The Basics Of Celiac Disease
The Basics Of Celiac Disease
Celiac disease, an autoimmune disorder of the small intestine caused by consuming gluten, is receiving more attention every day. But what exactly is Celiac disease? As the symptoms, diagnosis, treatment and prevalence are investigated, it becomes apparent that there are many more questions concerning Celiac disease than answers.
What is Celiac disease?
Celiac disease is an autoimmune disorder of the small intestine, triggered by extreme sensitivity to gliadin, a protein found in the gluten of wheat and similar grains. When the affected person ingests gluten, it enters the small intestine during the digestive process. Once there, it breaks down. When the tissue of the small intestine comes into contact with the gliadin, it triggers an immune system response. The immune system starts attacking the tissues of the small intestine, causing chronic inflammation to the villi that line this part of the gastrointestinal tract. The villi is what breaks down food and absorbs nutrients. The chronic inflammation causes permanent damage to the villi, leading to villous atrophy. This atrophy makes the small intestine less able to absorb nutrients. In time, the entire small intestine can be affected.
What are the symptoms of Celiac disease?
Symptoms for Celiac disease vary widely. The "classic" symptoms of this disease are diarrhea and weight loss, especially in toddlers and small infants. However, there are over 300 recognized symptoms for this condition, none of which is universal. Some of the most common symptoms of this disease include bloating, gas, itchy skin rash, delayed growth in small children, headaches, diarrhea, poor weight gain, skin tingling or numbness, depression, mouth sores, constipation, thin bones, irritability, fatigue, joint pain, infertility, and discolored teeth.
How is Celiac diagnosed?
Diagnosing Celiac disease is difficult because many of its symptoms are similar to the symptoms of other conditions. Celiac disease can have many of the same symptoms as Crohn's disease, irritable bowel syndrome, lactose intolerance, and even depression. If a doctor suspects a patient has Celiac disease, the first test recommended is a blood test which measures the level of certain antibodies. When someone has this condition, it causes the levels of these antibodies to climb. A simple blood test can detect these elevated levels. If the test comes back positive, the next step is doing an endoscopy and a biopsy. During an endoscopy, the doctor will observe the small intestine for tell-tale signs of the disease such as scalloping of the small bowel folds, a cracked-mud appearance to the surface, and the prominence of certain blood vessels. While there, the doctor will take a series of samples from various sections of the small intestine. These samples will give a definitive diagnosis of the condition. The samples are put under a microscope to see how the tissue looks. Distinct changes in the tissue can show the disease's progression.
What is the treatment for Celiac disease?
There is only one treatment for Celiac disease: a life-long gluten free diet.
After going on such a diet, the immune system stops attacking the small intestine. In time, the tissues of the small intestine start to heal and antibody levels will start to go down. Eating any amount of gluten in the future will trigger the disease to start up again. In a few cases, even changing the diet is not enough to reverse the disease's symptoms. In those cases, doctors may prescribe immunosuppressants or steroids to control the inflammation in the small intestine.
How prevalent is Celiac disease?
Estimates of who has this medical condition varies widely based on geography. UK estimates that one in 100 of its citizens have this condition. US estimates vary from one in 105 to one in 1750, depending on the reporting agency. People of Western Caucasian or Indian ancestry tend to have a much higher chance of developing this disease than people of African, Japanese, or Chinese ancestry. Women are slightly more at risk for developing it than men. First degree relatives (siblings, parents, or children) of someone with Celiac disease have a 4 to 5 percent chance of developing it, as well. Some people with certain genetic conditions or medical conditions also have a higher chance of developing Celiac disease. Those with Down's syndrome, Turner's syndrome, autoimmune thyroid disease, and type 1 diabetes are especially at risk.
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