Notes on Celiac Disease

Introduction

• Celiac Disease: An autoimmune disease triggered by gluten intake, affecting the small intestine.
• Genetic predisposition: Celiac disease is hereditary; first-degree relatives have a higher risk.
• Damage to Villi: Gluten causes immune responses damaging villi, affecting nutrient absorption.
• Alternative Names: Known as sprue, non-tropical sprue, and gluten-sensitive enteropathy.
• Diagnosis Markers: Specific blood markers confirm diagnosis.
• Non-Celiac Gluten Sensitivity (NCGS): Causes symptoms without intestinal damage. Diagnosis through symptom improvement on a gluten-free diet.

Symptoms

In Adults

• Abdominal issues: Pain, gas, bloating, constipation, diarrhea.
• Other symptoms: Anemia, bone or joint pain, heartburn, headaches, fatigue, dermatitis herpetiformis (itchy skin), mouth ulcers, nerve issues, weight loss.
• Potential decrease in bone density and spleen function.

In Children

• Bowel issues: Bloating, constipation, diarrhea, pale stools, vomiting, weight loss.
• Other concerns: Anemia, dental enamel damage, delayed puberty, growth issues.
• Neurological problems: Learning disabilities, ADHD.
• Not all patients show symptoms, complicating diagnosis.

Diagnosis

• Examination and History: Physical exams and medical history discussion.
• Blood Tests: Measure antibodies to gluten; genetic testing may be needed.
• Iron Level Tests: Check for anemia due to low iron from celiac disease.
• Biopsy: Endoscopic procedure to check intestinal villi damage. Requires sedation.

Management and Treatment

• Dietary Changes: Strict gluten-free diet required; consult a dietitian.
  • Avoid wheat, rye, barley, and processed foods containing gluten.
  • Be cautious of hidden gluten in foods like ice cream, salad dressings.
  • Use gluten-free alternatives: potato, rice, corn, soybean-based products.
  • Fresh, unprocessed foods like fruits, vegetables, meat, fish are safe.
• Healing Timeline: Intestinal healing can take months (children) to years (adults).
• Follow-up: Regular medical check-ups (3 months, 6 months, then yearly).
• Awareness of Cross-Contamination: Avoid accidental gluten exposure from gluten-free foods contacting gluten.

Conclusion

• Maintaining a gluten-free diet is crucial for managing celiac disease and preventing symptoms. Regular monitoring and dietary adjustments are essential to avoid complications.