Celiac

Overview
Celiac disease is an autoimmune disorder. It may affect every organ in the body. In most cases celiac disease damages or destroys the villi, which are the very component of the small intestine that enable us to absorb the nutrients we need to survive. The damage will extend to other parts of the body as it progresses. Transglutaminanse may be found in the brain, skin and gut. Gluten is the trigger for the destruction of the villi in the intestines.

Gluten is a protein found in wheat, rye, barley, spelt and oats. The immune system treats gluten as a foreign body and inflames that villi of the small intestines in order to protect the body from the invader. The villi, which enable the body to digest and absorb foods and nutrients become inflamed and eventually flatten out. This leads to a lack of absorption of vital nutrients.

Celiac disease affects 1 in 120 people. It is often misdiagnosed and affects men, women and children.

Symptoms

Because celiac disease symptoms may develop after consuming gluten, they are often misinterpreted as signs of more common digestive disorders, such as irritable bowel syndrome, Crohn’s Disease or Ulcerative Colitis. But celiac sprue disease is an autoimmune disease, and often the most insidious and serious celiac disease symptoms are not as tangible and immediate as more common gastrointestinal symptoms. Celiac disease may manifest itself differently in different people, so it is challenging to isolate a checklist of celiac symptoms and expect patients to identify their own celiac disease symptoms.

  • Anemia
  • Arthritis
  • Bone loss
  • Borborygmi (stomach rumbling)
  • Depression and irritability
  • Fatigue
  • Infertility
  • Joint pain
  • Nausea
  • Seizures
  • Numbness in the patient’s hands and feet
  • Dermatitis Herpetiformis
  • Abdominal pain
  • Bloating
  • Constipation
  • Diarrhea
  • Weight loss
  • Vomiting
  • Delayed growth, stunted growth or Failure to Thrive
  • Sjogren’s Disease
  • Juvenile Idiopathic Arthritis
  • Turner Syndrome
  • Peripheral Neuropathy
  • Type 1 Diabetes
  • Autism
  • Bone pain
  • Mouth sores or mouth ulcers
  • Stomach pain
  • Gas
  • Foul smelling or bloody stools
  • Hypoglycemia
  • Hair loss (Alopecia)
  • Lactose intolerance
  • Teeth and gum problems
  • Vitamin and Mineral deficiencies
  • Osteoporosis and Osteopenia
  • Steatorrhea (high fat or lipids within the stool or feces); often causes floating stools

Testing

    Blood Test
  • IgA Endomysial antibodies (EMA) – a highly specific marker for celiac
  • IgA Tissue Transglutaminase antibodies (tTG) – a very specific and fairly sensitive marker for celiac
  • IgG Tissue Transglutaminase – valuable in diagnosing celiac in people with selective IgA deficiency

If the test comes back positive an upper endoscopy is done to test a piece of your small intestine. A biopsy is then done after several months of being diagnosed with the disease to see how you are responding to treatment. Additionally a genetic test (to look for the HLA-DQ8 or HLA-DQ2 genes) can be done to see if you are considered at risk for the disease. Usually these tests are combined to pinpoint celiac disease as the culprit and not another similarly manifesting condition such as Crohn’s disease or Ulcerative Colitis.

Some believe that the biopsy of the small intestine is the “Gold Standard” test for Celiac. Others believe that the blood tests are enough. Someone with adrenal insufficiency may not want to go through the stress of having a biopsy.

Patients who have government funded health care use government funded hospital or in government funded living facilities may need to have a confirmation of Celiac disease by biopsy in order to continue receiving government funded care.

Negative test results do not mean that you do not have Celiac. Test should be repeated in 6 months to a year if you have symptoms or a family member with Celiac.

Testing is necessary. It is necessary to have gluten in your diet to test. Eating gluten free comes with many nutritional challenges. Unlike wheat breads, Gluten-free breads are not fortified with vitamins and minerals.

Treatment

Treatment for Celiac is a completely gluten-free diet. This would also include checking all medications, supplements, bathing products, hair products, lotions and makeup.

Anything that contains wheat, rye, barley, spelt and in some cases oats could not be used.

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