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, also spelled celiac disease, is an autoimmune disorder affecting primarily the small intestine that occurs in people who are genetically predisposed. Classic symptoms include gastrointestinal problems such as chronic diarrhoea, abdominal distention, malabsorption, loss of appetite, and among children failure to grow normally. This often begins between six months and two years of age. Non-classic symptoms are the most common, especially in people older than two years. There may be mild or absent gastrointestinal symptoms, a wide number of symptoms involving any part of the body, or no obvious symptoms. Coeliac disease was first described in childhood; however, it may develop at any age. It is associated with other autoimmune diseases, such as diabetes mellitus type 1 and thyroiditis, among others.

Coeliac disease is caused by a reaction to gluten, which are various proteins found in wheat and in other grains such as barley, and rye. Moderate quantities of oats, free of contamination with other gluten-containing grains, are usually tolerated but problems may depend on the type consumed. Upon exposure to gluten, an abnormal immune response may lead to the production of several different autoantibodies that can affect a number of different organs. In the small-bowel this causes an inflammatory reaction and may produce shortening of the villi lining the small intestine (villous atrophy). This affects the absorption of nutrients, frequently leading to anaemia.

Diagnosis is typically made by a combination of blood antibody tests and intestinal biopsies, helped by specific genetic testing. Making the diagnosis is not always straightforward. Frequently, the autoantibodies in the blood are negative and many people have only minor intestinal changes with normal villi. People may have severe symptoms and be investigated for years before a diagnosis is achieved. Increasingly, the diagnosis is being made in people without symptoms as a result of increased screening. While the disease is caused by a permanent intolerance to wheat proteins, it is usually classified as different from the other forms of wheat allergy.

The only known effective treatment is a strict lifelong gluten-free diet, which leads to recovery of the intestinal mucosa, improves symptoms, and reduced risk of developing complications in most people. If untreated it may result in cancers such as intestinal lymphoma and a slight increased risk of early death. Rates vary between different regions of the world, from as few as 1 in 300 to as many as 1 in 40, with an average of between 1 in 100 and 1 in 170 people. In developed countries, it is estimated that five out of six cases (83%) remain undiagnosed, usually because of non-classic, minimal, or absent complaints. Coeliac disease is slightly more common in women than in men. The term "coeliac" is 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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