Celiac Disease

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Celiac Disease
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Celiac Disease

• Celiac disease (CD) is a common disorder that is
  known to affect about 1 of the population. It is
  a condition in which the absorptive surface of
  the small intestine is damaged by a substance
  called gluten. Gluten is a cluster of proteins
  present in wheat, rye and barley and their cross
  bred grains.The damage to the intestine can
  lead to a number of symptoms and result in an
  inability of the body to absorb nutrients such as
  protein, fat, carbohydrates, vitamins and
  minerals, which are necessary for good health.

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Diagnosis of Celiac disease

• ScreeningIn the past, physicians had to rely
  on clinical symptoms and signs alone to suspect
  the diagnosis of Celiac disease and select
  patients who would require further investigations
  for confirmation.Now, highly effective blood
  tests are available to screen for Celiac disease.
  The IgA-tissue transglutaminase (TTG) antibody is
  the currently recommended test for screening. The
  patients must be on a regular (gluten-containing)
  diet at the time of testing to make the results
  valid.

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Diagnosis of Celiac disease
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• BiopsyThe definitive diagnosis of Celiac
  disease is made by a small intestinal biopsy. The
  biopsy is performed via endoscopy by
  gastroenterologists.Again, it is important that
  gluten not be removed from the diet before the
  biopsy is completed as it may impair the
  confirmation of the diagnosis.

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Symptoms of Celiac disease

• Patients with Celiac disease can present with
  numerous symptoms. The classical (typical)
  symptoms include chronic diarrhea, abdominal
  pain, malabsorption and weight loss.However,
  many patients now present with non-classical
  (atypical) symptoms includes anemia,
  osteoporosis, extreme fatigue, oral ulcers, liver
  enzyme abnormalities, constipation, infertility,
  dental enamel defects, neurological problems,
  etc. Children can present with short stature,
  irritability, vomiting, etc.Celiac disease
  happens commonly in patients with other
  autoimmune disorders such as thyroid disease and
  type-I diabetes. It can also run in families,
  both in first and second degree relatives.
  Therefore, screening of these high risk
  individuals should be considered.

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Symptoms of Celiac disease
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• Since many patients with celiac disease do not
  present with classical symptoms, delays in
  diagnosis can occur.Dermatitis herpetiformis is
  celiac disease of the skin. The patients
  present with severely itchy blistering rash. The
  diagnosis can be confirmed with a skin biopsy.
  Treatment consists of strict gluten-free diet
  and, in some cases, medications.

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Treatment of Celiac disease

• At present, there is no permanent cure for
  Celiac disease but it can be effectively treated
  with a gluten-free diet. The adherence to the
  gluten-free diet must be strict and
  lifelong.Gluten-free diet can be challenging
  and complicated and a consultation with a
  registered dietitian with expertise in
  gluten-free diet is essential.Individuals with
  celiac disease need to vigilant about hidden
  sources of gluten and cross contamination in food
  products. Careful label reading each time when
  buying products is important.Since celiac
  disease is a chronic disorder, regular long-term
  follow-up with the physician and dietitian is
  recommended.

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