Celiac disease Definition:
Celiac disease is an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats.Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.
The exact cause of celiac disease is unknown. The intestines contain projections (called villi) that absorb nutrients. In undiagnosed or untreated celiac disease, these villi become flattened, and the ability to absorb nutrients properly is altered.
The disease can develop at any point in life, from infancy to late adulthood.
Those with a family member with celiac disease are at greater risk for developing the disease. The disorder is most common in Caucasians and those of European ancestry. Women are affected more commonly than men.
There are numerous diseases and conditions associated with celiac disease, including:
- Anemia
- Autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus
- Certain types of intestinal cancer
- Dermatitis herpetiformis
- Down syndrome
- Lactose intolerance
- Miscarriage or unexplained infertility
- Neurological conditions
- Osteoporosis or osteopenia
- Thyroid disease
- Type 1 diabetes
Symptoms
The symptoms of celiac disease can vary significantly from person to person. This is part of the reason the diagnosis is frequently delayed. For example, one person may have constipation, a second may have diarrhea, and a third may have no irregularity in stools.
A partial listing of gastrointestinal symptoms:
- Abdominal pain
- Abdominal distention, bloating, gas, indigestion
- Constipation
- Decreased appetite (may also be increased or unchanged)
- Diarrhea, chronic or occasional
- Lactose intolerance (common upon diagnosis, usually goes away following treatment)
- Nausea and vomiting
- Stools that float, are foul smelling, bloody, or “fatty”
- Unexplained weight loss (although people can be overweight or of normal weight upon diagnosis)
A partial listing of non-intestinal symptoms:
- Anemia (low blood count)
- Bone and joint pain
- Bone disease (osteoporosis, kyphoscoliosis, fracture)
- Breathlessness (due to anemia)
- Bruising easily
- Dental enamel defects and discoloration
- Depression
- Fatigue
- Growth delay in children
- Hair loss
- Hypoglycemia (low blood sugar)
- Irritability and behavioral changes
- Malnutrition
- Mouth ulcers
- Muscle cramps
- Nosebleed
- Seizures
- Short stature, unexplained
- Skin disorders (dermatitis herpetiformis)
- Swelling, general or abdominal
- Vitamin or mineral deficiency, single or multiple nutrient (for example, iron, folate, vitamin K)
The Treatment:
You must follow a life-long gluten-free diet. This allows the intestinal villi to heal. Foods, beverages, and medications that contain wheat, barley, rye, and possibly oats should be eliminated completely. You must read food and medication labels carefully to look for hidden sources of these grains and their derivatives. Since wheat and barley grains are found abundantly in the American diet, keeping to this diet is challenging. With education and planning, you will achieve the goal of healing.
You should NOT begin the gluten-free diet before a diagnosis is made. Doing so will alter future testing for the disease.
Vitamin and mineral supplements may be prescribed to correct nutritional deficiencies. Occasionally, corticosteroids (such as prednisone) may also be prescribed for short-term use or if you have refractory sprue. Following a well-balanced, gluten-free diet is generally the only treatment required for staying well.
Upon diagnosis, seek consultation from a registered dietitian with a specialty in celiac disease and the gluten-free diet. A support group may also help you cope with the disease and diet.
Other topical about malabsorption related:
 Malabsorption overview: Malabsorption is the inability to absorb nutrients through the gut lining into the bloodstream. Malabsorption is the failure of the GI tract to absorb one or more substances from the diet.
Lactose intolerance is a common disorder caused by a lack of a specific enzyme necessary to break down a sugar in milk, resulting in diarrhea, cramps, and gas.
Whipple's disease is a relatively rare disorder, mostly affecting middle-aged men. Symptoms include severe malabsorption, nutritional deficiencies, chronic low-grade fever, diarrhea, and joint pain. Tropical sprue is uncommon in the U.S. Symptoms include anemia and other nutritional deficiencies, weight loss, and diarrhea. A sore tongue and passage of fatty stools are common. |
