Lecture Notes: Coeliac Disease

Overview

• Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder.
• Primarily affects the small intestine.
• Characterized by intolerance to gluten (found in wheat, rye, barley, etc.).
• Symptoms include gastrointestinal issues, malabsorption, and failure to thrive in children.

Other Names

• Coeliac sprue
• Nontropical sprue
• Endemic sprue
• Gluten enteropathy

Symptoms and Complications

• Symptoms:
  • Gastrointestinal: diarrhea, abdominal distention, constipation.
  • Non-specific: dermatitis herpetiformis, weight loss.
• Complications:
  • Anemia, osteoporosis, infertility.
  • Increased risk of cancers and neurological problems.

Onset and Duration

• Can occur at any age.
• Lifelong condition.

Causes and Risk Factors

• Caused by an immune reaction to gluten.
• Risk Factors:
  • Genetic predisposition.
  • Associated with other autoimmune diseases, type 1 diabetes, thyroid diseases, Down and Turner syndromes.

Diagnosis

• Methods include family history, blood antibody tests, biopsies, and genetic testing.
• Challenging as symptoms can be mild or absent.

Treatment

• A strict gluten-free diet is the primary treatment.
• Leads to recovery of the intestinal lining and reduces complication risks.

Prevalence

• Affects about 1 in 135 people globally.
• Underdiagnosed, particularly due to mild symptoms.
• More common in women.

Historical Context

• First described in 19th century, based on ancient medical texts.
• Modern understanding and diagnosis have evolved significantly.

Dietary Considerations

• Gluten-free diet essential.
• Oats can be consumed in moderate amounts if uncontaminated.
• Safe foods: corn, millet, sorghum, rice, and non-cereals like quinoa and buckwheat.

Additional Considerations

• Regular health monitoring and diet management are crucial.
• Awareness campaigns, such as Coeliac Awareness Month, help increase understanding.

Research and Future Directions

• Studies on new treatments and early detection methods are ongoing.
• Genetic and environmental factors continue to be investigated.