooms Hibiscus is a trumpet shaped flower found abundantly in tropical countries. It has been historically used for its…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
bradycardia fainting
What does hypoglycemia look like when you don’t have diabetes? Hypoglycemia is not just a disease that co-occurs with diabetes. Non-diabetics could also become hypoglycemic. Hypoglycemia can be…
Internal bleeding brain
Beware: Ignoring these tell-tale signs of stroke could cost a life The signs and symptoms of a stroke differ depending on which part of the brain has been affected.…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
EEG
Electroencephalogram – EEG EEG or electroencephalogram is a diagnostic tool used to access the functioning of neurons and brain activity to…
Tachycardia heart
Cardiac Profile Cardiac profile is panel of blood tests performed to check cholesterol level and other heart disease markers to…