Celiac Disease

Image Caption : This image shows the damage that eating the protein gluten can cause in the small intestine of a person with celiac disease. Experts believe that nearly 1 in 100 people may have this autoimmune ailment which is triggered by exposure to the protein gluten in wheat and similar proteins in rye and barley. This man's small intestine enlarged in the background image is lined with finger-like healthy villi (inset) which absorb nutrients from food. But when those with celiac disease eat gluten it is seen as a foreign invader. The resulting autoimmune response damages villi cells (right inset). The villi are worn away and cannot absorb nutrients properly resulting in malnutrition and many other serious effects. Photo credit: wheat image comes from the National Cancer Institute.

Celiac Disease

Also called: Celiac sprue, Gluten-sensitive enteropathy, Nontropical sprue

Celiac disease is an immune disease in which people can't eat gluten because it will damage their small intestine. If you have celiac disease and eat foods with gluten, your immune system responds by damaging the small intestine. Gluten is a protein found in wheat, rye, and barley. It is found mainly in foods but may also be in other products like medicines, vitamins and supplements, lip balm, and even the glue on stamps and envelopes.

Celiac disease affects each person differently. Symptoms may occur in the digestive system, or in other parts of the body. One person might have diarrhea and abdominal pain, while another person may be irritable or depressed. Irritability is one of the most common symptoms in children. Some people have no symptoms.

Celiac disease is genetic. Blood tests can help your doctor diagnose the disease. Your doctor may also need to examine a small piece of tissue from your small intestine. Treatment is a diet free of gluten.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Coeliac disease (/ˈsli.æk/; celiac disease in the United States and often celiac sprue) is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy onward. Symptoms include pain and discomfort in the digestive tract, chronic constipation and diarrhoea, failure to thrive (in children), anaemia and fatigue, but these may be absent, and symptoms in other organ systems have been described. Vitamin deficiencies are often noted in people with coeliac disease owing to the reduced ability of the small intestine to properly absorb nutrients from food.

Coeliac disease is caused by a reaction to gliadin, a prolamin (gluten protein) found in wheat, and similar proteins found in the crops of the tribe Triticeae (which includes other common grains such as barley and rye). Upon exposure to gliadin, and specifically to three peptides found in prolamins, the enzyme tissue transglutaminase modifies the protein, and the immune system cross-reacts with the small-bowel tissue, causing an inflammatory reaction. That leads to a truncating of the villi lining the small intestine (called villous atrophy). This interferes with the absorption of nutrients because the intestinal villi are responsible for absorption. The only known effective treatment is a lifelong gluten-free diet. While the disease is caused by a reaction to wheat proteins, it is usually classified as different from the other forms of wheat allergy.

Increasingly, diagnoses are being made in persons without symptoms as a result of increased screening. Globally coeliac disease affects between 1 in 100 and 1 in 170 people; rates do, however, vary between different regions of the world from as few as one in 300 to as many as one in 40.

This condition has several other names, including c(o)eliac sprue, nontropical sprue, endemic sprue, and gluten enteropathy. The term "coeliac" is derived from the Greek κοιλιακός (koiliakós, "abdominal") and was introduced in the 19th century in a translation of what is generally regarded as an ancient Greek description of the disease by Aretaeus of Cappadocia.

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