Digestive System Disorders: Celiac Disease

Digestive System Disorders: Celiac Disease

Perhaps you may have seen several food products in the store that state "gluten free" on the labels. Or you may also have heard of the term gluten free diet and might wonder what it is. Gluten is a protein substance that is often found in wheat, rye, and barley as well as other products. In people with celiac disease, this protein is the cause of many undesirable symptoms that are painful. In the lining of the small intestine, finger like protrusions, called villi, normally allow nutrients from food to be absorbed into the bloodstream. In celiac disease, these villi become damaged or destroyed upon the ingestion of gluten. Regardless of the quantity of food eaten, a person can become malnourished without healthy villi. Since the immune system is responsible for damaging the small intestine in the condition, Celiac Disease is considered an auto immune disorder as well as a malabsorbtion disorder due to the nutrients not being absorbed. It is a genetic condition which can be triggered by surgery, pregnancy, severe emotional stress or viral infection. Celiac disease is also known as gluten-sensitive enteropathy, celiac sprue or nontropical sprue.

Symptoms of celiac disease are varied and affects people in different ways and therefore might be very difficult to diagnose. It can mimic such diseases as Crohn's Disease, irritable bowel syndrome, parasite infections, anemia, gastric ulcers, skin disorders or even a nervous condition. Some people with Celiac may have no gastrointestinal symptoms at all, some develop symptoms as children, while others develop it as adults. It is also noted that the symptoms can occur in the digestive system while other symptoms occur elsewhere in the body. Among the wide variety of symptoms of celiac include the following:

- chronic diarrhea
- recurring abdominal bloating and pain
- pale, foul-smelling, or fatty stool
- gas
- fatigue
- weight loss / weight gain
- unexplained anemia
- osteoporosis, osteopenia
- bone or joint pain
- infertility, recurrent miscarriage
- missed menstrual periods (often because of excessive weight loss)
- seizures
- tingling numbness in the legs (from nerve damage)
- muscle cramps
- behavioral changes
- pale sores inside the mouth, called aphthous ulcers
- tooth discoloration or loss of enamel
- itchy skin rash called dermatitis herpetiformis
- failure to thrive in infants
- delayed growth

Before the diagnostic tests for celiac disease, it is advisable that the patient should continue to eat a regular diet that includes foods with gluten, such as breads and pastas for an accurate diagnosis. Several tests for celiac disease would include a blood tests that measures anti-tissue transglutaminase (tTGA), IgA anti-endomysium antibodies (AEA), Immunoglobulin A (IgA) and possible a Complete Blood Count (CBC) (to look for anemia). If celiac disease is suspected due to the symptoms and the blood tests, more tests would be done for conformation. These tests can be done by examining the tissue (in particular, the villi), which is acquired through a biopsy of the small intestine. Other tests might include a CRP (C-Reactive protein) to evaluate inflammation, a CMP (complete metabolic panel) to determine electrolyte, protein, and calcium levels, and to verify the status of the kidney and liver, Vitamin D, E, and B12 levels to measure vitamin deficiencies, an evaluation of stool fat, to help evaluate malabsorption as well as an ESR (erythrocyte sedimentation rate) to evaluate inflammation.

Treatment begins immediately once the diagnosis has been made. Unlike many conditions, celiac disease does not require any special medications, frequent visits to the doctor or surgery. The only treatment that is known is the "gluten free" diet; meaning the elimination of foods that contain the protein gluten. This elimination is lifelong commitment and can be difficult at first, but the results of good health are very rewarding. Some of the foods that contain gluten include those that contain wheat or wheat flour. However, there are several more foods that need to be avoided as well due to the fact that they still contain gluten. There are still many products available that are gluten free which the person can still enjoy.

Celiac Disease
Celiac Disease